CTICasesCystic Lung Disease secondary to Crack Cocaine Use (Crack Lung)
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Imaging findings
Chest CT in a trauma patient reveals chronic lung findings characterized by numerous cystic areas. Many of these cysts are peri-bronchovascular, radiating out from the hila, and affect both anterior upper and lower lobes. There are no acute respiratory symptoms. A pelvic radiograph shows a crack pipe, indicating drug use. The cysts do not resemble those seen in Pneumocystis infection, and appear mostly upper lobe predominant.
Key takeaways
Crack cocaine use ("crack lung") can lead to chronic lung changes, including cystic lung disease. While the exact mechanism is debated (e.g., sequelae of prior hemorrhage, inflammatory response), the presence of such findings in a patient with a history of crack use is highly suggestive. It's important to consider social history and all available clues (like a crack pipe on imaging) to aid diagnosis in complex cases, especially when other common causes of cysts are excluded.
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