There is fibrous thickening of the fissure and apical pleura. The lingula shows more extensive honeycombing. Subpleural apical bullae can be seen anteriorly. There are scattered thin-walled cysts throughout. The pale consolidation at the base is caused by his terminal nocardial pneumonia.
Pericicatricial emphysema develops around scar remaining from the granulomas.
Honeycombing is distinguished from pericicatricial emphysema by finding fibrotic walls completely surrounding honeycombed spaces. Most of the enlarged spaces in this picture have some portion of the wall that is thin. The major feature here is the bilateral central conglomerate masses consisting of peribronchovascular interstitial and pulmonary fibrosis. Note the perihilar, mass-like, coarse densities surrounding dilated, distorted bronchi, which comprise cicatricial bronchiectasis. Note the irregular pleural thickening.