CTICasesCentrilobular Emphysema Mimicking Lymphangioleiomyomatosis
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Imaging findings
High-resolution chest CT shows extensive, diffuse, lucent areas throughout both lungs. On thin-section imaging, these lucencies have imperceptible or completely absent walls, show a characteristic branching or "clover" shape, and are centered on central vascular dots representing the centrilobular arteries. No renal abnormalities are identified, and the serum VEGF-D level is normal. Surgical biopsy confirmed centrilobular emphysema.
Key takeaways
Centrilobular emphysema can occasionally mimic cystic lung diseases such as lymphangioleiomyomatosis (LAM), especially in female smokers. Key features distinguishing emphysema from true cysts on HRCT include the lack of defined walls, the presence of centrilobular arteries running directly through the lucent spaces, and the absence of systemic findings such as renal angiomyolipomas or elevated serum VEGF-D levels.
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