CTICasesHookah Smoking-Induced Foreign Body Granulomatous Bronchiolitis
Imaging findings
Chest CT in a young patient with a history of hookah smoking reveals a striking, diffuse pattern of centrilobular nodules throughout both lungs. Surgical lung biopsy demonstrated a foreign body granulomatous reaction within the airways, secondary to inhaled aerosolized oils and additives from the hookah setup.
Key takeaways
Similar to marijuana and vaping-associated lung injury, hookah smoking can introduce foreign oils and flavored additives into the lower airways. This can trigger an intense, diffuse centrilobular bronchiolitis characterized histologically by foreign body giant cell and granulomatous reactions.
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