CTICasesExcipient talc granulomatosis
Imaging findings
CT shows a dilated pulmonary artery and diffuse, symmetric centrilobular nodules sparing the subpleural spaces, in a patient who injected crushed oral tablets (oxycodone) through a central catheter.
Key takeaways
Intravenous injection of crushed oral medications leads to embolization of insoluble tablet binders (such as talc, starch, or cellulose) into the pulmonary microcirculation. This presents as diffuse centrilobular nodules and progressive pulmonary hypertension.
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