CTICasesABPA with Alternating Lobar Collapse
Imaging findings
Serial chest radiographs in a patient with severe asthma show alternating lobar atelectasis (right upper lobe collapse, which resolves, followed by left lower lobe collapse). CT chest shows central bronchiectasis filled with high-attenuation mucus plugs.
Key takeaways
Allergic bronchopulmonary aspergillosis (ABPA) is characterized by mucoid impaction of the central airways. The thick, tenacious mucus plugs can cause complete bronchial obstruction, presenting with classically 'shifting' or alternating lobar collapse in asthmatic patients.
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