Panacinar emphysema affects the entire acinus uniformly and is classically associated with alpha-1 antitrypsin deficiency. In contrast, centriacinar (centrilobular) emphysema preferentially affects which part of the acinus and is most strongly associated with:
- A The respiratory bronchiole and surrounding alveoli; cigarette smoking ✓
- B The entire acinus; idiopathic cause
- C The alveolar ducts and sacs; dust inhalation
- D The alveolar septa; chronic heart failure
Correct answer: A. The respiratory bronchiole and surrounding alveoli; cigarette smoking
Explanation
Centriacinar (centrilobular) emphysema preferentially destroys the respiratory bronchioles and proximal alveoli (central portion of the acinus), sparing the peripheral alveolar sacs. It is predominantly caused by cigarette smoking, which leads to proteolytic damage (elastase release from neutrophils/macrophages) exceeding the protective capacity of alpha-1 antitrypsin in central acini. Panacinar emphysema involves the entire acinus and is characteristically seen in alpha-1 antitrypsin deficiency (ZZ phenotype).
Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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