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Paraseptal Emphysema
Allen Heeger, DO
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Paraseptal emphysema (PSE)
              • Synonyms

                • Distal acinar emphysema
              • Definitions

                • Destruction located in lung periphery adjacent to pleura or along interlobular septa
                • Permanently enlarged distal airspaces with destruction
                • Bulla: Dilated airspace measuring > 1 cm
                  • Bullae: Circumscribed, thin-walled, coalescent destroyed acini
                • Vanishing lung syndrome: Severe PSE and large bullae (> 1/3 of hemithorax) compression of adjacent lung

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Martini K et al: Advances in imaging for lung emphysema. Ann Transl Med. 8(21):1467, 2020
                                        2. Hochhegger B et al: Pulmonary acinus: understanding the computed tomography findings from an acinar perspective. Lung. 197(3):259-65, 2019
                                        3. Copeland CR et al: Paratracheal paraseptal emphysema and expiratory central airway collapse in smokers. Ann Am Thorac Soc. 15(4):479-84, 2018
                                        4. Lynch DA et al: CT-based visual classification of emphysema: association with mortality in the COPDGene study. Radiology. 288(3):859-66, 2018
                                        5. Mouronte-Roibás C et al: Influence of the type of emphysema in the relationship between COPD and lung cancer. Int J Chron Obstruct Pulmon Dis. 13:3563-70, 2018
                                        6. Corrections. Lancet Respir Med. 4(11):e55, 2016
                                        7. van Agteren JE et al: Lung volume reduction surgery for diffuse emphysema. Cochrane Database Syst Rev. 10:CD001001, 2016
                                        8. Araki T et al: Paraseptal emphysema: prevalence and distribution on CT and association with interstitial lung abnormalities. Eur J Radiol. 84(7):1413-8, 2015
                                        9. Lynch DA et al: CT-definable subtypes of chronic obstructive pulmonary disease: a statement of the Fleischner Society. Radiology. 277(1):192-205, 2015
                                        10. Smith BM et al: Pulmonary emphysema subtypes on computed tomography: the MESA COPD study. Am J Med. 127(1):94.e7-23, 2014
                                        11. Litmanovich D et al: CT of pulmonary emphysema--current status, challenges, and future directions. Eur Radiol. 19(3):537-51, 2009
                                        12. Satoh K et al: CT assessment of subtypes of pulmonary emphysema in smokers. Chest. 120(3):725-9, 2001
                                        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

                                                      • Paraseptal emphysema (PSE)
                                                    • Synonyms

                                                      • Distal acinar emphysema
                                                    • Definitions

                                                      • Destruction located in lung periphery adjacent to pleura or along interlobular septa
                                                      • Permanently enlarged distal airspaces with destruction
                                                      • Bulla: Dilated airspace measuring > 1 cm
                                                        • Bullae: Circumscribed, thin-walled, coalescent destroyed acini
                                                      • Vanishing lung syndrome: Severe PSE and large bullae (> 1/3 of hemithorax) compression of adjacent lung

                                                    IMAGING

                                                    • General Features

                                                      • Radiographic Findings

                                                        • CT Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Microscopic Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Martini K et al: Advances in imaging for lung emphysema. Ann Transl Med. 8(21):1467, 2020
                                                                              2. Hochhegger B et al: Pulmonary acinus: understanding the computed tomography findings from an acinar perspective. Lung. 197(3):259-65, 2019
                                                                              3. Copeland CR et al: Paratracheal paraseptal emphysema and expiratory central airway collapse in smokers. Ann Am Thorac Soc. 15(4):479-84, 2018
                                                                              4. Lynch DA et al: CT-based visual classification of emphysema: association with mortality in the COPDGene study. Radiology. 288(3):859-66, 2018
                                                                              5. Mouronte-Roibás C et al: Influence of the type of emphysema in the relationship between COPD and lung cancer. Int J Chron Obstruct Pulmon Dis. 13:3563-70, 2018
                                                                              6. Corrections. Lancet Respir Med. 4(11):e55, 2016
                                                                              7. van Agteren JE et al: Lung volume reduction surgery for diffuse emphysema. Cochrane Database Syst Rev. 10:CD001001, 2016
                                                                              8. Araki T et al: Paraseptal emphysema: prevalence and distribution on CT and association with interstitial lung abnormalities. Eur J Radiol. 84(7):1413-8, 2015
                                                                              9. Lynch DA et al: CT-definable subtypes of chronic obstructive pulmonary disease: a statement of the Fleischner Society. Radiology. 277(1):192-205, 2015
                                                                              10. Smith BM et al: Pulmonary emphysema subtypes on computed tomography: the MESA COPD study. Am J Med. 127(1):94.e7-23, 2014
                                                                              11. Litmanovich D et al: CT of pulmonary emphysema--current status, challenges, and future directions. Eur Radiol. 19(3):537-51, 2009
                                                                              12. Satoh K et al: CT assessment of subtypes of pulmonary emphysema in smokers. Chest. 120(3):725-9, 2001