An 80-year-old woman who developed allergic bronchopulmonary aspergillosis (ABPA) was admitted to our institution in 2023 for an enlarged pulmonary mass lesion. She had developed ABPA in 2017, and corticosteroid therapy had improved the mucoid impaction of the bronchi. Because part of the lesion remained, increased doses of corticosteroid, antifungals, and biologics were administered, but the pulmonary lesion enlarged in 2022. Bronchoscopy showed necrotic tissue in the bronchial lumen, and bronchial washing fluid showed neutrophilic inflammation and fungal hyphae. We subsequently diagnosed her as having chronic pulmonary aspergillosis overlapping ABPA, and voriconazole was started that resulted in shrinkage of the nodules.
Keywords: allergic bronchopulmonary aspergillosis; chronic pulmonary aspergillosis; invasive pulmonary aspergillosis; overlap.