Panacinar emphysema (involving the entire acinus from respiratory bronchiole to alveolar sac) is characteristically associated with:

• A Cigarette smoking causing predominantly centriacinar emphysema in upper lobes
• B Alpha-1 antitrypsin deficiency causing lower lobe predominant panacinar emphysema ✓
• C Intravenous drug use causing scar emphysema around healed granulomas
• D Compensatory hyperinflation of adjacent lung after lobectomy

Explanation

Alpha-1 antitrypsin (AAT) deficiency classically causes panacinar emphysema predominantly in the lower lobes. Absence of AAT allows uninhibited neutrophil elastase and other proteases to destroy the entire acinus. Smoking-related emphysema is centriacinar (centrilobular), affecting the respiratory bronchioles of the upper lobes first.

Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.