Scleroderma: with UIP type pulmonary fibrosis
Long standing GERD and dry cough.
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Inter-lobular septal thickening and subpelural lines peripherally and basally, bilateral and symmetrical. Evidence of traction bronchietctesis and small air cysts. No frank evidence of honey-combing. No pleural effusion.
A dilated patuolous esophagus with food material within.
Scleroderma is a systemic disease with typical pulmonary involvement in the form of usual interstitial pneumonitis that, with time, progresses to fibrosis.
The presence of a dilated malfunctioning esophagus as in this case hints to the diagnosis, as it implies a systemic disease rather than an isolated pulmonary process.