Date: 26 November 2013
Recurrent pulmonary shadows 1. 6 Jan 1988 – chest radiograph showing right hilar enlargement, consistent with ABPA.
Recurrent pulmonary shadows 1. 3 Feb 1989 – chest radiograph showing right upper-lobe consolidation and contraction consistent with obstruction of RUL bronchus, in ABPA.
Clearing of pulmonary shadows 3, pt BJ. 5 April 1989 – resolution of shadows seen in February, with a course of corticosteroids.
Recurrence of pulmonary shadows 4, pt BJ. 2 September 1989 – recurrence of pulmonary shadows with an exacerbation of ABPA.
Central bronchiectasis, pt BJ. CT scan of thorax October 1989 showing central bronchiectasis, characteristic of ABPA (and cystic fibrosis).
Copyright: n/a
Notes:
The patient was later treated with itraconazole and reported in Denning DW, Van Wye J, Lewiston NJ, Stevens DA. Adjunctive therapy of allergic bronchopulmonary aspergillosis with itraconazole. Chest 1991; 100: 813-819.
Images library
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4 Total obstruction of the sinuses due to inflamed mucosa. (Patient 04)
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1 Axial computed tomography (CT) scans of the frontal sinus.
A: due to the long lasting pressure of mucus, the bone of the anterior wall of frontal sinus is thinned out and elevated anteriorly, forming a bulge. B: same situation as depicted in fig A: the posterior bony wall of frontal sinus is thinned out and extremely elevated posteriorly towards the frontal lobe of the brain. As depicted on the scan, a thin bony layer covering the dura could be recognized intraoperatively -
2 Same patient as 1 and 3, frontal CT
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D. 6 months later, tenacious yellow secretions in L basal bronchial division
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C. After suction the material was seen to extend distally – obstructing the right basal stem bronchus
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B. After suction the material was seen to extend distally – obstructing the right basal stem bronchus