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Numerous hyperlucent foci and bullae are seen in the subpleural distribution of both lungs, predominantly in the posterior lower lobes. Possible honeycombing and reticulation at the lowermost lungs, suggesting early fibrosis.
At the histologic level, fibrosis is a common component of emphysema (see reference article).
Imaging findings of fibrosis can also coexist with those of emphysema. The abnormalities likely affect pulmonary function together.
Dr. Farhad Farzam has also contributed to this case.