CXR in AAT

Q: Emphysematous bullae are predominantly present in ___________ region in alpha-1 antitrypsin (AAT) deficiency? (select one)

A) apical

B) basilar

Answer: B

Although not a rule, classically, CXR in AAT shows basilar predominant emphysematous bullae. This leads to redistribution of vascular flow to less involved upper lobes. 

CXR shows markedly visible hyper-expansion with paucity of vascular structures at the bases.

#pulmonary

#radiology

Reference:

Huang YT, Wencker M, Driehuys B. Imaging in alpha-1 antitrypsin deficiency: a window into the disease. Ther Adv Chronic Dis. 2021 Jul 29;12_suppl:20406223211024523. doi: 10.1177/20406223211024523. PMID: 34408834; PMCID: PMC8367205.