Chronic aspiration ILD bronchiectasis radiography CT and barium swallow

An axial CT scan through the chest (A) is normal with clear lung bases. Image B is a corresponding normal frontal chest radiograph. Image C is a barium swallow showing free aspiration into left mainstem bronchus (arrow). Image D is a CT scan performed two years later. A coarse reticular pattern and bronchiectasis are present in the lung bases (arrows), most likely due to fibrosis from chronic aspiration. Bilateral pleural effusions are also present (arrowheads), corresponding to bibasilar pleuro-parenchymal disease (arrows). Image E is a corresponding chest radiograph and shows bilateral pleural effusions (arrows).