Localized circumferential narrowed bronchial wall lesions in allergic bronchopulmonary aspergillosis

We present a 67‐year‐old man with allergic bronchopulmonary aspergillosis (ABPA), whose chest computed tomography (CT) scans showed localized circumferential bronchial wall thickening in the right main bronchus to middle truncus. Chest CT scans showed high‐attenuation mucus in the right B8 bronchus. Bronchoscopy showed narrowing of the right main bronchus and inspissated mucus plugging in the right B8 bronchus. Histological examination of the right main bronchus revealed bronchial inflammation with numerous neutrophils and plasma cells. Treatment with corticosteroid and antifungal agents resulted in resolution of the symptoms and right bronchial lesions. The clinical course may indicate that the bronchial lesions were associated with ABPA.
The typical bronchial manifestations of allergic bronchopulmonary aspergillosis (ABPA) include intraluminal retention of inspissated mucus plugging and chronic inflammation of airway walls with eosinophils, lymphocytes, and neutrophils. Bronchiectasis and bronchial wall thickening can be seen on chest computed tomography (CT) scans. However, localized circumferential narrowing of the bronchus has not been reported. Herein, we report such a patient with ABPA, whose bronchial lesions disappeared after treatment with prednisolone and antifungal agents.