What is the striking abnormality within the chest?
A honeycomb appearance with traction bronchiectasis consistent with pulmonary fibrosis.
Is there another finding that narrows the potential differential diagnosis?
The distal oesophagus is dilated.
What is the likely diagnosis?
Scleroderma with interstitial pulmonary fibrosis.
What percentage of patients with this underlying disease are symptomatic for pulmonary disease?
What other mechanism of pulmonary injury frequently co-exists in this condition?
Aspiration pneumonitis due to oesophageal involvement.
HRCT of the chest demonstrates characteristic changes of pulmonary fibrosis, particularly in the bases and in the subpleural lung. Honeycomb change, intralobular septal thickening and traction bronchiectasis are all present. No pleural effusion or obvious nodal enlargement is visible.
The oesophagus is dilated and air filled.