Difference between revisions of "Emphysema"

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{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Emphysema_low_mag.jpg
| Width      =
| Caption    = Emphysematous changes. [[H&E stain]].
| Synonyms  =
| Micro      =
| Subtypes  =
| LMDDx      =
| Stains    =
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      = usually upper lobe predominant - blebs, bullae
| Grossing  =
| Site      = [[lung]]
| Assdx      = +/-pneumothorax
| Syndromes  = [[Alpha-1 antitrypsin deficiency]], others
| Clinicalhx = [[smoking]]
| Signs      = barrel chest
| Symptoms  = shortness of breath
| Prevalence = common
| Bloodwork  =
| Rads      = hyperinflation
| Endoscopy  =
| Prognosis  = dependent on underlying cause
| Other      =
| ClinDDx    =
| Tx        = stop smoking, bullectomy
}}
'''Emphysema''' is a common [[medical lung diseases|medical lung disease]] strongly associated with [[smoking]].
'''Emphysema''' is a common [[medical lung diseases|medical lung disease]] strongly associated with [[smoking]].


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Causes of emphysema other than smoking:<ref name=pmid12546267>{{Cite journal  | last1 = Lee | first1 = P. | last2 = Gildea | first2 = TR. | last3 = Stoller | first3 = JK. | title = Emphysema in nonsmokers: alpha 1-antitrypsin deficiency and other causes. | journal = Cleve Clin J Med | volume = 69 | issue = 12 | pages = 928-9, 933, 936 passim | month = Dec | year = 2002 | doi =  | PMID = 12546267 | URL = http://www.ccjm.org/cgi/pmidlookup?view=long&pmid=12546267 }}</ref>
Causes of emphysema other than smoking:<ref name=pmid12546267>{{Cite journal  | last1 = Lee | first1 = P. | last2 = Gildea | first2 = TR. | last3 = Stoller | first3 = JK. | title = Emphysema in nonsmokers: alpha 1-antitrypsin deficiency and other causes. | journal = Cleve Clin J Med | volume = 69 | issue = 12 | pages = 928-9, 933, 936 passim | month = Dec | year = 2002 | doi =  | PMID = 12546267 | URL = http://www.ccjm.org/cgi/pmidlookup?view=long&pmid=12546267 }}</ref>
*[[Alpha-1 antitrypsin deficiency]]
*[[Alpha-1 antitrypsin deficiency]].
*[[Connective tissue diseases]].
*[[Connective tissue diseases]].
**[[Marfan syndrome]].
**[[Marfan syndrome]].

Revision as of 18:03, 14 April 2014

Emphysema
Diagnosis in short

Emphysematous changes. H&E stain.
Gross usually upper lobe predominant - blebs, bullae
Site lung
Associated Dx +/-pneumothorax
Syndromes Alpha-1 antitrypsin deficiency, others
Clinical history smoking
Signs barrel chest
Symptoms shortness of breath
Prevalence common
Radiology hyperinflation
Prognosis dependent on underlying cause
Treatment stop smoking, bullectomy

Emphysema is a common medical lung disease strongly associated with smoking.

Chronic obstructive pulmonary disease, abbreviated COPD, redirects here.

General

Causes of emphysema other than smoking:[2]

Pathologic classification

Based on morphology:[3]

  1. Centriacinar (centrilobular) emphysema - associated with heavy smoking.
  2. Panacinar (panlobular) emphysema - associated with alpha-1 antitrypsin deficiency.
  3. Distal (paraseptal) acinar emphysema - associated with spontaneous pneumothorax.
  4. Irregular emphysema - usu. insignificant.
  • Q. Why does smoking lead to centriacinar emphysema?
  • A. The bad stuff from smoking gets enters the acinus at the centre; ergo, this is the location of the most damage.

Gross

  • Holes (blebs, bullae), usually upper lung field predominant.
  • Lungs may overlap the heart.[4]

Notes:

Microscopic

Features:[4]

  • Large alveoli.
  • Thin septa (no interstitial thickening).

Images

  • Emphysema. (WC)

See also

References

  1. ↑ Mitchell, Richard; Kumar, Vinay; Fausto, Nelson; Abbas, Abul K.; Aster, Jon (2011). Pocket Companion to Robbins & Cotran Pathologic Basis of Disease (8th ed.). Elsevier Saunders. pp. 368. ISBN 978-1416054542.
  2. ↑ Lee, P.; Gildea, TR.; Stoller, JK. (Dec 2002). "Emphysema in nonsmokers: alpha 1-antitrypsin deficiency and other causes.". Cleve Clin J Med 69 (12): 928-9, 933, 936 passim. PMID 12546267.
  3. ↑ Mitchell, Richard; Kumar, Vinay; Fausto, Nelson; Abbas, Abul K.; Aster, Jon (2011). Pocket Companion to Robbins & Cotran Pathologic Basis of Disease (8th ed.). Elsevier Saunders. pp. 368. ISBN 978-1416054542.
  4. ↑ 4.0 4.1 Mitchell, Richard; Kumar, Vinay; Fausto, Nelson; Abbas, Abul K.; Aster, Jon (2011). Pocket Companion to Robbins & Cotran Pathologic Basis of Disease (8th ed.). Elsevier Saunders. pp. 369. ISBN 978-1416054542.
  5. ↑ URL: http://dictionary.reference.com/browse/bleb. Accessed on: 3 August 2011.
  6. ↑ URL: http://dictionary.reference.com/browse/bulla. Accessed on: 3 August 2011.
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