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Severe and cystic bronchiectasis. There is associated mild emphysema and some of the cysts are not clearly associated with bronchi although the majority in fact are. The extensive changes are associated with mosaic perfusion and there is definite and significant emphysema in the lung bases particularly the right. The central pulmonary artery is dilated suggesting pulmonary arterial hypertension and the peripheral pulmonary arteries do not show any significant attenuation as might be suspected in Macleod syndrome.