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A 61-year-old woman was admitted with a tumor-like lesion in the middle lobe of the right lung which showed substantial uptake on 18F-fluorodeoxyglucose positron emission tomography (18FDG-PET). The chief complaint was dry cough. On the basis of these findings, lung cancer was first to be ruled out. However, subsequent examinations showed Aspergillus fumigatus in sputum and aspergillus-specific IgE and IgG antibodies in the serum. The tumor-like lesion gradually disappeared. Allergic bronchopulmonary aspergillosis without clinical symptom of bronchial asthma was diagnosed with Rosenberg's clinical criteria. The patient's condition stabilized after treatment with inhaled corticosteroid and oral itraconazole. To our knowledge, this is the second report of allergic bronchopulmonary aspergillosis with tumor-like lesions in the lung showing intense 18FDG-PET uptake.

We present a case of acute respiratory distress syndrome (ARDS) caused by allergic reactions to shiniseihaito. An 84-year-old woman showed acute interstitial pneumonia followed by ARDS after taking shiniseihaito for the treatment of rhinitis. The ARDS were markedly improved with corticosteroid therapy. This case was diagnosed as being induced by shiniseihaito because it was compatible with 4 of 5 of Camus's criteria. The stimulation index of the drug lymphocyte stimulation test with shiniseihaito increased after corticosteroid therapy had been tapered and suggested that the mechanism of acute interstitial pneumonia in this case was allergic reaction induced by shiniseihaito. This is the seventh reported case of drug induced lung injury by shiniseihaito. We recommend careful observation when this medicine is prescribed.

A 39-year-old woman, who had a history of recurrent oral and genital ulcerations and folliculitis and had had a low-grade fever since December 2003, consulted our hospital on February 5, 2004. Chest radiography and computed tomography (CT) showed multiple pulmonary abscess-like opacities. She was admitted to the Department of Respiratory Medicine and Allergology, Kinki University School of Medicine on February 19, 2004. A transbronchial lung biopsy showed nonspecific inflammation with lymphocytic infiltration. The patient was discharged after she showed improvement with antibiotic therapy. She was readmitted to our hospital on October 3, 2006, because of recurrence of pulmonary abscess-like opacities. Bronchoalveolar lavage showed lymphocytosis (53%) but yielded no significant bacteria on culture. Behçet's disease was diagnosed on the basis of the three major symptoms (recurrent oral and genital ulcerations and folliculitis). The frequent recurrence of pulmonary lesions was suspected to be due to immunological impairment associated with Behçet's disease, and the pulmonary lesions and inflammatory reaction tests showed improvement after colchicine was administered. The patient was discharged on October 28, 2006. To our knowledge this is the third reported case of frequently recurrent multiple pulmonary abscess-like opacities in Behçet's disease.