Pulmonary emphysema

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Background

Morphological Subtypes

Subtype Description Associations
Centrilobular emphysema Most common, usually an upper lobe predominance Closely associated with smoking
Panlobular emphysema Involves entire acinus, more severe in lower lobes alpha-1-antitrypsin deficiency or IV methylphenidate use, Swyer-James syndrome, obliterative bronchiolitis
Paraseptal emphysema Occurs adjacent to the pleura and septal lines Smoking, Marfan syndrome; risk of pneumothorax
Paracicatricial emphysema Occurs adjacent to areas of scarring Silicosis, granulomatous lung disease, tuberculosis, pneumonia, pulmonary embolismcausing infarct

Risk Factors

Clinical Manifestations

  • Dyspnea
  • Decreased breath sounds, lung hyperinflation
  • Often moderate to severe airflow obstruction