The lungs are hyperinflated and the diaphragms are markedly flattened, especially
on the lateral view. There are numerous lucent “holes” in the lungs and the
vessels are displaced and asymmetrical.
Air trapping is present, especially in multiple bullae with thin walls. These
are the findings of bullous emphysema. Most such patients have COPD, the most
common of all airway diseases.
A few emphysematous patients have normal airways, with abnormal elasticity of
alveolar walls, such as in alpha one antitrypsin deficiency.
COPD with bullous emphysema
