Allergic bronchopulmonary aspergillosis (ABPA) and allergic fungal rhinosinusitis (AFRS) are characterized by hyper-responsiveness of the respiratory tract and the nasal cavity and paranasal sinuses, respectively to Aspergillus species and AFRS causes chronic rhinosinusitis. Herein, we report the first case of sinobronchial allergic mycosis (SAM) syndrome, defined as ABPA with concomitant AFRS, caused by Aspergillus fumigatus patient > 80 years. An 82-year-old male with interstitial pneumonia who returned for follow-up exhibited high-attenuation mucus plug in the right intermediate bronchial trunk, infiltration in the right lung field, and right pleural effusion on regular chest computed tomography (CT). We found unilateral central bronchiectasis in the right upper lobe. Similarly, CT scan of the paranasal sinuses revealed high-attenuation mucus plugs in left ethmoid sinuses. Biopsy specimens from the plugs in the right intermediate bronchial trunk and the left ethmoid sinuses revealed allergic mucin with layers of mucus eosinophils, eosinophil-predominant mixed inflammatory cell infiltrate and Aspergillus hyphae. The patient fulfilled all the major criteria for ABPA and AFRS, and was diagnosed with SAM syndrome. CT scan of the lung and paranasal sinuses revealed apparent amelioration after oral steroid therapy. Despite mostly reported in relatively young patients, SAM syndrome can occur in elderly individuals as well.

中文翻译：

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老年男性中华支气管过敏性真菌病综合征

过敏性支气管肺曲霉病 (ABPA) 和过敏性真菌性鼻窦炎 (AFRS) 的特征是呼吸道、鼻腔和鼻窦分别对曲霉属物种的高反应性，而 AFRS 会导致慢性鼻窦炎。在此，我们报告了首例由烟曲霉患者 > 80 岁引起的中华支气管过敏性真菌病 (SAM) 综合征，定义为 ABPA 并伴有 AFRS。一名患有间质性肺炎的 82 岁男性返回随访，在常规胸部计算机断层扫描 (CT) 上显示右中支气管干高密度粘液栓、右肺野浸润和右侧胸腔积液。我们在右上叶发现单侧中央支气管扩张。相似地，鼻旁窦 CT 扫描显示左侧筛窦内有高密度粘液栓。来自右侧中间支气管干和左侧筛窦栓的活检标本显示过敏性粘蛋白伴粘液嗜酸性粒细胞层、以嗜酸性粒细胞为主的混合炎症细胞浸润和曲霉菌丝。患者符合 ABPA 和 AFRS 的所有主要标准，并被诊断为 SAM 综合征。肺部和鼻窦 CT 扫描显示口服类固醇治疗后明显改善。尽管大多在相对年轻的患者中报道，但 SAM 综合征也可能发生在老年人身上。嗜酸性粒细胞为主的混合炎症细胞浸润和曲霉菌丝。患者符合 ABPA 和 AFRS 的所有主要标准，并被诊断为 SAM 综合征。肺部和鼻窦 CT 扫描显示口服类固醇治疗后明显改善。尽管大多在相对年轻的患者中报道，但 SAM 综合征也可能发生在老年人身上。嗜酸性粒细胞为主的混合炎症细胞浸润和曲霉菌丝。患者符合 ABPA 和 AFRS 的所有主要标准，并被诊断为 SAM 综合征。肺部和鼻窦 CT 扫描显示口服类固醇治疗后明显改善。尽管大多在相对年轻的患者中报道，但 SAM 综合征也可能发生在老年人身上。