Centrilobular emphysema: Diagnosis, treatment, and outlook

Centrilobular emphysema is also called centriacinar emphysema. It is most common in people over the age of 50 with a history of smoking.

The term centrilobular means that the disease occurs in the center of the functional units of the lungs, called the secondary pulmonary lobules. In a different type of emphysema, called panlobular emphysema, the damage begins in tissues throughout the lungs simultaneously.

In this article, we take a look at the symptoms and stages of centrilobular emphysema as well as its diagnosis and treatment.


Centrilobular emphysema causes damage in the respiratory passages, and mainly affects the upper lobes in the centers of the functioning lung units. This damage can obstruct the flow of air from the lungs and make it difficult to breathe.

Symptoms of centrilobular emphysema can vary depending on the overall health of a person, but may include:

  • shortness of breath
  • difficulty performing regular tasks
  • persistent coughing
  • producing a lot of extra mucus or phlegm
  • wheezing
  • tightness in the chest
  • blueness in the lips and fingernails

Symptoms can be more apparent if there are additional complications, and they may get worse as the condition progresses.

It is not currently possible to reverse the damage that centrilobular emphysema does to the lung tissue. Treatment instead focuses on managing the symptoms as best as possible and slowing the progression of the disease.

Acute flares can cause the progression of emphysema to accelerate over time. These flares may be life-threatening and require hospitalization for treatment. Controlling the symptoms and preventing acute flares is essential in the treatment of emphysema.

Medical treatments vary based on the severity of the case but can include a few different options. Anyone needing treatment should discuss these options with a doctor.

Inhaled medicines

Doctors may prescribe corticosteroids in an inhaler. These steroids work to relieve symptoms by reducing inflammation in the lungs. They help prevent acute flares and make it easier to breathe.

A doctor may also prescribe bronchodilators. These medicines relax the bronchial muscles to dilate the airways and improve airflow in the lungs. They can be used for short-term relief but are also suitable for daily use as a long-term management option.

In some cases, people may need to take an inhaled medicine containing both a bronchodilator and a corticosteroid.

Oxygen supplementation

Some people may need to use a device to supplement the amount of oxygen they are getting into their body. An oxygen concentrator is a machine that takes in air and concentrates the oxygen in it before delivering it to the person via a cannula or mask. If this is still not enough, a doctor may recommend that a person uses an oxygen tank.

Additional treatments

Other treatment options include:

  • antibiotics to fight off any respiratory infections
  • vaccines to prevent infections
  • proper diet and nutrition
  • lung transplant or surgery to remove the damaged lung tissue

People with centrilobular emphysema may be at a higher risk of other medical conditions. These include:

  • Bronchitis or other respiratory tract infections.
  • Difficulties with the heart, as the pressure in the arteries can build up and cause the heart to swell and weaken.
  • Bullae, which are holes inside the lungs caused by abnormal air pockets. These holes can drastically reduce the space that a lung has to expand, and may even lead to lung collapse.
  • A collapsed lung, which occurs when air enters the space between the chest wall and lungs called the pleural space. This happens as a result of damage to lung tissue and may be a life-threatening complication.


In many cases, it is possible to prevent centrilobular emphysema by reducing exposure to toxins such as tobacco smoke and environmental pollutants, but there is no cure for the disease.

It is not possible to repair the damage that is already present, but treatment can help slow the progression of the condition and allow a person to use their existing lung capacity more efficiently.

Medical treatment should always be the priority following a centrilobular emphysema diagnosis. Catching the condition early on may improve a person’s outlook and make it easier to manage their symptoms.

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