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Imaging Manifestations of E-Cig, Vaping Lung Injury Described

Most commonly presents on CT as acute lung injury with multifocal ground-glass opacity, consolidation

THURSDAY, Sept. 3, 2020 (HealthDay News) — Imaging manifestations of electronic cigarette or vaping product use-associated lung injury include an acute lung injury pattern exhibiting as multifocal ground-glass opacity and/or consolidation, according to a study published online Aug. 27 in Radiology: Cardiothoracic Imaging.

Prasad M. Panse, M.D., from the Mayo Clinic in Phoenix, and colleagues describe pulmonary injury resulting from e-cigarette or vaping product use.

The authors note that an acute lung injury pattern at computed tomography (CT) is the most common presentation for e-cigarette or vaping product use-associated lung injury, manifesting as multifocal ground-glass opacity and/or consolidation, typically multifocal and multilobar, possibly with subpleural sparing. As the illness evolves, areas of organization, manifesting as contracting consolidation, mild architectural distortion, intralobular lines, lobular distortion, and traction bronchiectasis may occur. A CT appearance resembling hypersensitivity pneumonitis may be encountered. Organizing pneumonia or acute eosinophilic pneumonia patterns are less common CT appearances. Presentation with pneumothorax or pneumomediastinum may occur, or these conditions may develop during the course of illness. On follow-up, most patients improve clinically and at imaging, especially after exposure cessation and corticosteroid therapy; the time course to improvement is variable.

“We hope to make radiologists aware that if they see diffuse lung opacities in a younger patient without clearly defined causes, then they may want to seriously consider that the patient could have a vaping injury,” a coauthor said in a statement.

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