Abstract
症例は73歳，女性．既往歴で喘息を有していた．検診の胸部X線で右上肺野の異常影を指摘された．胸部CTで左肺S8に最大径40mmの腫瘤と右肺S3に最大径13mmの結節を認めた．PET/CT検査では右肺の病変にFDGの集積なく左肺の病変にFDGの高集積を認めた．2カ月後のCTで左肺の病変のみ増大傾向を認め，原発性肺癌を疑い手術を施行した．術中針生検で癌が疑われ胸腔鏡下左下葉切除術を施行した．病理では拡張した気管支内に多数の好酸球を含む粘液栓子や壊死物質の中に真菌菌糸を認めた．気管支壁には類上皮肉芽腫を認め，アレルギー性気管支肺アスペルギルス症（ABPA）と診断した．ABPAでは，FDG-PET/CT検査でFDGの強い集積を認めることがあり，また，CEAが高値となることがあり，悪性腫瘍との鑑別は困難と考えられた．喘息の既往がある患者ではABPAを念頭に置いた検査の施行を検討すべきと考えられた．
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