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Centrilobular Emphysema
Allen Heeger, DO
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Centrilobular emphysema (CLE)
            • Synonyms

              • Centriacinar emphysema
              • Proximal acinar emphysema
            • Definitions

              • Enlargement and destruction of respiratory bronchioles near center of secondary pulmonary lobule

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • Imaging Recommendations

                    • MR Findings

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. El Kaddouri B et al: Fleischner Society visual emphysema CT patterns help predict progression of emphysema in current and former smokers: results from the COPDGene study. Radiology. 298(2):441-9, 2021
                                          2. Martini K et al: Advances in imaging for lung emphysema. Ann Transl Med. 8(21):1467, 2020
                                          3. Bhatt SP et al: Imaging advances in chronic obstructive pulmonary disease. insights from the genetic epidemiology of chronic obstructive pulmonary disease (COPDGene) study. Am J Respir Crit Care Med. 199(3):286-301, 2019
                                          4. Hochhegger B et al: Pulmonary acinus: understanding the computed tomography findings from an acinar perspective. Lung. 197(3):259-65, 2019
                                          5. Lynch DA et al: CT-based visual classification of emphysema: association with mortality in the COPDGene study. Radiology. 288(3):859-66, 2018
                                          6. Tanabe N et al: Analysis of airway pathology in COPD using a combination of computed tomography, micro-computed tomography and histology. Eur Respir J. 51(2), 2018
                                          7. Tanabe N et al: Micro-computed tomography comparison of preterminal bronchioles in centrilobular and panlobular emphysema. Am J Respir Crit Care Med. 195(5):630-8, 2017
                                          8. Corrections. Lancet Respir Med. 4(11):e55, 2016
                                          9. Ostridge K et al: Distinct emphysema subtypes defined by quantitative CT analysis are associated with specific pulmonary matrix metalloproteinases. Respir Res. 17(1):92, 2016
                                          10. Lynch DA et al: CT-definable subtypes of chronic obstructive pulmonary disease: a statement of the Fleischner Society. Radiology. 277(1):192-205, 2015
                                          11. Smith BM et al: Pulmonary emphysema subtypes on computed tomography: the MESA COPD study. Am J Med. 127(1):94.e7-23, 2014
                                          12. Gietema HA et al: Quantifying the extent of emphysema: factors associated with radiologists' estimations and quantitative indices of emphysema severity using the ECLIPSE cohort. Acad Radiol. 18(6):661-71, 2011
                                          13. Mets OM et al: Identification of chronic obstructive pulmonary disease in lung cancer screening computed tomographic scans. JAMA. 306(16):1775-81, 2011
                                          14. Gietema HA et al: Distribution of emphysema in heavy smokers: impact on pulmonary function. Respir Med. 104(1):76-82, 2010
                                          15. Sciurba FC et al: A randomized study of endobronchial valves for advanced emphysema. N Engl J Med. 363(13):1233-44, 2010
                                          16. Akira M et al: Quantitative CT in chronic obstructive pulmonary disease: inspiratory and expiratory assessment. AJR Am J Roentgenol. 192(1):267-72, 2009
                                          17. Litmanovich D et al: CT of pulmonary emphysema--current status, challenges, and future directions. Eur Radiol. 19(3):537-51, 2009
                                          18. Ohno Y et al: Oxygen-enhanced magnetic resonance imaging versus computed tomography: multicenter study for clinical stage classification of smoking-related chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 177(10):1095-102, 2008
                                          19. Parraga G et al: Hyperpolarized 3He ventilation defects and apparent diffusion coefficients in chronic obstructive pulmonary disease: preliminary results at 3.0 Tesla. Invest Radiol. 42(6):384-91, 2007
                                          20. Watz H et al: Micro-CT of the human lung: imaging of alveoli and virtual endoscopy of an alveolar duct in a normal lung and in a lung with centrilobular emphysema--initial observations. Radiology. 236(3):1053-8, 2005
                                          21. Bankier AA et al: CT quantification of pulmonary emphysema: assessment of lung structure and function. Crit Rev Comput Tomogr. 43(6):399-417, 2002
                                          22. Sugi K et al: The outcome of volume reduction surgery according to the underlying type of emphysema. Surg Today. 31(7):580-5, 2001
                                          23. Bankier AA et al: Pulmonary emphysema: subjective visual grading versus objective quantification with macroscopic morphometry and thin-section CT densitometry. Radiology. 211(3):851-8, 1999
                                          24. Slone RM et al: Preoperative and postoperative imaging in the surgical management of pulmonary emphysema. Radiol Clin North Am. 36(1):57-89, 1998
                                          25. Webb WR: Radiology of obstructive pulmonary disease. AJR Am J Roentgenol. 169(3):637-47, 1997
                                          26. Stern EJ et al: CT of the lungs in patients with pulmonary emphysema. Semin Ultrasound CT MR. 16(5):345-52, 1995
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Pathology

                                                  • Clinical Issues

                                                    TERMINOLOGY

                                                    • Abbreviations

                                                      • Centrilobular emphysema (CLE)
                                                    • Synonyms

                                                      • Centriacinar emphysema
                                                      • Proximal acinar emphysema
                                                    • Definitions

                                                      • Enlargement and destruction of respiratory bronchioles near center of secondary pulmonary lobule

