Emphysema: this is defined as abnormal, permanent enlargement of air spaces distal to
the terminal bronchioles, due to destruction of aveolar walls and without fibrosis. It is
classified as follows:
- Centriacinar emphysema involves primarily the respiratory
bronchioles and is the most common type. It is the type seen
in cigarette smokers
- Panacinar emphysema involves the entire acinus. It is 1/20 as
common as centricular emphysema. It is the type seen in
alpha 1 - antitrypsin deficiency
- Paraseptal emphysema involves the distal part of the lobule.
Extensive involvement of the lung is rare. Some cases of
spontaneous pneumothorax may be due to this type of
emphysema
- Irregular emphysema is associated with scarring and has no
particular relationship to the acinus
- Bullous emphysema, by definition, is composed of lesions > 1
cm in diameter, and can be associated with any type of
emphysema
- A bleb is a localized pocket of interstitial emphysema,
typically subpleural, with no destruction of lung tissue
Normal
Distal
Gross lungs
Centriacinar
Centrilobular emphysema
Centrilobular emphysema/Ba in arteries E-Emphysema S-septa.
Panacinar emphysema
Panacinar emphysema/Involves entire parenchyma
Irregular emphysema
Paraseptal emphysema
Severe emphysema/Anderson's path
Panacinar Emphysema
