CTICasesCentrilobular Emphysema (Marijuana-related)
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Imaging findings
Diffuse cysts are seen, some with small vessels or structures running through them. The distribution is craniocaudal and axial. Initially suspected to be LAM, but VEGF-D was normal. Surgical biopsy showed centrilobular emphysema, though a pathologist noted it was "odd" and not typical LAM or other cystic disease.
Key takeaways
This case highlights the diagnostic challenge of cystic lung disease. While initially resembling LAM (lymphangioleiomyomatosis), a normal VEGF-D level prompted biopsy. The ultimate diagnosis of centrilobular emphysema in a young nonsmoker who uses marijuana raises the question of whether marijuana smoking can induce a unique form of centrilobular emphysema or parenchymal cysts, a topic of ongoing discussion in the literature.
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