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Talcosis Associated with IV Abuse of Oral Medications

CT Findings

Suzanne Ward1, Laura E. Heyneman1, Pia Reittner1, Ella A. Kazerooni2, J. David Godwin3 and Nestor L. Müller1

1 Department of Radiology, Vancouver General Hospital and University of British Columbia, 855 W. 12th Ave., Vancouver, B. C., V5Z 1M9, Canada.
2 Department of Radiology, University of Michigan Hospitals, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-0326.
3 Department of Radiology, University of Washington, 1959 N.E. Pacific St., Seattle, WA 98195.



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  		Fig. 1. —36-year-old woman with talcosis related to IV abuse of methylphenidate and pentazocine. High-resolution CT scan (1-mm collimation) reveals diffuse fine granular pattern. In some areas profusion of micronodules creates ground-glass appearance (arrows).

 


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  		Fig. 2A. —36-year-old woman with talcosis related to IV abuse of methylphenidate. High-resolution CT scan (1-mm collimation), photographed at lung windows, shows conglomerated masses (arrows) in left lower lobe, lingula, and superior segment of right lower lobe. Note panacinar emphysema in both lower lobes and lingula.

 


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  		Fig. 2B. —36-year-old woman with talcosis related to IV abuse of methylphenidate. High-resolution CT scan (1-mm collimation) at same level as A, but photographed at mediastinal settings, shows highly attenuated material and conglomerated masses.

 


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  		Fig. 2C. —36-year-old woman with talcosis related to IV abuse of methylphenidate. High-resolution CT scan (1-mm collimation) through lung bases shows lower lobe panacinar emphysema.

 


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  		Fig. 3. —46-year-old man with talcosis associated with IV abuse of meperidine. High-resolution CT scan (1.5-mm collimation) shows areas of ground-glass attenuation in both upper lobes.

 


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  		Fig. 4A. —51-year-old man with talcosis related to IV abuse of methylphenidate. CT scan (5-mm collimation) through upper lobes shows no definite evidence of emphysema.

 


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  		Fig. 4B. —51-year-old man with talcosis related to IV abuse of methylphenidate. CT scan (5-mm collimation) through lower lobes shows diffuse panacinar emphysema. Note blood flow redistribution to upper lobes.

 

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