Demographics:
12 years old, Male
Indication:
Cough, fever
Findings
Chest radiograph
- Bilateral airspace opacities, most confluent in the left upper and right middle lobes
- Background diffuse interstitial coarsening
- Small right pleural effusion
CT
Chest
- Multifocal bronchiectasis with marked widespread bronchial wall thickening and areas of mucous plugging
- Bilateral clusters of dense tree-in-bud nodularity with areas of airspace consolidation and air bronchograms in the superior segment of the left lower lobe and apicoposterior segment of the left upper lobe
- Near complete right middle lobe collapse
- Trace, partially loculated right pleural fluid collection with associated smooth pleural thickening and enhancement
- Multiple enlarged mediastinal and bilateral hilar lymph nodes
Upper abdomen
- No acute findings
MSK
- No acute findings
Diagnosis
Allergic bronchopulmonary aspergillosis (ABPA)
Sample Report
Findings are concerning for multifocal pneumonia with underlying areas of bronchiectasis and mucous plugging concerning for chronic atypical infection or allergic bronchopulmonary aspergillosis (ABPA). Consider bronchoscopy for further evaluation.
Trace, partially loculated right pleural effusion.
Discussion