G. Wayne Silvers

Are centrilobular emphysema and panlobular emphysema two different diseases

Abstract The study of the pathogenesis of emphysema would be substantially aided if two types of emphysema, centrilobular and panlobular, could be clearly identified as separate diseases with separate pathogeneses. A study was therefore undertaken to test observer agreement on emphysema typing and to determine whether clinical or radiologic differences between these two types could be identified. Emphysema typing was found to be more difficult than the published literature indicates. This experience re-emphasizes previous findings that emphysema is often mixed in type, and that a common source of disagreement in typing is the relative weight given to each type. Only one previously published difference between centrilobular and panlobular emphysema is confirmed: the former tends to be located predominantly in the upper lung whereas the latter does not. It cannot be concluded from our data that the two types either do or do not constitute separate diseases. The difference in predominant location is in favor of such a distinction but all other findings suggest no distinction.

The Pathogenesis of Chronic Airway Obstruction.

Excerpt Between 1959 and 1968 special studies were made of the lungs from 500 autopsied subjects—mostly men and all over 40 year old—with and without chronic airway obstruction. Attention was focus...