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Giant bullous emphysema associated with chronic marijuana smoking

Imaging findings

Chest CT shows striking, large, posteriorly-predominant bullae and bullous emphysema in both lower and upper lobes, with mild paraseptal emphysema, in a 65-year-old male with a history of lifelong marijuana smoking.

Key takeaways

Chronic, heavy marijuana smoking is associated with the development of giant bullous emphysema. Interestingly, marijuana-related emphysema often presents with large bullae in a posterior or apical distribution, which can be seen in relatively young patients.

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