                                                    IMAGING

                                                    • General Features

                                                      • Radiographic Findings

                                                        • CT Findings

                                                          • Imaging Recommendations

                                                            • MR Findings

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Staging, Grading, & Classification

                                                                    • Gross Pathologic & Surgical Features

                                                                      • Microscopic Features

                                                                        CLINICAL ISSUES

                                                                        • Presentation

                                                                          • Demographics

                                                                            • Natural History & Prognosis

                                                                              • Treatment

                                                                                DIAGNOSTIC CHECKLIST

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. El Kaddouri B et al: Fleischner Society visual emphysema CT patterns help predict progression of emphysema in current and former smokers: results from the COPDGene study. Radiology. 298(2):441-9, 2021
                                                                                  2. Martini K et al: Advances in imaging for lung emphysema. Ann Transl Med. 8(21):1467, 2020
                                                                                  3. Bhatt SP et al: Imaging advances in chronic obstructive pulmonary disease. insights from the genetic epidemiology of chronic obstructive pulmonary disease (COPDGene) study. Am J Respir Crit Care Med. 199(3):286-301, 2019
                                                                                  4. Hochhegger B et al: Pulmonary acinus: understanding the computed tomography findings from an acinar perspective. Lung. 197(3):259-65, 2019
                                                                                  5. Lynch DA et al: CT-based visual classification of emphysema: association with mortality in the COPDGene study. Radiology. 288(3):859-66, 2018
                                                                                  6. Tanabe N et al: Analysis of airway pathology in COPD using a combination of computed tomography, micro-computed tomography and histology. Eur Respir J. 51(2), 2018
                                                                                  7. Tanabe N et al: Micro-computed tomography comparison of preterminal bronchioles in centrilobular and panlobular emphysema. Am J Respir Crit Care Med. 195(5):630-8, 2017
                                                                                  8. Corrections. Lancet Respir Med. 4(11):e55, 2016
                                                                                  9. Ostridge K et al: Distinct emphysema subtypes defined by quantitative CT analysis are associated with specific pulmonary matrix metalloproteinases. Respir Res. 17(1):92, 2016
                                                                                  10. Lynch DA et al: CT-definable subtypes of chronic obstructive pulmonary disease: a statement of the Fleischner Society. Radiology. 277(1):192-205, 2015
                                                                                  11. Smith BM et al: Pulmonary emphysema subtypes on computed tomography: the MESA COPD study. Am J Med. 127(1):94.e7-23, 2014
                                                                                  12. Gietema HA et al: Quantifying the extent of emphysema: factors associated with radiologists' estimations and quantitative indices of emphysema severity using the ECLIPSE cohort. Acad Radiol. 18(6):661-71, 2011
                                                                                  13. Mets OM et al: Identification of chronic obstructive pulmonary disease in lung cancer screening computed tomographic scans. JAMA. 306(16):1775-81, 2011
                                                                                  14. Gietema HA et al: Distribution of emphysema in heavy smokers: impact on pulmonary function. Respir Med. 104(1):76-82, 2010
                                                                                  15. Sciurba FC et al: A randomized study of endobronchial valves for advanced emphysema. N Engl J Med. 363(13):1233-44, 2010
                                                                                  16. Akira M et al: Quantitative CT in chronic obstructive pulmonary disease: inspiratory and expiratory assessment. AJR Am J Roentgenol. 192(1):267-72, 2009
                                                                                  17. Litmanovich D et al: CT of pulmonary emphysema--current status, challenges, and future directions. Eur Radiol. 19(3):537-51, 2009
                                                                                  18. Ohno Y et al: Oxygen-enhanced magnetic resonance imaging versus computed tomography: multicenter study for clinical stage classification of smoking-related chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 177(10):1095-102, 2008
                                                                                  19. Parraga G et al: Hyperpolarized 3He ventilation defects and apparent diffusion coefficients in chronic obstructive pulmonary disease: preliminary results at 3.0 Tesla. Invest Radiol. 42(6):384-91, 2007
                                                                                  20. Watz H et al: Micro-CT of the human lung: imaging of alveoli and virtual endoscopy of an alveolar duct in a normal lung and in a lung with centrilobular emphysema--initial observations. Radiology. 236(3):1053-8, 2005
                                                                                  21. Bankier AA et al: CT quantification of pulmonary emphysema: assessment of lung structure and function. Crit Rev Comput Tomogr. 43(6):399-417, 2002
                                                                                  22. Sugi K et al: The outcome of volume reduction surgery according to the underlying type of emphysema. Surg Today. 31(7):580-5, 2001
                                                                                  23. Bankier AA et al: Pulmonary emphysema: subjective visual grading versus objective quantification with macroscopic morphometry and thin-section CT densitometry. Radiology. 211(3):851-8, 1999
                                                                                  24. Slone RM et al: Preoperative and postoperative imaging in the surgical management of pulmonary emphysema. Radiol Clin North Am. 36(1):57-89, 1998
                                                                                  25. Webb WR: Radiology of obstructive pulmonary disease. AJR Am J Roentgenol. 169(3):637-47, 1997
                                                                                  26. Stern EJ et al: CT of the lungs in patients with pulmonary emphysema. Semin Ultrasound CT MR. 16(5):345-52, 1995