Student SYB Chet Cunha MS IV January 29, 2009

History 35 y/o M complaining of dyspnea on exertion. Has had DOE x 5 years, but has recently worsened. Smokes 2ppd x 19yrs

CT Chest

Alpha 1-antitrypsin deficiency CXR Radiographic findings Loss of lung markings

Alpha 1-antitrypsin deficiency CT Radiographic findings Panacinar emphysema predominantly involving the lower lung fields Simplification of lung architecture (normal lung structures are replaced by abnormal airspaces) Diffuse cystic bronchiectasis Ground glass opacities

Alpha 1-antitrypsin deficiency Treatment Options Supplemental O2 Inhaled Beta agonists and corticosteroids Alpha 1-antitrypsin replacement therapy Lung volume reduction surgery Lung transplantation

Further Reading Gourtsoyiannis, N.C., Ros, P.R. Radiologic-Pathologic Correlations from Head to Toe. Springer Publishing, Berlin Grossman, Z.D., Katz, D. S., et al. Cost-Effective Diagnostic Imaging. Mosby Elsevier, Philadelphia, CXR image courtesy of eMedicine

Thank you!