Kinoshita Y, et al. - In clinically diagnosed patients with idiopathic pulmonary fibrosis (IPF) with coexisting emphysema, researchers examined the intrapulmonary distribution of fibrosis and emphysema. From 1993 to 2018, they retrospectively selected 19 patients with IPF having coexisting emphysema based on the presence on chest computed tomography among 40 IPF patients who had been autopsied or pneumonectomized for lung transplantation. Fibrosis and emphysema coexisted in the upper and lower lobes in 15 of the 19 IPF patients with emphysema. In the autopsied and pneumonectomized specimens of IPF patients with emphysema, there was a histologically rare craniocaudal separation of emphysema and fibrosis (emphysema in the upper lobes and interstitial pneumonia in the lower lobes). Coexistence or collision of fibrosis and emphysema was fairly common in each lobe.