Fact-sheet: Centrilobular emphysema


Updated on 09/17/2021 at 12:16 PM

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Definition

- Permanent enlargement of the distal air spaces, with destruction of the alveolar walls
- Depending on the distribution, emphysema is classified as centrilobular, panacinar, or paraseptal.
- Centrilobular emphysema: heterogeneous destruction of the alveoli, predominating in the upper lobes.

Clinical features

- Form predominating in smokers
- Blue bloater
- Dyspnea, cyanosis, marked hypoxia

Radiography

1/ Hyperinflation:
- increase in the anteroposterior and craniocaudal diameter of the lung parenchyma
- flattening of the hemidiaphragms
- enlargement of the retrosternal clear space
- lowering of the hila
2/ Vascular attenuation:
- decrease in the number and caliber of the pulmonary vessels

CT

- poorly defined hypodense areas, without a definite wall, in the center of the pulmonary lobules
- severe centrilobular emphysema may progress to involve the entire lobule and become panacinar
- centrilobular artery still visible
- predominates in the upper lobe