Will copd show up on a chest ct scan? my pulmonologist said the tissues look "normal".

Yes: Depending on the severity of the copd, it will show up on a ct scan. There can be emphysema and airway thickening which represents chronic bronchitis. However, the diagnosis of COPD is not made radiologically, but by pulmonary function tests which are much more sensitive. It would be unusual to see COPD in someone less than 40 years of age. Unless due to alpha-1-antitrypsin deficiency.

It definitely can : COPD represents a spectrum of obstructive airway diseases including chronic bronchitis and emphysema. In chronic bronchitis, ct may show bronchial wall thickening, enlarged vessels and possibly scarring & fibrosis as sequela of repeated inflammation. In emphysema alveolar septal destruction & airspace enlargement eventually leads to lung hyperinflation, flattenened diaphragms and bullous changes.

Not necessarily: COPD is not a radiological diagnosis. There are findings suggestive of COPD such as increased lung volumes, bronchial wall thickening or lung destruction. The diagnosis is based on clinical symptoms and pulmonary function tests. You could have severe COPD and a normal ct.