Peribronchial Cuffing EMPHYSEMA WITH ACUTE ON CHRONIC BRONCHITIS62-year-old male with emphysema and chronic bronchitis. Initial CXR confirms the presence of bibasilar tram tracking confirming the presence of associated chronic bronchitis. Upper lobe bronchi (blue arrows) are barely visible. The CXR on presentation with exacerbation of cough reveals new peribronchial cuffing (red arrows)Ashley Davidoff MD 040Lu Emphysema with Acute on Chronic Bronchitis