What is a feature of paraseptal emphysema?

• A. Involvement of the upper lobes
• B. Association with spontaneous pneumothorax
• C. Related to alpha-1 antitrypsin deficiency
• D. Resulting from long-term smoking

Answer: (B)

Paraseptal emphysema is characterized by the destruction of alveolar walls primarily affecting the areas adjacent to the interlobular septa, which often leads to the formation of blebs or bullae. One notable feature of paraseptal emphysema is its association with spontaneous pneumothorax. This happens because the bullae that form can rupture spontaneously, leading to the collapse of the lung and the consequent occurrence of a pneumothorax.

In contrast, the involvement of the upper lobes, while more common in other forms of emphysema such as centriacinar emphysema typically seen in smokers, is not characteristic of paraseptal emphysema. Likewise, paraseptal emphysema is not directly related to alpha-1 antitrypsin deficiency, which mainly causes panacinar emphysema. Long-term smoking is a significant risk factor for many types of emphysema, but paraseptal emphysema can occur independently of smoking history. Therefore, the correct answer reflects a unique clinical connection related to paraseptal emphysema and its potential complications.