Centrilobular emphysema

Case contributed by Farzaneh Shobeirian
Diagnosis certain

Presentation

Heavy smoker patient with a complaint of chronic short of breath

Patient Data

Age: 55 years
Gender: Male

Chest

x-ray

Marked hyperinflation of the lungs and flattening of hemidiaphragms are noted.

Chest

ct

Focal lucencies (emphysematous spaces) located centrally within the secondary pulmonary lobules, some with central or peripheral dots representing bronchovascular bundles, are seen bilaterally. Emphysematous changes are seen predominantly in upper zones of each lung and more extensive on the right side.

Case Discussion

Pulmonary emphysema is an abnormal permanent enlargement of the airspaces distal to the terminal bronchioles associated with destruction of the alveolar wall. 

Centrilobular emphysema is the most frequent type of pulmonary emphysema which affects the proximal respiratory bronchioles, particularly of the upper zones. Centrilobular emphysema is associated with smoking.

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