I am sure there is a lot of anxiety with this finding. It is not often that a diagnosis of emphysema is made based on a single chest x-ray without getting pulmonary function tests (PFTs) and a history. If there is concern, getting PFTs is a simple and non-invasive next step to better understanding this radiologic finding. It is important to get this information to better understand if there is a problem or not. If there is a problem, then there are medical ways to deal with this problem and it is best to see a pulmonologist. Not everyone who smokes gets emphysema. Unfortunately, there are some with a genetic predisposition who get emphysema who may never have smoked. The best next step is to get PFTs.
I had a CT scan that showed some emphysema and followed that up with PFT's. Those showed mild to moderate obstruction - even though I never noticed any shortness of breath - I exercise 4-5 nights a week for 20-30 minutes on an elliptical or jog 2-1/2 miles outside in the summer. When jogging and really breathing hard, it IS obvious that my lungs aren't like they were 33 years ago when I was running cross-country in high-school (I'm 51 and was a heavy smoker until 4-1/2 years ago - haven't had a drag since the day I quit). Wait to hear what the doc/nurse says here when he or she replies. I'd guess they'll recommend PFT's as well as getting tested for the alpha 1 deficiency since your husband hasn't smoked since he was 32. I've read where some folks think its a combination of factors that permit/cause the development of emphysema. Since my grandpa smoked like a chimney and lived to be 85, I think I got it from a combination of smoking AND a case of LPR/EER reflux aspirating stuff into my lungs while I slept. I used to drink about six beers a night and eat a big meal just before going to bed. Plus, to really top things off - I always slept on my stomach. Not a good combination. In addition to quitting or staying quit on the ciggies, make sure your husband doesn't have something like reflux that could cause further injury to his lungs - that's a tip I don't see recommended enough by doctors - even super pros like those here.
Your husband needs to live life to it's fullest and not worry about life expectancy. If he has a little bit of emphysema then he definitely needs to stop smoking and being around second-hand smoke so his little bit doesn't get to alot. My physician has me on spiriva for my moderate-severe emphysema. Whenever I was diagnosed almost two years ago, I asked the life expectancy question and was told as long as I follow those guidelines I would definitely have 15-20 more years or longer to live. I am currently in a pulmonary exercise program 3 days per week that helps build my uppper body, hear and lungs so that I can breathe without straining my lungs. None of us know when we are going to die. We could be killed tomorrow in a car accident, heart attack or whatever. I know as my youngest daughter did die two years ago today in a car accident and she was only 22. X-rays are not conclusive. It could have been an infection or something that reflected on the x-rays. I definitely would request further pulmonary function tests. It is not how long we live that makes a difference. It is what we do with our life while we are here on earth. Have a great life and smile today because he woke up beside you today. Today is important not tomorrow.
I would guess that if your husband has no symptoms he has no emphysema.
A pulmonary function test should confirm the diagnosos.