Faces of Emphysema

Centrilobular Emphysema

Emphysema
A drawing showing the normal acinus in teal and the abnormal emphysematous acinus in green characterised by destruction of the septal walls, enlargement of the alveoli, and loss of elasticity. The absence of involvement of the respiratory bronchiole makes the pathological diagnosis of centrilobular emphysema. Ashley Davidoff MD
TheCommonVein.net 32645

CENTRILOBULAR EMPHYSEMA, COR PULMONALE and PULMONARY HYPERTENSION
71-year-old female presents with history emphysema
Chest X-ray shows hyperinflated lungs with flattened hemidiaphragms and increase in the retrosternal space and right ventricular enlargement based on the decrease in the retrosternal air space
CT scan confirms the presence of centrilobular emphysema, predominantly in the upper lobes with associated right atrial, right ventricular and pulmonary arterial enlargement. The LA and LV are normal
These findings are consistent with cor pulmonale and pulmonary hypertension, secondary to emphysema.
Ashley Davidoff MD

Magnified view of the upper lobes of a 66year female with centrilobular emphysema shows an expanded lobule with a centrilobular vessel in the middle characteristic of centrilobular emphysema
Ashley Davidoff MD TheCommonvein.net

Moderate CHF with Interstitial Edema in a
Background of Emphysema

Moderate CHF with Interstitial Edema CXR Frontal View
68 year old male with a history of emphysema presents with increasing dyspnea, Frontal Chest X-ray shows an enlarged left atrium and diffuse interstitial thickening most prominent in the upper lobes.
There is global cardiomegaly, an enlarged main pulmonary artery indicating pulmonary hypertension and a single lead pacemaker.
Ashley Davidoff MD TheCommonVein.net 136556 288Lu

Moderate CHF with Interstitial Edema and Centrilobular Emphysema CT
68 year old male with a history of emphysema presents with increasing dyspnea. CT in the axial plane shows predominant upper lobe centrilobular emphysema with diffuse thickening of the interlobular septa .
Ashley Davidoff MD TheCommonVein.net 288Lu 136558

Moderate CHF with Interstitial Edema CT
68 year old male with a history of emphysema presents with increasing dyspnea. CT in the coronal plane y shows predominant upper lobe centrilobular emphysema with diffuse thickening of the interlobular septa (b white circle) with evidence of Kerley B lines (c red arrowheads) best exemplified in the left upper lung field, and thickening of the minor fissure (b, pink arrowhead). The left atrium (LA) is enlarged. These findings are consistent with moderate CHF with interstitial edema
Ashley Davidoff MD TheCommonVein.net 288Lu 136557cL

Paraseptal Emphysema

Panlobular Emphysema Alpha-1-Antitrypsin Deficiency