Yoshida N, Suguro H, Kohara F, Akiyama Y, Katoh H, Hashimoto N, Majima T, Yamaguchi M, Horie T, Kawabata Y
First Department of Internal Medicine, Nihon University School of Medicine.
Nihon Kyobu Shikkan Gakkai Zasshi. 1992 Dec;30(12):2123-7.
A 53-year-old male was admitted to our hospital because of an abnormal shadow in the left upper lung. Bronchofiberscopy revealed edematous mucosa and pus at the orifice of the left upper lobe bronchus. Pathological examination revealed bronchial inflammatory change with infiltration of eosinophils and also the existence of aspergillus in the pus. Mild eosinophilia and elevation of serum IgE level were observed in the peripheral blood, and serum precipitin against Aspergillus fumigatus was positive. Bronchogram showed central bronchiectasis, and the diagnosis of allergic bronchopulmonary aspergillosis (ABPA) was made. In cases of ABPA, bronchial asthma is usually present prior to presentation, but this patient had no history of asthma even though airway hyperresponsiveness to methacholine was confirmed.
一名53岁男性因左上肺异常阴影入住我院。纤维支气管镜检查显示左上叶支气管开口处黏膜水肿并有脓液。病理检查显示支气管炎症改变，伴有嗜酸性粒细胞浸润，脓液中还存在曲霉菌。外周血中观察到轻度嗜酸性粒细胞增多和血清IgE水平升高，抗烟曲霉血清沉淀素阳性。支气管造影显示中央型支气管扩张，诊断为变应性支气管肺曲霉菌病（ABPA）。在ABPA病例中，支气管哮喘通常在发病前就已存在，但该患者即使证实对乙酰甲胆碱气道高反应性，也无哮喘病史。
