CTICasesSystemic Sclerosis-associated Nonspecific Interstitial Pneumonia (NSIP) - Progression
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Imaging findings
Serial CT scans over 10 years in a patient with systemic sclerosis demonstrated progressive interstitial lung disease. Initial scans (2005) showed subtle peripheral ground-glass opacity, basal predominance, subtle subpleural sparing, and arcading traction bronchiectasis, classic for NSIP. Subsequent scans (2009, 2015) revealed increasing reticulation, more severe traction bronchiectasis, and focal areas suggestive of honeycombing.
Key takeaways
Nonspecific interstitial pneumonia (NSIP) associated with systemic sclerosis can progress slowly over many years, with imaging features evolving to resemble usual interstitial pneumonia (UIP) in advanced stages. However, NSIP typically maintains dominant traction bronchiectasis and central cystic spaces (representing dilated airways), differentiating it from the subpleural honeycombing characteristic of UIP.
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