What are the two basic classifications of emphysema?


The two basic classifications of emphysema are panlobular and centrilobular.

  • The panlobular form involves a destruction of the respiratory bronchiole, alveolar duct, and alveoli. Air spaces are usually enlarged and the individual usually shows symptoms of labored breathing. Pulmonary hypertension, in which the individual’s blood pressure may increase due to the breakdown of surrounding capillaries and shifting of blood flow to the more normal lung areas, may occur.
  • In the centrilobular type, changes in the lung are restrictive to the central portion of the second lobule. Hypoxia (a reduction of oxygen in the body tissues), hypercapnia (an excess of carbon dioxide in the blood), and polycythemia (a large increase in the red cell mass of the blood) may be produced by the ventilation/perfusion ratios that are negatively affected by the condition. Persons with centrilobular emphysema generally produce excessive mucus secretions, and have a chronic and conspicuous cough accompanied by wheezing. The mucus restricts airflow, which in turn reduces oxygenation of the blood, resulting in polycythemia. This person may also exhibit a bluish discoloration of his or her skin and mucus membranes (cyanosis), peripheral edema, and respiratory failure. These individuals may be referred to as “blue bloaters.”


Deutsch. “Chronic Obstructive Pulmonary Disease.” In P. Deutsch and H. Sawyer (Ed.) A Guide to Rehabilitation. White Plains, NY: AHAB Press.

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