Serial thoracic CT of a patient with restrictive PcGVHD. (A) Baseline, with small pleural effusion (arrow). (B) At 3.5 years after HCT, admitted for hypoxia. CT scan shows normal lung apices and patchy foci of consolidation within the mid- to lower lungs (stars). (C-D) At 7 years after HCT. (C) Routine CT scan and (D) high-resolution CT scan images show apical pleural thickening (arrowhead) and subpleural consolidation and reticulation (arrow) that are associated with upper lobe traction bronchiectasis and volume loss. (E) At 10 years after HCT. CT scan shows progressive upper lobe volume loss, pleural thickening, and subpleural fibrotic consolidation. Upper lobe traction bronchiectasis (arrow) has also progressed.