Concept:
Anti-Scl-70 antibody, also called anti-topoisomerase I antibody, is associated with diffuse systemic sclerosis. It is strongly linked with interstitial lung disease.
Step 1: Identify the antibody.
Anti-Scl-70 is a marker of systemic sclerosis, especially diffuse cutaneous systemic sclerosis.
Step 2: Recall major association.
A serious complication associated with anti-Scl-70 positivity is:
\[
\text{Interstitial lung disease}
\]
Step 3: Choose the best option.
Among the options, interstitial lung disease is most strongly associated with anti-Scl-70.
Therefore, the correct answer is Interstitial lung disease.