Diagnosis
The diagnosis is usually confirmed by pulmonary function testing (e.g. spirometry or body plethysmography); however, X-ray radiography may aid in the diagnosis. Diffusing capacity of the lung for carbon monoxide (DLCO) may be tested to differentiate emphysema from other types of obstructive disorders such as chronic bronchitis and asthma. DLCO is a test that measures the ability of gases to diffuse across the alveolar-capillary membrane. DLCO will be decreased in emphysema, whereas it will be normal or increased in asthma and chronic bronchitis.
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H&E stained lung tissue of end-stage emphysema. RBCs are red, nuclei are purple, other material is pink, and air spaces are white.
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Micrograph demonstrating emphysema (left of image - large empty spaces) and lung tissue with relative preservation of the alveoli (right of image). H&E stain.
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Axial CT image of the lung of a person with end-stage bullus emphysema.
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A severe case of emphysema.
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Lung bulla as seen on CXR in a person with severe COPD
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