CT of progressive interstitial lung disease in a patient with scleroderma

An axial CT scan through the base of the lungs (A) shows a reticular pattern (dashed arrow), early bronchiectasis (arrowhead), and a patulous esophagus (arrow). Image (B) is a CT scan performed 10 years later and shows progressive septal thickening (dashed arrow), bronchiectasis (arrowhead), and bilateral pleural effusions (arrows). The thickening of the bronchial walls suggests inflammation from recurrent aspiration.