What is pulmonary emphysematous changes?

Sounds like: You are reading a chest x ray report. Ask the doctor who ordered the test. Emphysema is damage to lung tissue that prevents normal elasticity, caused usually by smoking, or more rarely chronic lung infection or exposure to toxic substances. You might be headed toward full emphysema.

Emphysema: These changes occur when enzymes in your lung destroy alveoli causing the loss of gas exchange surface area... Smoking is the most common cause of increased enzyme activity.