

This is a 57 year old black female who had been a smoker but stopped 1 yr ago . She complained of increasing shortness of breath over 1 year. She had undergone PFT’s that showed reduced FVC (59%) predicted and FEV1 (72% predicted). Her total lung capacity was 71 % predicted. She was unable to do a diffusion capacity. The intial chest radiograph was read as normal. Representative images from her CT scan are above
Do you think this is an abnormal scan? Would you perform a diagnositic procedure? If abnormal, suggest a diagnosis compatible with the CT scan.