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Almeida RR
; Zanetti G
; Souza AS Jr
; Souza LS
; Silva JL
; Escuissato DL
; Irion KL
; Mançano AD
; Nobre LF
; Hochhegger B
; Marchiori E
J Bras Pneumol
2015[Jul]; 41
(4
): 323-30
PMID26398752
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OBJECTIVE: To evaluate HRCT scans of the chest in 22 patients with
cocaine-induced pulmonary disease. METHODS: We included patients between 19 and
52 years of age. The HRCT scans were evaluated by two radiologists independently,
discordant results being resolved by consensus. The inclusion criterion was an
HRCT scan showing abnormalities that were temporally related to cocaine use, with
no other apparent causal factors. RESULTS: In 8 patients (36.4%), the clinical
and tomographic findings were consistent with "crack lung", those cases being
studied separately. The major HRCT findings in that subgroup of patients included
ground-glass opacities, in 100% of the cases; consolidations, in 50%; and the
halo sign, in 25%. In 12.5% of the cases, smooth septal thickening, paraseptal
emphysema, centrilobular nodules, and the tree-in-bud pattern were identified.
Among the remaining 14 patients (63.6%), barotrauma was identified in 3 cases,
presenting as pneumomediastinum, pneumothorax, and hemopneumothorax,
respectively. Talcosis, characterized as perihilar conglomerate masses,
architectural distortion, and emphysema, was diagnosed in 3 patients. Other
patterns were found less frequently: organizing pneumonia and bullous emphysema,
in 2 patients each; and pulmonary infarction, septic embolism, eosinophilic
pneumonia, and cardiogenic pulmonary edema, in 1 patient each. CONCLUSIONS:
Pulmonary changes induced by cocaine use are varied and nonspecific. The
diagnostic suspicion of cocaine-induced pulmonary disease depends, in most of the
cases, on a careful drawing of correlations between clinical and radiological
findings.
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