Upper Lobes and Centrilobular Emphysema


Upper lung field distribution
Ashley Davidoff MD TheCommonvein.net lungs-0774
69 year old male with neurofibromatosis and emphysema
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
  1. Gravity: The upper lobes of the lungs are more susceptible to the effects of gravity, as they are located higher up in the chest than the lower lobes. This means that blood flow to the upper lobes is reduced, and they receive less ventilation than the lower lobes. As a result, the upper lobes are more vulnerable to damage from inhaled toxins such as cigarette smoke.
  2. Ventilation: The upper lobes of the lungs have a greater volume of air than the lower lobes, which means that they are subjected to greater forces during inhalation and exhalation. Over time, this increased strain on the air sacs can lead to damage and loss of elasticity.
  3. Inhaled Smoke will rise and damage upper lobes
  4. Localized inflammation: Some researchers have suggested that the upper lobes of the lungs may be more prone to inflammation, which can contribute to the development of emphysema. This may be due to differences in the distribution of immune cells or exposure to environmental toxins.
  5. Genetic factors: Some studies have suggested that genetic factors may play a role in the development of emphysema, and that certain genetic mutations may be more likely to affect the upper lobes of the lungs.

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