CTICasesRitalin Tablet Injection Emphysema (Talc Lung)
Imaging findings
Chest radiograph and CT demonstrate basal predominant panacinar-type emphysema with hypovascular lung bases and spreading of vessels. The emphysema is worse in the lower lobes, similar in distribution to alpha-1 antitrypsin deficiency. There is additionally some bronchial wall thickening. The basal predominance reflects the gravitational distribution of blood flow carrying talc particles to the lower lobes.
Key takeaways
Intravenous injection of crushed Ritalin tablets delivers talc particles to the pulmonary vasculature, causing macrophages to attempt clearance of the indigestible material. The macrophage lysosomal enzymes, including elastases, are released and destroy alveolar walls, producing a basal predominant pattern of emphysema that mimics alpha-1 antitrypsin deficiency. The street name for crushed Ritalin was Seattle in some communities. Recognition of talc lung requires knowledge of IV drug use history.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- Renal Cell Carcinoma with Intravascular Metastatic SpreadNeoplastic
- RCA Stent Protrusion into the Aortic Root Lumen (Pre-TAVI Planning CT)Iatrogenic
- Wood-Burning Stove Smoke Inhalation Lung InjuryExposure
- Near-Drowning with Gravel Aspiration and BronchiolitisTrauma
- Pulmonary Mucormycosis (Rhizomucor pusillus) in a Non-Immunocompromised PatientInfection
- Uncorrected Tetralogy of Fallot in an Adult with Major Aortopulmonary Collateral ArteriesCongenital
- High Origin Right Coronary ArteryCongenital
- Pulmonary Arterial Hypertension with Systemic-to-Pulmonary Collateral VesselsVascular
See all cases from September 29, 2017 →
Related Exposure cases
- Sand Bronchograms from Surf Aspiration (Near-Drowning in Ocean)
- Silicone Embolization Syndrome from Penile Injection
- Acute Inhalation Injury from Mineral Oil Smoke Simulant in a Firefighter
- Hookah Smoking-Induced Foreign Body Granulomatous Bronchiolitis
- Methamphetamine-Induced Pulmonary Arterial Hypertension and Restrictive Allograft Syndrome
- Intravenous Metallic Mercury Embolization