摘要本文介绍1例变应性支气管肺曲霉病（ABPA）血清总IgE及烟曲霉特异性IgE水平正常而延迟诊断的患者。患者女，55岁，病程中影像学曾出现过肿块影，合并血癌胚抗原明显升高，疑诊为肺肿瘤。后经支气管肺活检组织培养出烟曲霉，结合病史、临床、影像学表现，诊断为ABPA合并侵袭性肺曲霉病。鉴于ABPA诊断标准不能覆盖所有患者，在免疫学证据尚不充足的少见情况下，需结合临床、影像学表现，以进行早期诊断及治疗。

abstractsHere, we reported a case of delayed diagnosis of allergic bronchopulmonary aspergillosis (ABPA) with low serum IgE and normal Aspergillus fumigatus-specific IgE levels. During the course of the disease, the patient (female, 55 years old) had imaging manifestation of mass shadow and significant elevation of carcinoembryonic antigen, leading to suspicion of a lung tumor. Later, transbronchial lung biopsy tissue culture showed Aspergillus fumigatus. Combined with the history, clinical characteristics and imaging, she was diagnosed with allergic bronchopulmonary aspergillosis combined with invasive pulmonary aspergillosis. As the diagnostic criteria for ABPA do not cover all patients with ABPA, in rare cases where immunological evidence is insufficient, a combination of clinical and imaging features is required for early diagnosis and treatment.