Subjective imaging analysis was done by one experienced thoracic radiologist, blinded to the patients' clinical data, who identified the following characteristics on HRCT: presence or absence and degree (mild, moderate, severe) of emphysema, types of emphysema (centrilobular, panlobular
, paraseptal), presence or absence of airway disease (wall thickening, irregularity, airway opacities), presence or absence of air trapping on expiratory images, and presence or absence of bronchiectasis.
High-resolution computer tomography revealed centrilobular and panlobular
emphysema in the upper lobes and bilateral fibrotic changes in the basal segments of the lower lobes with sporadic honeycombing (Figures 3 and 4).
For calculation of accuracy there are four classes designed: normal tissue (NT), centrilobular emphysema (CLE), paraseptal emphysema (PSE), and panlobular
Although excess risk is not established for MZ never-smokers, group mean lung function differences can hide the clinical observation that some MZ individuals present at a young age with panlobular
emphysema similar to ZZ (classic, severe) AATD .
Chest computed tomography (CT) scans (Figure 1) revealed pulmonary infiltrates along the bronchovascular bundles and panlobular
ground-glass opacities in both lungs.
Histologic sections of the liver biopsy were notable for a predominantly lymphohistiocytic panlobular
inflammatory infiltrate accompanied by swaths of parenchymal dropout (Figures 2(a) and 2(b)).
Cigarette smoking can result in either panlobular
emphysema (PLE) or centrilobular emphysema (CLE), and the latter shows worse remodeling and narrowing of small airways, which can result in the airflow obstruction similar to asthma.
D-GaIN caused panlobular
focal necrosis and periportal inflammation, which was accompanied by an inflammatory infiltrate of predominantly polymorph nuclear cells with a few lymphocytes and swollen macrophages (Robert et al., 1999).
Deep wedge incisional biopsies taken from the left thigh nodule and calf showed panlobular
infarction of subcutaneous fat with extensive mural calcification of small and medium sized vessels within the pannus, with luminal occlusion (Figure 2).
The liver histology was notable for submassive necrosis with portal, periportal, and panlobular
inflammation with lymphocytes, numerous neutrophils, plasma cells, and few eosinophils (Figures 1(a) and 1(b)).
Emphysema may be classified into various types, based on the pattern of lung parenchyma destruction with respect to the secondary pulmonary lobule: proximal acinus in centriacinar (centrilobular) emphysema and distal in paraseptal and whole acinus in panacinar (panlobular
In 1952, Gough (5) used paper-mounted sections to describe what he termed "fundamentally different" types of emphysema, types that we now know as centriacinar (centrilobular) and panacinar (panlobular