CTICasesE-Cigarette or Vaping-Associated Lung Injury (EVALI)
Imaging findings
CT in a young patient with pneumomediastinum and a parenchymal abnormality initially called COVID shows numerous centrilobular nodules with striking peribronchovascular, subpleural, and central sparing, features atypical for COVID. COVID testing was negative and a repeat CT with a PE study showed no COVID or pulmonary embolism. The patient reported daily marijuana vaping.
Key takeaways
EVALI can mimic COVID-19 but is suggested by centrilobular nodularity with peribronchovascular, subpleural, and central sparing, a pattern of inhalational injury rather than viral pneumonia. A history of vaping (here daily marijuana vaping) and negative COVID testing help make the diagnosis, and pneumomediastinum can accompany the parenchymal injury.
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