A 40 year old man presented with repeated episodes of bronchospasm and hemoptysis. Chest X-ray revealed perihilar bronchiectasis. The most likely diagnosis is :: (A) Sarcoidosis, (B) Idiopathic pulmonary fibrosis, (C) Extrinsic allergic alveolitis, (D) Bronchopulmonary aspergillosis
Answer is D. Answer is D (Bronchopulmonary Aspergillosis): Coexistence of repeated of bronchospasm (asthma), Central (perihilar) bronchiectasis and haemoptysis suggest a diagnosis of allergic bronchopuhnonary aspergillosis. The questions gives us three leads: bronchospasm, hemoptysis, bronchiectasis. Presence of repeated episodes of bronchospasm indicates towards a possible existence of asthma. Hemoptysis, central bronchiectasis are well known complications of Allergic Broncho Pulmonary Aspergillosis. All three of these features are consistent with the diagnosis of ABPA.