There is extensive subcutaneous surgical emphysema dissecting along the fascial planes of the lower neck and extend right anterior and posterior chest wall. Significant pneumomediastinum is seen. There are bilateral diffuse predominantly upper lobes interstitial lung thickening with subpleural honeycombing are seen. Bilateral diffuse centrilobular cylindrical traction bronchiectatic changes. Bilateral predominantly upper centrilobular and paraseptal emphysematous changes. A calcified left hilar lymph node is noted.