CTICasesExcipient Lung Disease (IV crushed steroids/testosterone)
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Imaging findings
A radiograph (2007) shows tiny, unimpressive nodules. A high-resolution CT shows diffuse centrilobular nodules sparing the fissures, described as being everywhere. MIPS are useful for visualizing these nodules. Hefty diaphragm muscles are also noted.
Key takeaways
Excipient lung disease (or injection granulomatosis) results from intravenous injection of crushed tablets (e.g., steroids, testosterone) that contain insoluble fillers (excipients like cellulose, crospovidone, talc). It typically presents with diffuse centrilobular nodules, often sparing the fissures, and can lead to pulmonary hypertension. A history of substance abuse (e.g., a competitive weightlifter injecting steroids/testosterone) is key. The term "excipient lung disease" was coined by one of the attendees.
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