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The transition from normal lung anatomy to minimal and established fibrosis is an important feature of the pathology of idiopathic pulmonary fibrosis (IPF). The purpose of this report is to examine the molecular and cellular mechanisms associated with this transition. Pre-operative thoracic Multidetector Computed Tomography (MDCT) scans of patients with severe IPF (n=9) were used to identify regions of minimal(n=27) and established fibrosis(n=27). MDCT, Micro-CT, quantitative histology, and next-generation sequencing were used to compar