Because respiratory bronchioles are generally clustered in the center of the secondary lobule, their destruction (proximal acinar destruction) is seen as a hole in the center of the lobule, and hence the synonym centrilobular emphysema
Pulmonary edema superimposed on background centrilobular emphysema
High- resolution computed tomography of inflation-fixed lungs: pathologic-radiologic correlation of centrilobular emphysema
In addition to the 78 patients from the lung cancer prevention study, the researchers collected data on four deceased patients who each donated a lung for transplantation (controls), four patients with centrilobular emphysema
who each donated a lung, and eight patients with panlobular emphysema who donated 10 lungs after lung transplantation.
Kawabata et al (2) described pathologic changes, termed airs-pace enlargement with fibrosis, some of which are the same thing (although they also appear to be including examples of centrilobular emphysema
with fibrosis in the emphysematous space, which is not the same thing), in lungs from smokers; the incidence of the lesion increased with amount of smoking and was present in 21% of the heaviest smokers.