Original Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Radiol. Apr 28, 2012; 4(4): 141-150
Published online Apr 28, 2012. doi: 10.4329/wjr.v4.i4.141
Chest radiographic and computed tomographic manifestations in allergic bronchopulmonary aspergillosis
Ritesh Agarwal, Ajmal Khan, Mandeep Garg, Ashutosh N Aggarwal, Dheeraj Gupta
Ritesh Agarwal, Ajmal Khan, Mandeep Garg, Ashutosh N Aggarwal, Dheeraj Gupta, Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
Mandeep Garg, Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
Author contributions: Agarwal R conceived the article, performed the systematic review, drafted and revised the manuscript; Khan A, Garg M, Aggarwal AN and Gupta D drafted and revised the manuscript.
Correspondence to: Dr. Ritesh Agarwal, Associate Professor, Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012, India. riteshpgi@gmail.com
Telephone: +91-172-2748215  Fax: +91-172-2756825
Received: November 18, 2011
Revised: February 21, 2012
Accepted: February 28, 2012
Published online: April 28, 2012
Abstract

AIM: To investigate the chest radiographic and high resolution computed tomography (HRCT) chest manifestations in glucocorticoid-naïve allergic bronchopulmonary aspergillosis (ABPA) patients.

METHODS: This is a prospective observational study and includes 60 consecutive glucocorticoid-naïve patients with ABPA who underwent chest radiography and HRCT of the chest (1.25 mm every 10 mm) in the routine diagnostic workup for ABPA.

RESULTS: Chest radiographs were normal in 50% of cases. Of the remainder, most patients demonstrated permanent findings in the form of parallel line and ring shadows suggesting bronchiectasis. Consolidation was detected in 17 cases but in the majority, the corresponding HRCT chest scan showed mucus-filled bronchiectatic cavities. Chest HRCT was normal in 22 patients, while central bronchiectasis (CB) was demonstrated in the remaining 38 patients. Bronchiectasis extended to the periphery in 33%-43% depending on the criteria used for defining CB. The other findings observed on HRCT were mucoid impaction, centrilobular nodules and high-attenuation mucus in decreasing order of frequency.

CONCLUSION: Patients with ABPA can present with normal HRCT chest scans. Central bronchiectasis cannot be considered a characteristic feature of ABPA as peripheral bronchiectasis is commonly observed. Consolidation is an uncommon finding in ABPA.

Keywords: Allergic bronchopulmonary aspergillosis; Chest radiograph; High resolution computed tomography; Computed tomography; Aspergillus