CTICasesExcipient Lung Disease (Talc Granulomatosis)
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Imaging findings
The images reveal perihilar conglomerate fibrotic areas with high attenuation, representing a later stage of the disease. In earlier stages, centrilobular nodules from impaction into central arterioles may be seen. Mediastinal and hilar lymph nodes also demonstrate high attenuation. Biopsy confirmed granulomatous changes with birefringent crystals consistent with talc or methylcellulose.
Key takeaways
Excipient lung disease (previously known as talcosis) is a severe complication of intravenous drug abuse, resulting from the injection of crushed pills containing insoluble fillers like talc or microcrystalline cellulose. The characteristic findings include high-attenuation perihilar fibrosis and lymphadenopathy due to granulomatous foreign body reaction. It can mimic malignancy, necessitating biopsy for definitive diagnosis.
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