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Panlobular Emphysema
Allen Heeger, DO
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Panlobular emphysema (PLE)
                • α-1-antitrypsin deficiency (α1AD or AATD)
              • Synonyms

                • Panacinar emphysema
              • Definitions

                • Enlargement and destruction of entire acinus or secondary pulmonary lobule
                • Acinus: Lung distal to terminal bronchiole
                  • Respiratory bronchioles → alveolar ducts → alveolar sacs → alveoli

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          Selected References

                                          1. Martini K et al: Advances in imaging for lung emphysema. Ann Transl Med. 8(21):1467, 2020
                                          2. Lynch DA et al: CT-based visual classification of emphysema: association with mortality in the COPDGene study. Radiology. 288(3):859-66, 2018
                                          3. 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
                                          4. van Agteren JE et al: Lung volume reduction surgery for diffuse emphysema. Cochrane Database Syst Rev. 10:CD001001, 2016
                                          5. Lynch DA et al: CT-definable subtypes of chronic obstructive pulmonary disease: a statement of the Fleischner Society. Radiology. 277(1):192-205, 2015
                                          6. Smith BM et al: Pulmonary emphysema subtypes on computed tomography: the MESA COPD study. Am J Med. 127(1):94.e7-23, 2014
                                          7. Kukkonen MK et al: SERPINE2 haplotype as a risk factor for panlobular type of emphysema. BMC Med Genet. 12:157, 2011
                                          8. Litmanovich D et al: CT of pulmonary emphysema--current status, challenges, and future directions. Eur Radiol. 19(3):537-51, 2009
                                          9. Weder W et al: Persistent benefit from lung volume reduction surgery in patients with homogeneous emphysema. Ann Thorac Surg. 87(1):229-36; discussion 236-7, 2009
                                          10. Bankier AA et al: CT quantification of pulmonary emphysema: assessment of lung structure and function. Crit Rev Comput Tomogr. 43(6):399-417, 2002
                                          11. Copley SJ et al: Thin-section CT in obstructive pulmonary disease: discriminatory value. Radiology. 223(3):812-9, 2002
                                          12. Sugi K et al: The outcome of volume reduction surgery according to the underlying type of emphysema. Surg Today. 31(7):580-5, 2001
                                          13. 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
                                          14. Slone RM et al: Preoperative and postoperative imaging in the surgical management of pulmonary emphysema. Radiol Clin North Am. 36(1):57-89, 1998
                                          15. Webb WR: Radiology of obstructive pulmonary disease. AJR Am J Roentgenol. 169(3):637-47, 1997
                                          16. Stern EJ et al: CT of the lungs in patients with pulmonary emphysema. Semin Ultrasound CT MR. 16(5):345-52, 1995
                                          17. Stern EJ et al: CT of the lung in patients with pulmonary emphysema: diagnosis, quantification, and correlation with pathologic and physiologic findings. AJR Am J Roentgenol. 162(4):791-8, 1994
                                          18. Stern EJ et al: Panlobular pulmonary emphysema caused by i.v. injection of methylphenidate (Ritalin): findings on chest radiographs and CT scans. AJR Am J Roentgenol. 162(3):555-60, 1994
                                          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

                                                    • Diagnostic Checklist

                                                      TERMINOLOGY

                                                      • Abbreviations

                                                        • Panlobular emphysema (PLE)
                                                        • α-1-antitrypsin deficiency (α1AD or AATD)
                                                      • Synonyms

                                                        • Panacinar emphysema
                                                      • Definitions

                                                        • Enlargement and destruction of entire acinus or secondary pulmonary lobule
                                                        • Acinus: Lung distal to terminal bronchiole
                                                          • Respiratory bronchioles → alveolar ducts → alveolar sacs → alveoli

                                                      IMAGING

                                                      • General Features

                                                        • Radiographic Findings

                                                          • CT Findings

                                                            • Nuclear Medicine Findings

                                                              • Imaging Recommendations

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    • Gross Pathologic & Surgical Features

                                                                      • Microscopic Features

                                                                        CLINICAL ISSUES

                                                                        • Presentation

                                                                          • Demographics

                                                                            • Natural History & Prognosis

                                                                              • Treatment

                                                                                DIAGNOSTIC CHECKLIST

                                                                                • Consider

                                                                                  Selected References

                                                                                  1. Martini K et al: Advances in imaging for lung emphysema. Ann Transl Med. 8(21):1467, 2020
                                                                                  2. Lynch DA et al: CT-based visual classification of emphysema: association with mortality in the COPDGene study. Radiology. 288(3):859-66, 2018
                                                                                  3. 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
                                                                                  4. van Agteren JE et al: Lung volume reduction surgery for diffuse emphysema. Cochrane Database Syst Rev. 10:CD001001, 2016
                                                                                  5. Lynch DA et al: CT-definable subtypes of chronic obstructive pulmonary disease: a statement of the Fleischner Society. Radiology. 277(1):192-205, 2015
                                                                                  6. Smith BM et al: Pulmonary emphysema subtypes on computed tomography: the MESA COPD study. Am J Med. 127(1):94.e7-23, 2014
                                                                                  7. Kukkonen MK et al: SERPINE2 haplotype as a risk factor for panlobular type of emphysema. BMC Med Genet. 12:157, 2011
                                                                                  8. Litmanovich D et al: CT of pulmonary emphysema--current status, challenges, and future directions. Eur Radiol. 19(3):537-51, 2009
                                                                                  9. Weder W et al: Persistent benefit from lung volume reduction surgery in patients with homogeneous emphysema. Ann Thorac Surg. 87(1):229-36; discussion 236-7, 2009
                                                                                  10. Bankier AA et al: CT quantification of pulmonary emphysema: assessment of lung structure and function. Crit Rev Comput Tomogr. 43(6):399-417, 2002
                                                                                  11. Copley SJ et al: Thin-section CT in obstructive pulmonary disease: discriminatory value. Radiology. 223(3):812-9, 2002
                                                                                  12. Sugi K et al: The outcome of volume reduction surgery according to the underlying type of emphysema. Surg Today. 31(7):580-5, 2001
                                                                                  13. 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
                                                                                  14. Slone RM et al: Preoperative and postoperative imaging in the surgical management of pulmonary emphysema. Radiol Clin North Am. 36(1):57-89, 1998
                                                                                  15. Webb WR: Radiology of obstructive pulmonary disease. AJR Am J Roentgenol. 169(3):637-47, 1997
                                                                                  16. Stern EJ et al: CT of the lungs in patients with pulmonary emphysema. Semin Ultrasound CT MR. 16(5):345-52, 1995
                                                                                  17. Stern EJ et al: CT of the lung in patients with pulmonary emphysema: diagnosis, quantification, and correlation with pathologic and physiologic findings. AJR Am J Roentgenol. 162(4):791-8, 1994
                                                                                  18. Stern EJ et al: Panlobular pulmonary emphysema caused by i.v. injection of methylphenidate (Ritalin): findings on chest radiographs and CT scans. AJR Am J Roentgenol. 162(3):555-60, 1994