Chronic obstructive lung disease ( COPD) / Emphysema

Chronic obstructive lung disease ( COPD) / Emphysema
What is COPD?
• Emphysema, Chronic bronchitis and refractory asthma comprise COPD.
Describe the characteristic pathologic changes in emphysema.
• Destruction of septal walls of alveoli
• Loss of elastic recoil
• Destruction of vascular bed
• Fusion of adjacent alveoli producing large abnormal airspaces (blebs or bullae).
Chronic obstructive lung disease ( COPD) / Emphysema
What is COPD?
• Emphysema, Chronic bronchitis and refractory asthma comprise COPD.
Describe the characteristic pathologic changes in emphysema.
• Destruction of septal walls of alveoli
• Loss of elastic recoil
• Destruction of vascular bed
• Fusion of adjacent alveoli producing large abnormal airspaces (blebs or bullae).
What are the anticipated findings of COPD in CXR?
• Hyperinflation is the common finding in all three conditions presenting as COPD.
• Most of the times they are indistinguishable.
• Bullae and avascularity in the peripheral third of lung are findings in emphysema
What are the x-ray findings of emphysema?
• Lungs are large and hyper inflated.
• Signs of hyperinflation are
o Low set diaphragm
o Flat diaphragm best determined by lateral chest
o Hyper lucent lung fields
o Increased AP diameter
o Increased retro-sternal air
o Vertical heart
• Signs of hyperinflation can be seen in emphysema, chronic bronchitis and asthma.
• We can call it emphysema only when hyperinflation is associated with blebs and paucity of vascular markings in the outer third of the film.