Scleroderma with interstitial fibrosis
Shortness of breath.
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HRCT of the chest demonstrates characteristic changes of pulmonary fibrosis, particularly in the bases and in the subpleural lung. Honeycomb change, intralobular septal thickening and traction bronchiectasis are all present. No pleural effusion or obvious nodal enlargement is visible.
The esophagus is dilated and air filled.
6 case question available
The combination of basal pulmonary fibrosis and a dilated esophagus, is certainly suggestive of scleroderma. Although not pathognomonic it should be considered highly likely, especially in a woman.
In this case, the patient had clinically established scleroderma.