Types of emphysema Centriacinar Panacinar Paraseptal Irregular emphysema Bullous emphysema

Meaning - Meaning: Central areas - Meaning: Pan ~> - Meaning: Para ~> beside or Meaning: Irregular ~> Bullous ~> spaces in the
show marked all/Entire, so affect the adjacent to, so adjacent to random. distended state.
emphysematous damage entire secondary the pleura.
surrounded by relatively pulmonary lobule.
spared alveolar spaces.
Location - Upper lobes; apical Lower zones Alveolar ducts and sacs at the No constant subpleural, near the apex.
segments. lung periphery. relationship to any
- At the base if associated portion in the acinus.
with Salla disease.
Affect Proximal respiratory Entire secondary Distal part of acinus.
bronchiole. pulmonary lobule,
matching areas of blood
flow.
Gross Appearance Gross appearance: upper Pale, voluminous lungs Multiple, continuous, Fibrosis, foci of Spontaneous
two-thirds of the lungs that often obscure the enlargement of airspaces & Irregular emphysema. pneumothorax.
are more severely heart sometime forming cyst-like Invariably associated Cyst-like.
affected than the lower structures adjacent to the with scarring. Rupture of bulla
lungs. pleura. Pneumothorax may lead
May lead to to interstitial emphysema.
pneumothorax.
Caused by Smoking dependent Alpha anti-trypsin - Cigarette smoking
deficiency. Exacerbated - Increased proteinase
by smoking, Iv injection of release and decreased
methylphenidate. proteinase inhibitor capacity.
- Alpha 1 anti trypsin
deficiency
- Inflammation
- Intravenous drug abuse
- Immunodeficiency
syndromes
- Vasculitis syndromes
- Connective tissue disorders
Microscopic Appearance • Thinning and destruction of alveolar walls • Adjacent alveoli become confluent, creating large airspaces • Loss of elastic tissue in the
surrounding alveolar septa • The number of alveolar capillaries is diminished
* Both paraseptal & Bullous emphysema have cyst like structure, and both can cause pneumothorax.