And so the critical element for this case then becomes the high-resolution CT scan. Here we have a series of films, starting with the axial cuts showing the bases of the lungs that show subpleural reticulation in a peripheral distribution. There appear to be honeycomb cysts in both lower lobes and evidence of cicatricial traction bronchiectasis. A diffuse view of the lung shows a mildly abnormal parenchymal texture, in keeping with fairly diffuse fibrosis.
Down in the bases of the lung we see that in fact the honeycombing is more obvious in both lower lobes. The traction bronchiectasis is more exaggerated centrally, and we see again marked peripheral architectural distortion with regional volume loss and areas of traction bronchiectasis, suggesting pretty significant fibrosis.
