Centrolobular Emphysema

Pathological Features

Centrolobular emphysema is a specific type of emphysema characterized by destruction of respiratory bronchioles, alveolar ducts, and alveoli at the center of the acinus, while surrounding alveoli remain intact, as described by the European Respiratory Journal 1, 2
CLE is one of the major patterns of emphysema, distinct from panacinar and paraseptal emphysema, with specific anatomical and functional consequences, according to the European Respiratory Journal and Thorax 1, 3
It primarily affects the central portion of the secondary pulmonary lobule, sparing the peripheral alveoli, as reported by the European Respiratory Journal and Thorax 2, 4
CLE is associated with more small airways disease and less loss of elastic recoil for any level of respiratory function compared to other emphysema types, as found by Thorax 4

Unlike panacinar emphysema, CLE has uneven destruction focused on the central portion of the lobule, as described by the European Respiratory Journal 1
Unlike paraseptal emphysema, CLE affects the central portions of the secondary lobule, as reported by the European Respiratory Journal and Thorax 1, 4

High-resolution CT scanning is sufficiently sensitive to diagnose emphysema patterns, including CLE, as stated by the European Respiratory Journal 5

Recognition of CLE on imaging is important for risk stratification and management planning in patients with COPD, as noted by Thorax 4