196Lu Scleroderma NSIP 5 years Improved

71 yo F with PMH significant for hypothyroidism and dcSSc complicated by ILD and ischemic ulcers (on MMF 1g BID)

feeling well with stable to improved respiratory symptoms

TTE performed locally  did not reveal findings concerning for PH –

NSIP
71-year-old female presents with a history of scleroderma, ILD, hypothyroidism and dcSSc
Scout film of the CT shows bibasilar reticular changes
Ashley Davidoff MD TheCommonVein.net 196Lu 136604
NSIP
71-year-old female presents with a history of scleroderma, ILD, hypothyroidism and dcSSc
CT in the coronal plane shows bibasilar ground glass changes, left greater than right with some volume loss
Ashley Davidoff MD TheCommonVein.net 196Lu 136605
NSIP
71-year-old female presents with a history of scleroderma, ILD, hypothyroidism and dcSSc
CT in the coronal plane shows bibasilar ground glass changes, left greater than right with bronchovascular thickening traction bronchiectasis and volume loss
Ashley Davidoff MD TheCommonVein.net 196Lu 136606
NSIP
71-year-old female presents with a history of scleroderma, ILD, hypothyroidism and dcSSc
CT in the coronal plane shows bibasilar ground glass changes, with bronchovascular thickening traction bronchiectasis, and bronciolectasis
Ashley Davidoff MD TheCommonVein.net 196Lu 136607
NSIP
71-year-old female presents with a history of scleroderma, ILD, hypothyroidism and dcSSc
CT in the coronal plane of the posterior aspects of the lower lobes, shows extensive bibasilar ground glass changes, and thickening of the interlobular septa
Ashley Davidoff MD TheCommonVein.net 196Lu 136608
NSIP
71-year-old female presents with a history of scleroderma, ILD, hypothyroidism and dcSSc
CT in the sagittal plane of the posterior aspects of the left lower lobe, shows extensive ground glass changes.
Ashley Davidoff MD TheCommonVein.net 196Lu 136609
NSIP
71-year-old female presents with a history of scleroderma, ILD, hypothyroidism and dcSSc
CT in the axial plane,shows extensive ground glass changes in the inferior lingula middle lobe and traction bronchiectasis in the middle lobe. The left lower lobe shows bronchovascular changes, and bronchiolectasis and there is bilateral subpleural sparing
The fissures show irregular thickening
Ashley Davidoff MD TheCommonVein.net 196Lu 136610
NSIP
71-year-old female presents with a history of scleroderma, ILD, hypothyroidism and dcSSc
CT in the axial plane,shows extensive ground glass changes in the inferior lingula middle lobe and traction bronchiectasis in the middle lobe. The left lower lobe shows bronchovascular changes, and bronchiolectasis and there is bilateral subpleural sparing
The fissures show irregular thickening.
The lower image exemplifies the traction bronchiectasis
Ashley Davidoff MD TheCommonVein.net 196Lu 136610c
NSIP Traction Bronchiectasis
71-year-old female presents with a history of scleroderma, ILD, hypothyroidism and dcSSc
CT of the middle lobe in the axial plane, shows extensive traction bronchiectasis in a background of ground glass changes and reticulations caused by thickening of the interlobular septa.
The fissures show irregular thickening.
Ashley Davidoff MD TheCommonVein.net 196Lu 136611
NSIP
71-year-old female presents with a history of scleroderma, ILD, hypothyroidism and dcSSc
CT of the lower lobes in the axial plane, shows bronchovascular changes with some volume loss in a background of extensive ground glass changes with traction bronchiectasis and irregular thickening of the interlobular septa. Subpleural sparing is noted at the right base
The fissures show irregular thickening as well.
Air-fluid level is noted in the dilated esophagus
Ashley Davidoff MD TheCommonVein.net 196Lu 136612
NSIP
71-year-old female presents with a history of scleroderma, ILD, hypothyroidism and dcSSc
CT of the lower lobes in the axial plane, shows bronchovascular changes with some volume loss in a background of extensive ground glass changes with traction bronchiectasis and irregular thickening of the interlobular septa.
The fissures show irregular thickening as well.
Air-fluid level is noted in the dilated esophagus
Ashley Davidoff MD TheCommonVein.net 196Lu 136613
NSIP
71-year-old female presents with a history of scleroderma, ILD, hypothyroidism and dcSSc
CT of the lower lobes in the coronal plane, shows extensive ground glasschanges with irregular thickening of the interlobular septa.
Ashley Davidoff MD TheCommonVein.net 196Lu 136616
Pulmonary Hypertension NSIP
71-year-old female presents with a history of scleroderma, ILD, hypothyroidism and dcSSc
CT through the main pulmonary artery shows an enlarged MPA indicating pulmonary hypertension
Ashley Davidoff MD TheCommonVein.net 196Lu 136617