Other nonneoplastic disease

Intravenous drug abusers

Topic Completed: 1 December 2011

Minor changes: 24 August 2020

Copyright: 2003-2021,, Inc.

PubMed search: pulmonary intravenous drug abuse

Elliot Weisenberg, M.D.
Page views in 2020: 630
Page views in 2021 to date: 413
Cite this page: Weisenberg E. Intravenous drug abusers. website. Accessed October 25th, 2021.
Clinical features
  • Often incidental findings at autopsy or biopsy
  • Lesions due to injection of insoluble fillers of oral mediation, which lodge in small pulmonary arteries; may include crospovidone, talc, cornstarch or microcrystalline cellulose with characteristic findings
  • All but cornstarch persist indefinitely
  • Patients may have dyspnea or hypoxia; due to related infection, pulmonary edema, diffuse alveolar damage, vasculopathy leading to pulmonary hypertension or interstitial fibrosis
  • Chest xray usually shows a micronodular pattern
Microscopic (histologic) description
  • Fresh or organizing arterial thrombi with foreign material
  • Perivascular foreign body granulomas contain birefringent foreign material resembling starch, talc or other materials
  • May be associated with acute vasculitis, interstitial inflammation and fibrosis
Microscopic (histologic) images

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