High attenuation mucus in bronchi with allergic bronchopulmonary mycosis.
allergic bronchopulmonary aspergillosis
allergic bronchopulmonary mycosis
aspergillus
computed tomography
high attenuation mucus
mucus plug
Journal
Mycoses
ISSN: 1439-0507
Titre abrégé: Mycoses
Pays: Germany
ID NLM: 8805008
Informations de publication
Date de publication:
Feb 2024
Feb 2024
Historique:
revised:
04
02
2024
received:
10
06
2023
accepted:
07
02
2024
medline:
19
2
2024
pubmed:
19
2
2024
entrez:
18
2
2024
Statut:
ppublish
Résumé
High-attenuation mucus (HAM) is a specific manifestation of allergic bronchopulmonary mycosis (ABPM) on chest computed tomography (CT). To compare the diagnostic accuracy of the two definitions of HAM and to clarify the clinical and radiographic characteristics of HAM-positive and HAM-negative ABPM. CT images at the diagnosis of ABPM using Asano's criteria were retrospectively analysed. In Study #1, radiographic data obtained using the same CT apparatus in a single institute were analysed to determine the agreement between the two definitions of HAM: a mucus plug that is visually denser than the paraspinal muscles or that with a radiodensity ≥70 Hounsfield units. In Study #2, HAM was diagnosed by comparison with the paraspinal muscles in patients with ABPM reporting to 14 medical institutes in Japan. In Study #1, 93 mucus plugs from 26 patients were analysed. A substantial agreement for HAM diagnosis was observed between the two methods, with a κ coefficient of 0.72. In Study #2, 60 cases of ABPM were analysed; mucus plugs were present in all cases and HAM was diagnosed in 45 (75%) cases. The median A. fumigatus-specific IgE titre was significantly lower in HAM-positive patients than in HAM-negative patients (2.5 vs. 24.3 U In conclusion, agreement between the two methods to diagnose HAM was substantial. HAM was associated with some immunological and radiographic characteristics, including lower levels of sensitization to A. fumigatus and the presence of distal airway lesions.
Sections du résumé
BACKGROUND
BACKGROUND
High-attenuation mucus (HAM) is a specific manifestation of allergic bronchopulmonary mycosis (ABPM) on chest computed tomography (CT).
OBJECTIVES
OBJECTIVE
To compare the diagnostic accuracy of the two definitions of HAM and to clarify the clinical and radiographic characteristics of HAM-positive and HAM-negative ABPM.
METHODS
METHODS
CT images at the diagnosis of ABPM using Asano's criteria were retrospectively analysed. In Study #1, radiographic data obtained using the same CT apparatus in a single institute were analysed to determine the agreement between the two definitions of HAM: a mucus plug that is visually denser than the paraspinal muscles or that with a radiodensity ≥70 Hounsfield units. In Study #2, HAM was diagnosed by comparison with the paraspinal muscles in patients with ABPM reporting to 14 medical institutes in Japan.
RESULTS
RESULTS
In Study #1, 93 mucus plugs from 26 patients were analysed. A substantial agreement for HAM diagnosis was observed between the two methods, with a κ coefficient of 0.72. In Study #2, 60 cases of ABPM were analysed; mucus plugs were present in all cases and HAM was diagnosed in 45 (75%) cases. The median A. fumigatus-specific IgE titre was significantly lower in HAM-positive patients than in HAM-negative patients (2.5 vs. 24.3 U
CONCLUSION
CONCLUSIONS
In conclusion, agreement between the two methods to diagnose HAM was substantial. HAM was associated with some immunological and radiographic characteristics, including lower levels of sensitization to A. fumigatus and the presence of distal airway lesions.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13705Subventions
Organisme : The Research Grant on Allergic Disease and Immunology from Japan Agency for Medical Research and Development
ID : JP21ek0410055
Organisme : The Research Grant on Allergic Disease and Immunology from Japan Agency for Medical Research and Development
ID : JP23ek0410097
Informations de copyright
© 2024 Wiley-VCH GmbH. Published by John Wiley & Sons Ltd.
Références
Agarwal R, Muthu V, Sehgal IS, Dhooria S, Prasad KT, Aggarwal AN. Allergic bronchopulmonary aspergillosis. Clin Chest Med. 2022;43(1):99-125.
Bosken CH, Myers JL, Greenberger PA, Katzenstein AL. Pathologic features of allergic bronchopulmonary aspergillosis. Am J Surg Pathol. 1988;12(3):216-222.
Katzenstein AL, Liebow AA, Friedman PJ. Bronchocentric granulomatosis, mucoid impaction, and hypersensitivity reactions to fungi. Am Rev Respir Dis. 1975;111(4):497-537.
Rosenberg M, Patterson R, Mintzer R, Cooper BJ, Roberts M, Harris KE. Clinical and immunologic criteria for the diagnosis of allergic bronchopulmonary aspergillosis. Ann Intern Med. 1977;86(4):405-414.
Asano K, Kamei K, Hebisawa A. Allergic bronchopulmonary mycosis - pathophysiology, histology, diagnosis, and treatment. Asia Pac Allergy. 2018;8(3):e24.
Goyal R, White CS, Templeton PA, Britt EJ, Rubin LJ. High attenuation mucous plugs in allergic bronchopulmonary aspergillosis: CT appearance. J Comput Assist Tomogr. 1992;16(4):649-650.
Logan PM, Müller NL. High-attenuation mucous plugging in allergic bronchopulmonary aspergillosis. Can Assoc Radiol J. 1996;47(5):374-377.
