Emphysema happens when the small air sacs in your lungs become damaged. There are three types of emphysema, which are categorized based on the appearance of lung damage as seen on imaging.
Emphysema is a form of chronic obstructive pulmonary disease (COPD), a condition that occurs due to lung damage. The American Lung Association estimates that emphysema affects over three million people in the United States.
There are three different types of emphysema. These types are divided up based on the pattern of the lung damage seen through imaging.
Continue reading to discover more about the different types of emphysema. We’ll also cover what causes emphysema, how this lung condition is treated, and its outlook.
Emphysema is a form of COPD that involves damage to the small air sacs in your lungs (alveoli). The alveoli are where fresh oxygen enters your bloodstream while carbon dioxide, a waste gas, moves out.
Normally, the alveoli are stretchy and inflate like tiny balloons when you inhale, deflating when you exhale. However, in emphysema, the walls of the alveoli have become damaged and lose their elasticity. This causes them to become larger.
The effects of emphysema lead to stale air becoming trapped in your lungs. This not only makes it hard to breathe, but also means that oxygen cannot as readily enter your bloodstream.
There are three different types of emphysema. These are characterized based on how the lung damage looks using imaging like X-ray or CT scan.
Centrilobular emphysema
Centrilobular emphysema is the
The lungs are divided into lobes, with your right lung having three lobes and your left having two. The lobes are further divided into segments, with segments being divided into lobules.
Lobules are the smallest subdivision of your lungs that can be seen with your naked eye. They’re the functional units of the lungs where oxygen and carbon dioxide are exchanged.
In centrilobular emphysema, lung damage is present at the center of the lobule. This area of damage is surrounded by regular lung tissue.
Some research suggests that centrilobular emphysema is associated with a higher degree of trapped air compared to other emphysema types.
Panlobular emphysema
In panlobular emphysema, damage is found throughout the lobule. This is in contrast to centrilobular emphysema where damage is at the center of the lobule.
While panlobular emphysema can impact all lobes of the lungs, damage from this type of emphysema is often more severe at the bottom of the lungs.
Panlobular emphysema is associated with alpha-1 antitrypsin (AAT) deficiency. This is a rare genetic condition that boosts the risk of disease of the lungs, liver, and skin. Emphysema due to AAT deficiency often comes on at an earlier age.
Paraseptal emphysema
Paraseptal emphysema is also associated with lung damage from smoking and mainly impacts the upper lobes of the lungs. It typically occurs along with other types of emphysema.
Damage from paraseptal emphysema is found in the outer part of the lobule, close to the septa and pleura. Septa are the divisions between lung lobules. The pleura are fluid-filled sacs that surround and cushion the lungs.
Based off of its location, paraseptal emphysema increases the risk of experiencing a collapsed lung (pneumothorax).
Smoking is the most common cause of emphysema overall. In fact,
Other potential causes of emphysema include:
- long-term exposure to:
- air pollution
- dust
- alpha-1 antitrypsin deficiency
Both centrilobular and paraseptal emphysema are most often caused by smoking, while panlobular emphysema is often linked to AAT deficiency.
Emphysema is often treated with medications. These are typically taken via an inhaler or nebulizer containing a bronchodilator, a corticosteroid, or both.
Bronchodilators help to open the airways, alleviating symptoms like cough and shortness of breath. Corticosteroids reduce inflammation in the airways.
Other treatments for emphysema include:
- oral corticosteroids
- oral roflumilast (Daliresp), which also helps to relax airways and lower inflammation
- pulmonary rehabilitation
- supplemental oxygen
- surgery
- lung transplant
Lifestyle adjustments like quitting smoking if you do smoke, staying physically active, and eating a healthy diet can also make managing emphysema easier.
The outlook for emphysema depends on several factors, such as:
- the severity of your emphysema
- whether or not you have other co-occurring health conditions, called comorbidities, such as cardiovascular disease, high blood pressure, or diabetes
- how well your emphysema is managed
- your age and overall health
Although research is limited, it’s possible that emphysema type may influence outlook. For instance, some research suggests that panlobular emphysema is linked to a greater amount of airway obstruction, higher extent of emphysema, and worse respiratory symptoms and quality of life.
Emphysema is a form of COPD where the alveoli in your lungs become damaged and enlarged. This traps in stale air and makes it harder to get fresh oxygen into your lungs.
There are three types of COPD. They’re categorized based on how the lung damage looks using imaging technology. Centrilobular emphysema is the most common type of emphysema.
While there’s no cure for emphysema, it is treatable. Outlook depends on factors like emphysema severity, other health conditions, and your age and overall health.