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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 = alveoli too large, thin septa (no interstitial thickening) | |||
| Subtypes = centriacinar (centrilobular) emphysema, panacinar (panlobular) emphysema, distal (paraseptal) acinar emphysema, irregular emphysema | |||
| 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-shaped chest | |||
| Symptoms = shortness of breath | |||
| Prevalence = common | |||
| Bloodwork = | |||
| Rads = hyperinflation, Saber-sheath trachea (associated with COPD) | |||
| 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]]. | ||
''Chronic obstructive pulmonary disease'', abbreviated ''COPD'', redirects here. | |||
==General== | ==General== | ||
*Usually due to [[smoking]]. | *Usually due to [[smoking]]. | ||
*Often lumped together with ''[[chronic bronchitis]]'' and called ''chronic obstructive pulmonary disease (COPD)''.<ref name=Ref_PCPBoD8_386>{{Ref PCPBoD8|368}}</ref> | *Often lumped together with ''[[chronic bronchitis]]'' and called ''chronic obstructive pulmonary disease (COPD)''.<ref name=Ref_PCPBoD8_386>{{Ref PCPBoD8|368}}</ref> | ||
*May cause [[pneumothorax]] - especially in young adults.<ref>{{Ref PPP|296}}</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> | 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]]. | ||
| Line 21: | Line 53: | ||
#Irregular emphysema - usu. insignificant. | #Irregular emphysema - usu. insignificant. | ||
* | Note: | ||
* | * Why does smoking lead to centriacinar emphysema? | ||
** The bad stuff from smoking gets enters the acinus at the centre; ergo, this is the location of the most damage. | |||
==Gross== | ==Gross== | ||
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*Bleb = (small) [[vesicle]].<ref>URL: [http://dictionary.reference.com/browse/bleb http://dictionary.reference.com/browse/bleb]. Accessed on: 3 August 2011.</ref> | *Bleb = (small) [[vesicle]].<ref>URL: [http://dictionary.reference.com/browse/bleb http://dictionary.reference.com/browse/bleb]. Accessed on: 3 August 2011.</ref> | ||
*Bulla = large vesicle.<ref>URL: [http://dictionary.reference.com/browse/bulla http://dictionary.reference.com/browse/bulla]. Accessed on: 3 August 2011.</ref> | *Bulla = large vesicle.<ref>URL: [http://dictionary.reference.com/browse/bulla http://dictionary.reference.com/browse/bulla]. Accessed on: 3 August 2011.</ref> | ||
===Images=== | |||
<gallery> | |||
Image:Centrilobular emphysema 865 lores.jpg |Centrilobular emphysema. (WC/Edwin Ewing Jr.) | |||
</gallery> | |||
===Radiology=== | |||
*''Saber-sheath trachea'' - a finding associated with ''COPD''.<ref name=pmid26912770>{{cite journal |authors=Tunsupon P, Dhillon SS, Harris K, Alraiyes AH |title=Saber-sheath trachea in a patient with severe COPD |journal=BMJ Case Rep |volume=2016 |issue= |pages= |date=February 2016 |pmid=26912770 |pmc=4769447 |doi=10.1136/bcr-2016-214648 |url=}}</ref> | |||
**Trachea's anterior to posterior dimension:left to right dimension is >2:1.<ref>{{cite journal |authors=Webb EM, Elicker BM, Webb WR |title=Using CT to diagnose nonneoplastic tracheal abnormalities: appearance of the tracheal wall |journal=AJR Am J Roentgenol |volume=174 |issue=5 |pages=1315–21 |date=May 2000 |pmid=10789785 |doi=10.2214/ajr.174.5.1741315 |url=}}</ref> | |||
*Barrel-shaped chest.<ref name=pmid30604704>{{cite journal |vauthors=Sarkar M, Bhardwaz R, Madabhavi I, Modi M |title=Physical signs in patients with chronic obstructive pulmonary disease |journal=Lung India |volume=36 |issue=1 |pages=38–47 |date=2019 |pmid=30604704 |pmc=6330798 |doi=10.4103/lungindia.lungindia_145_18 |url=}}</ref> | |||
==Microscopic== | ==Microscopic== | ||
| Line 44: | Line 87: | ||
==See also== | ==See also== | ||
*[[Medical lung diseases]]. | *[[Medical lung diseases]]. | ||
*[[Smoking]]. | |||
==References== | ==References== | ||