Hi thanks for contacting HCM.... You might have habit of smoking that lead such emphysema changes .... If no smoking look for diagnosis of alpha 1 antitrypsin deficiency by PCR test ..... For emphysema according to symptom management can be decided .. PFT needed to evaluate lung function and management ... You might needed ipratropium bromide like bronchodilator inhaler. ... If inflammation more short term steroid can be taken ... Pulmonary rehabilitation useful in emphysema ... If condition increasing than lung volume reduction surgery or lung transplantation like higher management needed. .. Avoid smoking .. Advise : consultation to pulmonologist Hope your concern solved ...