CTICasesTalc Granulomatosis mimicking Alpha-1 Antitrypsin
Imaging findings
Chest CT shows severe panlobular emphysema and bronchial wall thickening, predominantly in the lower lung zones. There is marked enlargement of the main pulmonary artery. Explant path confirmed talc granulomatosis (Ritalin lung).
Key takeaways
Intravenous injection of crushed tablets (e.g., Ritalin or methadone containing talc) causes microembolization, obliterating the pulmonary microvasculature. This leads to severe lower-lobe predominant emphysema and pulmonary hypertension, mimicking alpha-1 antitrypsin deficiency.
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