This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Respiratory system, Subject name: Anatomy
Diagnostic features of allergic bronchopulmonary aspergillosis (ABPA) include 
Select and explain. 
A. Changing pulmonary infiltrates, B. Peripheral eosinophilia, C. Serum precipitins against aspergillosis fumigants, D. Occurance in patients with old cavitatory lesions
D: Occurance in patients with old cavitatory lesions
Answer: D: Occurance in patients with old cavitatory lesions 
Explanation: ABPA is a distinct diagnosis from simple asthma, characterized by prominent peripheral eosinophilia and elevated circulating levels of IgE (>417 IU/mL). Establishing a diagnosis of ABPA also requires establishing sensitivity to Aspergillus antigens by skin test reactivity, positive serum precipitins for Aspergillus, and/or direct measurement of circulating specific IgG and IgE to Aspergillus. Central bronchiectasis is described as a classic finding on chest imaging in ABPA but is not necessary for making a diagnosis. Other possible findings on chest imaging include patchy infiltrates and evidence of mucus impaction. Ref Harrison 19th edition pg 1686