<prompt> Alpha -1 antitrypsin deficiency occurs inEmphysemaBronchiectasisEmpyemaBrochogenic carcinoma  <response>: Emphysema:Irreversible enlargement of airspaces distal to terminal bronchioles accompanied by destruction of their walls.Types: Centriacinar Common, panacinar, paraseptal and irregular.Panacinar emphysema is associated with a1-antitrypsin deficiency, which is an inhibitor of proteases secreted by neutrophils during inflammation. In a1-antitrypsin deficiency individuals, any stimulus like smoking that increases neutrophils in the lung causes an uninhibited destruction of lungs by proteases causing emphysema.Ref: Robbins 8e p684 