Usual interstitial pneumonia (UIP)
Progressive short of breath 6 months. No occupational history.
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Reticular opacities noted in both lungs along with traction bronchiectasis, areas of parenchymal destruction and fibrosis. There is interlobar and intralobular septal thickening. These changes are predominantly subpleural and show basal gradient. There are subpleural confluent cystic changes representing the typical honeycomb appearance. Incidental note is made of bi-apical pleural thickening and parenchymal scarring most likely representing previous tuberculosis. The calcified mediastinal nodes also support this.
These features of fibrosis, traction bronchiectasis, architectural distortion and honeycombing with a subpleural and basal distribution are consistent with a usual interstitial pneumonitis (UIP) pattern of pulmonary fibrosis.