CTICasesMethylcellulose Excipient Lung Disease from Injected Crushed Oxycodone Tablets
[...]. Methylcellulose Excipient Lung Disease from Injected Crushed Oxycodone Tablets. CTICases. Published October 23, 2026. https://cticases.com/c/2tamm
Imaging findings
The acute radiograph shows diffuse lung disease that is hard to characterise. CT shows innumerable well-formed centrilobular nodules with a basal predominance, and the maximum intensity projection brings out a central lobular pattern centred on arterioles. A large main pulmonary artery and right heart strain are present.
Key takeaways
Injecting crushed oral tablets that contain methylcellulose as a binder embolises the excipient into the pulmonary arterioles and provokes an inflammatory reaction centred on the arteries. The arterial branching pattern on CT separates it from aspiration bronchiolitis, which does not follow the arterial distribution. The patient in this case died after collapsing, and the injury may have been compounded by a recent dose.
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