CXR Finger in Glove Morphology in the Right Lower Lobe
60 year old male with history of asthma, allergic bronchopulmonary aspergillosis (ABPA)
CXR suggests hyperinflation, with tubular ectasia and soft tissue prominence of the bronchovascular bundle in the right lobe (magnified in lower image)
Ashley Davidoff TheCommonVein.net 221Lu 14644c
60 year old male with history of asthma, allergic bronchopulmonary aspergillosis (ABPA)
CT scan shows bibasilar bronchiectasis and soft tissue/fluid impaction of the bronchovascular bundles
Ashley Davidoff TheCommonVein.net 221Lu 14645
CT scan Upper Lobe Bronchiectasis and Impaction ABPA
60 year old male with history of asthma, allergic bronchopulmonary aspergillosis (ABPA)
CT scan with contrast shows bronchiectasis of bilateral upper lobe segmental airways impacted with soft tissue/fluid material confirmed on the soft tissue windows (lower panels) and consistent with ABPA
Ashley Davidoff TheCommonVein.net 221Lu 47110
CT scan Left Upper Lobe Finger in Glove ABPA
60 year old male with history of asthma, allergic bronchopulmonary aspergillosis (ABPA)
CT scan shows upper lobe bronchiectasis and soft tissue/fluid impaction in the left upper lobe reminiscent of the finger in glove appearance of ABPA
Ashley Davidoff TheCommonVein.net 221Lu 47112
CT scan Left Upper Lobe ABPA – Tree in Bud
60 year old male with history of asthma, allergic bronchopulmonary aspergillosis (ABPA)
CT scan shows left upper lobe bronchiectasis and soft tissue/fluid impaction in the anterior segmental and subsegmental airways associated with tree in bud appearance (yellow arrowhead) and centrilobular nodules (red arrowhead) reminiscent of associated small airway disease
Ashley Davidoff TheCommonVein.net 221Lu 47113
47114c01 bronchi lungs fx dilated enlarged impacted with sft tissue finger in glove dx allergic bronchopulmonary aspergillosis ABPA aspergillus dx infection inflammation CTscan Davidoff MD 221Lu 47114c01
CT scan through the chest shows medium sized bronchi, bronchioles and small airways impacted with fluid. This collage is presented to reveal tree in bud changes resulting from impaction in the smaller terminal bronchioles and respiratory units. The tree-in-bud pattern also results in small centrilobular nodules connected to multiple branching linear structures of similar caliber from a single stalk. Originally it was felt to result from endobronchial spread of Mycobacterium tuberculosis, but is is now recognized in diverse entities including peripheral airway diseases caused by infection (bacterial, fungal, viral, or parasitic), congenital disorders, idiopathic disorders (obliterative bronchiolitis, pan bronchiolitis), aspiration or inhalation of foreign substances, immunologic disorders, connective tissue disorders and peripheral pulmonary vascular diseases such as neoplastic pulmonary emboli.
In this case there are also dilated medium sized airways, impacted with soft tissue characteristic of the finger in glove sign and most likely due to allergic bronchopulmonary aspergillosis (ABPA)
Ashley Davidoff MD Ashley Davidoff MD TheCommonVein.net
221Lu 47113c01