What Is Centrilobular Emphysema? Everything to Know

Medically Reviewed By Adithya Cattamanchi, M.D.
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Centrilobular emphysema, or centriacinar emphysema, is a type of chronic obstructive pulmonary disease (COPD). It is a lung disease that gets worse over time. Emphysema affects the air sacs in the lungs where the oxygen and carbon dioxide exchange occurs. The air sacs are called alveoli.

In healthy lungs, the alveoli are elastic and stretch like balloons when you breathe. Long-term exposure to irritants such as cigarette smoke can cause the air sacs to lose shape and become “floppy.”

Read on to find out more about centrilobular emphysema. This guide includes information about symptoms, causes, treatments, and more.

What are the symptoms of centrilobular emphysema?

A person has their hand on their chest.
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Symptoms of centrilobular emphysema may include:

  • wheezing
  • chest tightness
  • broad barrel chest
  • frequent coughing with mucus
  • shortness of breath, especially with activity
  • stridor, or high-pitched squeaky noises when you breathe
  • frequent respiratory infections, including colds and flues

The symptoms of emphysema may worsen over time.

In mild or early phases, your face may appear pink or red, according to 2022 research. In more severe cases, it may take on a bluish hue, called cyanosis, as a result of a lack of oxygen in the body’s tissues and cells, according to experts.

Other symptoms of severe emphysema include: 

  • weight loss
  • rapid breathing
  • pursed-lip breathing
  • swelling in your feet and legs
  • lower extremity muscle weakness

Learn more about respiratory symptoms.

What causes centrilobular emphysema?

Centrilobular emphysema results from long-term exposure to lung irritants, which damage the airways and alveoli.
 
In the United States, the leading cause of centrilobular emphysema is cigarette smoking. According to the Centers for Disease Control and Prevention (CDC), 50-70% of people with COPD smoke.

It is important to note that not everybody with emphysema smokes. Long-term exposure to other irritants can also cause the condition to develop.

Examples of other lung irritants include:

  • second-hand smoke
  • chemical fumes
  • dust
  • exhaust fumes
  • air pollution

Learn more about the causes of COPD.

What are the treatments for centrilobular emphysema?

Centrilobular emphysema is a progressive disease, and there is no known cure. Treatments focus on alleviating symptoms, slowing disease progression, and improving functioning and quality of life.

Medical treatments

Your doctor may recommend medications and other medical treatments to help you to ease and manage your symptoms.

Medications your doctor may prescribe include:

  • bronchodilators to relax the muscles in your airways
  • steroids to reduce inflammation
  • antibiotics for bacterial or viral lung infections, which can occur frequently in people with emphysema

Your doctor may also recommend flu and pneumococcal pneumonia vaccines. This is because individuals with emphysema are at higher risk of complications from those conditions. Find out about how the flu vaccine works.

Other treatments your doctor may recommend include:

  • oxygen therapy to make breathing easier
  • pulmonary rehabilitation or physical exercise therapy
  • therapy or counseling to help you to manage symptoms and changes in your mental health

Surgery

Your doctor may recommend surgery in severe cases if your symptoms do not respond to other treatments.

Surgery may involve:

  • removing the damaged lung tissue
  • removing large air spaces that can affect breathing
  • performing a lung transplant, in very severe cases

Your doctor will be able to advise you on whether surgery is the best option for you.

Lifestyle changes

Your doctor may recommend certain lifestyle changes to help your symptoms. These can include:

  • quitting smoking, if you smoke
  • eating a healthy, balanced diet
  • getting enough regular exercise
  • avoiding places with smoke or other irritants

When should I see a doctor?

Contact your doctor if you have concerns about centrilobular emphysema or if you experience any related symptoms.

You should also contact your doctor if your symptoms worsen or if you develop signs of an infection, such as fever or chills.

Seek immediate medical help if you have severe breathing difficulties.

How do doctors diagnose centrilobular emphysema?

To assist with reaching an accurate diagnosis, your doctor may take a full medical history and carry out a physical examination. They may then order tests to help with identifying the cause of your symptoms.

Tests your doctor may arrange include:

  • lung function or breathing tests
  • computed tomography scan
  • chest X-ray

Your doctor will be able to explain what the tests involve and answer any questions you may have.

What are the risk factors for centrilobular emphysema?

Risk factors for centrilobular emphysema include:

  • Smoking: Around 50–70% of people with emphysema and other types of COPD smoke or have smoked.
  • Long-term exposure to lung irritants: Exposure to environmental or workplace lung irritants can lead to emphysema over time.
  • Age: The majority of people with emphysema are 40 years old or over when they first experience symptoms.
  • Genetics: If someone in your family has COPD, you have an increased risk of developing emphysema.
  • Exposure to smoke and cooking fires: Open cooking fires and frequently cooking in areas that are not well ventilated can cause lung irritation, 2022 research suggests.

Contact your doctor if you have concerns about the risk factors of centrilobular emphysema.

What are the complications of centrilobular emphysema?

People with emphysema are more than twice as likely to develop aneurysms. An aneurysm is a weakness in the wall of a blood vessel that causes the wall to bulge.

According to experts, other possible complications of centrilobular emphysema include:

Can I prevent centrilobular emphysema?

Since lung irritants cause centrilobular emphysema, avoiding these irritants is the best way to prevent it.

Steps you can take to reduce your risk of centrilobular emphysema include:

  • avoiding smoking
  • avoiding areas with heavy air pollution
  • wearing proper protective equipment when working with irritants
  • cooking in well-ventilated areas when using open cooking fires

Centrilobular vs. panlobular emphysema: What is the difference?

Centrilobular emphysema and panlobular emphysema are both types of COPD.

While centrilobular emphysema typically affects the upper lobes of the lungs, panlobular emphysema tends to affect the lower lobes, according to 2016 research.

Smoking is the most common cause of centrilobular emphysema.

Smoking and exposure to lung irritants can also cause panlobular emphysema. Other possible causes include:

  • crushed methylphenidate injected intravenously
  • Swyer-James syndrome
  • aging

Having alpha-1 antitrypsin deficiency increases your risk of panlobular emphysema.

A third type of emphysema is paraseptal emphysema. It usually affects the upper lobes, per 2020 research.

Summary

Centrilobular emphysema is a lung disease that occurs as a result of lung irritation. Long-term exposure to irritants damages and destroys the air sacks in the lungs where oxygen and carbon dioxide exchange occurs. The most common cause of centrilobular emphysema is cigarette smoking. 

Symptoms of centrilobular emphysema include shortness of breath, wheezing, and a broad barrel chest.
 
Most people who develop emphysema are over age 40. Contact your doctor if you have concerns about centrilobular emphysema. They will be able to carry out tests to reach an accurate diagnosis and advise on any treatments they recommend.

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Medical Reviewer: Adithya Cattamanchi, M.D.
Last Review Date: 2022 Sep 9
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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  2. Clinical overview, appendix A: Emphysema and chronic bronchitis. (2020). https://www.cdc.gov/niosh/learning/b-reader/clinical/appendix/2.html
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