Agarwal R, Gupta D, Aggarwal AN, Saxena AK, Chakrabarti A, Jindal SK. Clinical significance of hyperattenuating mucoid impaction in allergic bronchopulmonary aspergillosis: an analysis of 155 patients. Chest. 2007;132(4):1183-1190.
Agarwal R, Maskey D, Aggarwal AN, et al. Diagnostic performance of various tests and criteria employed in allergic bronchopulmonary aspergillosis: a latent class analysis. PLoS One. 2013;8(4):e61105.
Phuyal S, Garg MK, Agarwal R, et al. High-attenuation mucus impaction in patients with allergic bronchopulmonary aspergillosis: objective criteria on high-resolution computed tomography and correlation with serologic parameters. Curr Probl Diagn Radiol. 2016;45(3):168-173.
Agarwal R. High attenuation mucoid impaction in allergic bronchopulmonary aspergillosis. World J Radiol. 2010;2(1):41-43.
Agarwal R, Khan A, Gupta D, Aggarwal AN, Saxena AK, Chakrabarti A. An alternate method of classifying allergic bronchopulmonary aspergillosis based on high-attenuation mucus. PLoS One. 2010;5(12):e15346.
Lu HW, Mao B, Wei P, et al. The clinical characteristics and prognosis of ABPA are closely related to the mucus plugs in central bronchiectasis. Clin Respir J. 2020;14(2):140-147.
Asano K, Hebisawa A, Ishiguro T, et al. New clinical diagnostic criteria for allergic bronchopulmonary aspergillosis/mycosis and its validation. J Allergy Clin Immunol. 2021;147(4):1261-1268.e5.
Agarwal R, Chakrabarti A, Shah A, et al. Allergic bronchopulmonary aspergillosis: review of literature and proposal of new diagnostic and classification criteria. Clin Exp Allergy. 2013;43(8):850-873.
Harada K, Oguma T, Saito A, et al. Concordance between aspergillus-specific precipitating antibody and IgG in allergic bronchopulmonary aspergillosis. Allergol Int. 2018;67:S12-S17.
Okada N, Yamamoto Y, Oguma T, et al. Allergic bronchopulmonary aspergillosis with atopic, nonatopic, and sans asthma-factor analysis. Allergy. 2023;78(11):2933-2943.
Dunican EM, Elicker BM, Gierada DS, et al. Mucus plugs in patients with asthma linked to eosinophilia and airflow obstruction. J Clin Invest. 2018;128(3):997-1009.
Agarwal R. Allergic bronchopulmonary aspergillosis: lessons for the busy radiologist. World J Radiol. 2011;3(7):178-181.
Kaur M, Sudan DS. Allergic bronchopulmonary aspergillosis (ABPA)-the high resolution computed tomography (HRCT) chest imaging scenario. J Clin Diagn Res. 2014;8(6):RC05-RC07.
Mukherji SK, Figueroa RE, Ginsberg LE, et al. Allergic fungal sinusitis: CT findings. Radiology. 1998;207(2):417-422.
Kopp W, Fotter R, Steiner H, Beaufort F, Stammberger H. Aspergillosis of the paranasal sinuses. Radiology. 1985;156(3):715-716.
Dillon WP, Som PM, Fullerton GD. Hypointense MR signal in chronically inspissated sinonasal secretions. Radiology. 1990;174(1):73-78.
Garg MK, Gupta P, Agarwal R, Sodhi KS, Khandelwal N. MRI: a new paradigm in imaging evaluation of allergic bronchopulmonary aspergillosis? Chest. 2015;147(2):e58-e59.
Jelihovsky T. The structure of bronchial plugs in mucoid impaction, bronchocentric granulomatosis and asthma. Histopathology. 1983;7(2):153-167.
Muniz VS, Silva JC, Braga YAV, et al. Eosinophils release extracellular DNA traps in response to Aspergillus fumigatus. J Allergy Clin Immunol. 2018;141(2):571-585.e7.
Ueki S, Konno Y, Takeda M, et al. Eosinophil extracellular trap cell death-derived DNA traps: their presence in secretions and functional attributes. J Allergy Clin Immunol. 2016;137(1):258-267.
Meng Y, Zhang L, Piao Y, Lou H, Wang K, Wang C. The use of magnetic resonance imaging in differential diagnosis of allergic fungal sinusitis and eosinophilic mucin rhinosinusitis. J Thorac Dis. 2019;11(8):3569-3577.
Lee SH, Park SW, Kim YB, Nam TK, Lee YS. The fatty degeneration of lumbar paraspinal muscles on computed tomography scan according to age and disc level. Spine J. 2017;17(1):81-87.
Muthu V, Sehgal IS, Prasad KT, et al. Epidemiology and outcomes of allergic bronchopulmonary aspergillosis in the elderly. Mycoses. 2022;65(1):71-78.
Oguma T, Taniguchi M, Shimoda T, et al. Allergic bronchopulmonary aspergillosis in Japan: a nationwide survey. Allergol Int. 2018;67(1):79-84.
Agarwal R, Khan A, Garg M, Aggarwal AN, Gupta D. Chest radiographic and computed tomographic manifestations in allergic bronchopulmonary aspergillosis. World J Radiol. 2012;4(4):141-150.
Oguma T, Ishiguro T, Kamei K, et al. Clinical characteristics of allergic bronchopulmonary mycosis caused by Schizophyllum commune. Clinical and translational. Allergy. 2023;14(1):e12327.
Muthu V, Sehgal IS, Prasad KT, et al. Allergic bronchopulmonary aspergillosis (ABPA) sans asthma: a distinct subset of ABPA with a lesser risk of exacerbation. Med Mycol. 2020;58(2):260-263.