Which pattern of emphysema is characteristic of alpha-1 antitrypsin deficiency?

Which pattern of emphysema is characteristic of alpha-1 antitrypsin deficiency?

• A. Centrilobular
• B. Irregular
• C. Panacinar
• D. Paraseptal

Answer: (C)

Alpha-1 antitrypsin deficiency removes a protective brake on elastase, so elastases from neutrophils destroy elastic tissue across the entire acinus. This causes uniform, widespread enlargement of airspaces throughout the lungs—panacinar emphysema. It’s often basilar-predominant and can present younger than smoking-related disease. Other patterns reflect different processes: centrilobular emphysema from smoking affects the proximal acinus and upper lungs, paraseptal emphysema involves distal units along septa near the pleura, and irregular emphysema arises from scarring.

Alpha-1 antitrypsin deficiency removes a protective brake on elastase, so elastases from neutrophils destroy elastic tissue across the entire acinus. This causes uniform, widespread enlargement of airspaces throughout the lungs—panacinar emphysema. It’s often basilar-predominant and can present younger than smoking-related disease. Other patterns reflect different processes: centrilobular emphysema from smoking affects the proximal acinus and upper lungs, paraseptal emphysema involves distal units along septa near the pleura, and irregular emphysema arises from scarring.