What area of the lungs does centrilobar emphysema typically affect?

• A. Lower lobes
• B. Upper lobes
• C. Middle lobes
• D. All lobes equally

Answer: (B)

Centrilobar emphysema, also known as centriacinar emphysema, primarily affects the upper lobes of the lungs. This specific pattern is commonly associated with chronic bronchitis and is often seen in individuals with a long history of smoking. The damage in centrilobar emphysema occurs predominantly in the central part of the acinus, particularly affecting the respiratory bronchioles in the upper lobes.

The reason that centrilobar emphysema is localized to the upper lobes relates to the distribution of smoke exposure and the way the lungs respond to chronic irritation. Smoking tends to cause more injury to the upper parts of the lung because of the way air is circulated during breathing, leading to areas of increased dead space and ventilation-perfusion mismatch.

Understanding the specific regions affected by different types of emphysema is crucial for diagnosis and treatment, as it helps healthcare providers determine the likely cause and progression of the disease.