20 Dec 2004 05:16
Chronic hypersensitivity pneumonitis caused
1: Intern Med. 2004 Oct;43(10):982-5.
Chronic hypersensitivity pneumonitis caused by Aspergillus
complicated with pulmonary aspergilloma.
Yoshimoto A, Ichikawa Y, Waseda Y, Yasui M, Fujimura M, Hebisawa
A, Nakao S.
Department of Haematology-Oncology and Respiratory Medicine,
Cellular Transplantation Biology, Kanazawa University Graduate
School of Medical Science, 13-1 Takara-machi, Kanazawa 920-8641.
A 57-year-old man consulted our hospital with a history of the
gradual onset of dyspnea and a productive cough. Chest computed
tomographic (CT) scans showed a nodular shadow in a cavity
lesion, and reticulonodular, cystic, and ground-grass opacities
in the bilateral lung fields with honeycombing. He was diagnosed
as having pulmonary aspergilloma and idiopathic pulmonary
fibrosis (IPF). As an outpatient, he suffered from dyspnea upon
physical exertion with exacerbation of the high-resolution CT (HRCT)
opacities. An inhalation provocation test for Aspergillosis
fumigatus was positive and chronic hypersensitivity pneumonitis
(CHP) caused by Aspergillus was finally diagnosed. Insidious CHP
is sometimes misdiagnosed as IPF. The diagnosis of insidious CHP
should be made on the basis of a detailed history, specific HRCT
findings, and lymphocyte-dominant bronchoalveolar lavage fluid