Presentation
Cough dyspnea and chest pain.
Patient Data
Bilateral upper lobar, right middle lobar and to less extent left lower lobar bronchiectasis with endobronchial hyperdense mucoid impaction giving the finger in glove appearance most evident in the right middle lobe with subsequent middle lobe collapse. Scattered tree-in-bud densities denoting small airway involvement.
Case Discussion
The case demonstrates typical appearance of allergic bronchopulmonary aspergillosis in the form of bronchiectasis and endobronchial hyperdesne mucoid impaction in the dilated bronchi giving the finger in glove appearance. Subsequent right middle lobe collapse secondary to bronchial obstruction by mucoid impaction. Centrilobular nodules and tree in bud densities secondary to dilated obstructed bronchioles.
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