Panlobular emphysema at lung apex?
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Panlobular emphysema at lung apex?
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Hello everyone. I'm studying COPD for my Pneumology exam and among my notes I've just read that panlobular emphysema in AAT deficiency is more severe at the lung apex as the blood flow is reduced (les
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Forums » Open clinical » Respiratory medicine » Panlobular emphysema at lung apex?
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Panlobular emphysema at lung apex?
posted at 8/7/2012 10:41 AM BST
on bmj.com
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Posts: 51
First: 2/8/2010 Last: 8/7/2012 |
Hello everyone. I'm studying COPD for my Pneumology exam and among my notes I've just read that panlobular emphysema in AAT deficiency is more severe at the lung apex as the blood flow is reduced (less AAT) and ventilation is maximal (more polluting agents). In Robbins I can read exactly the opposite, i.e. in this case lesions are more severe at the bases. I obviously trust my textbook more than my notes but there is no explanation of the reasons of this and I can't think of many at the moment. May it be that at the bases there is less AAT but also more trypsin as there is more blood flow? Can anybody give me a clue? Thanks a lot! |
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Re: Panlobular emphysema at lung apex?
posted at 8/7/2012 3:37 PM BST
on bmj.com
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Posts: 3031
First: 27/3/2012 Last: 11/5/2013 |
Yes, the Robbins textbook description is surely accurate. Pan-lobular emphysema affects the entire secondary pulmonary lobule and is more pronounced in the lower zones, matching areas of maximal blood flow. It is seen particularly in alpha-1-antitrypsin (AAT) deficiency (exacerbated by smoking), intravenous injection of methylphenidate (Ritalin lung) or Swyer-James syndrome. |
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Re: Panlobular emphysema at lung apex?
posted at 10/7/2012 3:41 PM BST
on bmj.com
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Posts: 1177
First: 19/4/2010 Last: 16/5/2013 |
Yup - AAT usually causes basal emphysema, and bronchiectasis. But never say never, and never say always, so you can sometimes see anywhere. But characteristically it's bi basal. |
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