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©2013 UpToDate ® Print Email Chronic pulmonary aspergillosis (A) Chest radiograph showing several left upper lobe cavities, tracheal deviation indicating collapse due to contraction and fibrosis, as well as marked pleural thickening. There are marked infiltrates inferior to the largest cavity, and a linear opacity extending inferiorly from there. No overt aspergilloma is visible. (B) CT scan of the same patient, showing multi-cavity disease on the left and some emphysema on the right. There is gross mediastinal shift to the left. The cavities in the left are of variable size and at least one contains an aspergilloma. The pleural thickening is variable in thickness, and some fibrosis is visible between the cavities. Reproduced with permission from: Denning, DW. Chronic aspergillosis. In: Aspergillus fumigatus and aspergillosis, Latge, JP, Steinbach, WJ (Eds). ASM Press, Washington, DC 2009. Copyright © 2009 ASM Press.