Hong Kong Respiratory Medicine

Wayne Mitzner. N Engl J Med 2011; 365:1637-1639，October 27, 2011

In 1984, the Division of Lung Diseases at the National Heart, Lung, and Blood Institute funded a workshop that led to what is still the basis for most definitions of emphysema: “a condition of the lung characterized by abnormal, permanent enlargement of airspaces distal to the terminal bronchiole, accompanied by the destruction of their walls, and without obvious fibrosis.”¹ In this issue of the Journal, McDonough et al.² report findings that seem to challenge this definition — namely, the extensive obliteration of terminal bronchioles in patients with chronic obstructive pulmonary disease (COPD) who have emphysema. Indeed, when most people hear . . .

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