Kinoshita Y, et al. - In clinically diagnosed patients with idiopathic pulmonary fibrosis (IPF) and coexisting emphysema, researchers studied the intrapulmonary distribution of fibrosis and emphysema. Among 40 IPF patients who were autopsied or pneumonectomised for lung transplantation from 1993 to 2018, 19 patients with IPF and coexisting emphysema were retrospectively selected based on the chest computed tomography appearance (IPF patients with emphysema). The intrapulmonary distribution of emphysema and fibrosis in the upper lobes and lower lobes was then determined histologically separately. In the upper lobes and fibrosis exclusively in the lower lobes, no patients exhibited emphysema. The craniocaudal separation of emphysema and fibrosis (emphysema in the upper lobes and interstitial pneumonia in the lower lobes) was histologically rare in the autopsied and pneumonectomised specimens of IPF patients with emphysema. In each lobe, coexistence or collision of fibrosis and emphysema was common.