Public health

Here’s what lung injury from e-cigarettes looks like


Radiologists have published their radiographic and CT findings of lung injury due to e-cigarette use in a bid to raise awareness in the medical community.

In a special report, Dr Suhny Abbara and Dr Fernando Uliana Kay from the Department of Radiology at UT Southwestern Medical Center in Dallas, Texas, present a clinical case of a 24-year-old male patient with past medical history of asthma, who presented with shortness of breath, productive cough, chest pain and fever for one week.

The patient reported current daily use of e-cigarettes (with tobacco) and marijuana, without substantial change in recent vaping habits. He had high white cell and platelet counts. His chest X-ray showed ground-glass and reticular, or netlike, opacities in both lungs.

Chest CT angiographic images in a 24-year-old man with a history of e-cigarette use. A–C, Selected axial sections of the lung presented on lung windows reveal patchy ground-glass opacities distributed bilaterally with some, A, B, subpleural sparing and, C, consolidation in the lung bases. D, Coronal oblique thick-slab average intensity reconstruction shows the predominance of the findings in the basal lungs and demonstrates the peripheral subpleural sparing.

CT findings included ground glass opacities and pulmonary consolidation with relative subpleural sparing. Histologic specimens obtained from the right lower lobe at biopsy were suggestive of lipoid pneumonia. The patient was given steroids with a presumptive diagnosis of lung injury associated with e-cigarette use.

“The diagnosis of lung injury due to e-cigarette use should be a differential possibility in patients presenting with bilateral lung opacities on radiographs or ground-glass opacities on chest CT images and exposure to e-cigarette products within 90 days of the presentation,” Dr. Abbara said.

“Radiologists will continue to play an important role in recognizing this emerging entity,” said Dr. Abbara, who is also the editor of Radiology: Cardiothoracic Imaging, where the report is published. “We encourage the medical imaging community to produce scientific evidence and medical knowledge to help advance our collective understanding of the effects of e-cigarette use on the lungs and other organ systems.”

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