Scleroderma with interstitial fibrosis
Shortness of breath.
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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.
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The combination of basal pulmonary fibrosis and a dilated oesophagus, is certainly suggestive of scleroderma. Although not pathognomonic it should be considered highly likely, especially in a woman.
In this case, the patient had clinically established scleroderma.