Which option best defines panacinar emphysema distribution?

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Panacinar emphysema involves uniform destruction of the entire acinus, from the respiratory bronchioles through the alveolar ducts and alveoli. This means every part of the acinus is affected, not just a subset. That defining spread is why the best description is “affects all parts of the acinus.” While panacinar disease is often more pronounced in the lower lungs, the key feature is the involvement of the entire acinar unit, unlike centrilobular emphysema (central acinar involvement) or patterns limited only to the respiratory bronchioles. The other descriptions describe restricted or localized involvement that doesn’t match the full acinar distribution.