The CT chest demonstrates diffuse basilar bronchiectasis with bronchial wall thickening and mucus plugging, as weel as centrilobular nodules and tree-in-bud pattern. Given the distribution within the lower lobes (gravity dependent) and the history of an extensive head and neck surgery and radiotherapy, these findings are likely to represent changes due to subacute/chronic aspiration. Note that ground-glass and consolidation are not present.