CTICasesExcipient Lung Disease
Imaging findings
Serial chest CT scans in a patient with a history of IV heroin abuse show rapid development of right ventricular enlargement, septal straightening, and diffuse, bilateral centrilobular tree-in-bud opacities and ground-glass nodules throughout all lung zones. The adjacent pulmonary vein branches are normal.
Key takeaways
Excipient lung disease occurs when insoluble fillers in oral tablets are injected intravenously, embolizing to the pulmonary arterioles. On CT, this presents as diffuse, symmetric tree-in-bud and centrilobular nodules that involve all lung zones, representing micro-embolization and foreign-body granulomatous reaction. This vascular process leads to acute pulmonary hypertension and right heart strain.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- Right Upper and Middle Lobe AtelectasisTrauma
- Right Middle Lobe Lateral Segment AtelectasisInflammatory
- Bullet EmbolismTrauma
- Acupuncture-Induced PneumothoraxIatrogenic
- Transfusion-Related Acute Lung InjuryIatrogenic
- Unilateral Pulmonary EdemaVascular
- Unicuspid Aortic ValveCongenital
- Silicone LymphadenopathyExposure
See all cases from October 27, 2017 →
Related Exposure cases
- Wood-Burning Stove Smoke Inhalation Lung Injury
- Ritalin Tablet Injection Emphysema (Talc Lung)
- Sand Bronchograms from Surf Aspiration (Near-Drowning in Ocean)
- Silicone Embolization Syndrome from Penile Injection
- Acute Inhalation Injury from Mineral Oil Smoke Simulant in a Firefighter
- Hookah Smoking-Induced Foreign Body Granulomatous Bronchiolitis