First, we will review the axial series with cuts through the lower lobes. This is clearly a fibrotic process with architectural distortion, regional volume loss, and significant traction bronchiectasis. The disease is peripheral in predominance but also involves more central areas. There are also areas of ground glass opacity throughout the lungs in addition to fibrotic change.

As we move a bit lower through the lung we see that the airways are being held open. There is peripheral, subpleural reticulation and architectural distortion, and traction bronchiectasis is seen in areas of ground glass. It is important to note that the esophagus appears slightly dilated.

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Idiopathic Pulmonary Fibrosis (an Update) and Progressive Pulmonary Fibrosis in Adults: An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline