This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Obstructive Lung Disease, Subject name: Pathology
All of the following statement are true regarding panacinar emphysema, except: 
Select and explain. 
A. It affects only bronchiole sparing the alveoli, B. It have tendency to occur more in lower zones and base of lung, C. It is associated with alpha-1 antitrypsin deficiency, D. It can cause clinically significant airflow obstruction
A: It affects only bronchiole sparing the alveoli
Answer: A: It affects only bronchiole sparing the alveoli 
Explanation: Panacinar (panlobular) emphysema. acini are uniformly enlarged from the level of the respiratory bronchiole to the terminal blind alveoli. tends to occur more commonly in the lower zones and in the anterior margins of the lung, and it is usually most severe at the bases. associated with a1-antitrypsin deficiency (autosomal recessive). associated with micronodular cirrhosis a1-anti-trypsin, normally present in serum, tissue fluids, and macrophages, is a major inhibitor of proteases (paicularly elastase) secreted by neutrophils during inflammation. a1-anti-trypsin is encoded by a gene in the proteinase inhibitor (Pi) locus on chromosome 14. Population with homozygous for the Z allele (PiZZ), a genotype that is associated with markedly decreased serum levels of a1-anti-trypsin and higher chance of emphysema.