CTICasesExcipient Lung Disease (Liquid Methadone and Xanax)
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Imaging findings
CT scan showed diffuse centrolobular nodules throughout all lung lobes, with some areas of confluent consolidation, and the presence of a central venous catheter. A prior CT from November demonstrated very subtle centrolobular, bronchiocentric nodules that had significantly progressed to the current state. A CT from the previous summer was entirely normal, establishing a clear timeline.
Key takeaways
Excipient lung disease can result from the intravenous injection of crushed pills (e.g., Xanax) or liquid medications (e.g., methadone), often through central venous catheters. The imaging hallmark is diffuse centrolobular nodules, which can progress over time. A strong temporal correlation between the initiation of injection behavior and the development of lung abnormalities is key to diagnosis.
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