Severe centrilobular emphysema
Shortness of breath developing during exertion. She is a heavy smoker. FEV1/FVC < 70%.
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This patient is a Stage II: moderate COPD. The diagnosis of COPD is through spirometry.
Pulmonary emphysema is defined as the "abnormal permanent enlargement of the airspaces distal to the terminal bronchioles accompanied by destruction of the alveolar wall and without obvious fibrosis".