What are the two main underlying chronic lung pathologies that predispose to ABPA?
Asthma and cystic fibrosis.
Which laboratory tests are indicated if ABPA is clinically suspected?
1. Aspergillus serology; 2. Total serum IgE level; 3. Peripheral eosinophil count;
What are the classic radiographic features of ABPA?
1. Transient, bilateral alveolar or subsegmental infiltrates with upper lobe predominance; 2. Central ring shadows representing bronchiectasis and bronchial wall thickening; 3. Branching tubular opacities representing mucus plugging, so-called 'finger-in-glove'
There is nodular dense opacification in a finger-in-glove configuration overlying the right hilum and extending into the right upper lobe. This is likely to represent a combination of hilar lymphadenopathy and infective consolidation/bronchial plugging. In addition there is perihilar consolidation on the left.