EMPHYSEMA, A - CENTRILOBULAR (UPPER ZONES); AND B - PANACINAR (LOWER ZONES) - In centrilobular emphysema only the central or proximal portions of the respiratory lobule (respiratory bronchial) is involved. The distal alveoli are spared. It usually involves the upper lobe and is the most common type of emphysema. Associated with smoking and coal dust. In panacinar (panlobular) emphysema, there is involvement of the complete respiratory lobule (all alveoli are involved of a respiratory lobule). Typically involves the lower zones and anterior margins of the lung. Associated with alpha 1-antitrypsin deficiency.
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