Pathologically Confirmed, Early-onset, Severe Chronic Obstructive Pulmonary Disease

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A 27-year-old man who had been a smoker since 14 years of age presented with exertional dyspnea. Approximately three years earlier, he had been occupationally been exposed to an organic solvent and felt dyspnea during its use. He later developed severe dyspnea and received treatment for asthma. He had no relevant family history. Chest auscultation revealed decreased breath sounds without rales. Spirometry and high-resolution computed tomography scans suggested a diagnosis of chronic obstructive pulmonary disease (COPD). Video-assisted thoracoscopic surgery performed to obtain a pathological diagnosis confirmed the presence of centrilobular emphysema. High susceptibility, smoking from an early age and organic solvent exposure may have caused early-onset COPD in this case.