CTICasesAllergic Bronchopulmonary Aspergillosis with Bronchocentric Granulomatosis
Imaging findings
A woman with an allergic history had a series of chest radiographs showing waxing and waning consolidation, predominantly in the left upper lobe but patchy elsewhere, and a high-attenuation mucus plug within an area of consolidation. Sputum/culture confirmed Aspergillus, and given atypically prominent findings, biopsy was pursued and showed granulomatous inflammation in addition to the Aspergillus, consistent with bronchocentric granulomatosis, a granulomatous airway-centered inflammatory pattern that can occur as a variant/manifestation of allergic bronchopulmonary aspergillosis.
Key takeaways
High-attenuation mucus plugging within waxing-and-waning consolidation is a useful clue to allergic bronchopulmonary aspergillosis, and when granulomatous inflammation is found on pathology in addition to Aspergillus, the term bronchocentric granulomatosis is used; this is best understood not as a wholly separate disease but as a pattern of airway-centered granulomatous injury that can be seen with Aspergillus and other infections, historically over-separated as its own entity in the radiology literature.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- Disseminated CoccidioidomycosisInfection
- Post-Bronchoscopy Hemorrhage with Bronchial Obstruction and Lobar CollapseIatrogenic
- Aggressive Vertebral HemangiomaNeoplastic
- Persistent Sciatic Artery with Infected PseudoaneurysmVascular
- Polymicrobial Tracheostomy Stoma InfectionInfection
- Mediastinitis from Infected Breast Tissue ExpanderInfection
- Blunt Traumatic Aortic Injury with Multifocal Thoracic and Abdominal InvolvementTrauma
- Aortic Root Pseudoaneurysms from Staphylococcal EndocarditisVascular
See all cases from June 21, 2018 →
Related Inflammatory cases
- Localized (Unilobar) Allergic Bronchopulmonary Aspergillosis
- Acute Flare of Chronic Eosinophilic Pneumonia
- Peri-myocarditis Following PFO Closure Device Removal
- Fibrosing Mediastinitis with Right Pulmonary Artery and Vein Encasement
- Fibrosing Mediastinitis from Prior Histoplasmosis
- Pembrolizumab-Associated Sarcoid-like Reaction