https://doi.org/10.4081/monaldi.2021.1962

E-cigarette, or vaping, product use Associated Lung Injury (EVALI): new scenarios for physicians and radiologists

Vol. 92 No. 3 (2022)
Submitted: June 9, 2021
Accepted: October 6, 2021
Published: December 3, 2021
E-cigarette, EVALI, organizing pneumonia, exogenous lipoid pneumonia, lipid laden macrophages
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Authors

Carmine Guarino
Unit of Bronchology, Monaldi Hospital, Azienda Ospedaliera dei Colli, Naples, Italy.
Ilaria Pedicelli
ilaria.pedicelli@gmail.com
Unit of Bronchology, Monaldi Hospital, Azienda Ospedaliera dei Colli, Naples, Italy.
Francesco Perna
Respiratory Medicine Division, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
Valentina Di Spirito
Unit of Pathophysiology and Respiratory Rehabilitation, Monaldi Hospital, Azienda Ospedaliera dei Colli, Naples, Italy.
Giuseppe Fiorentino
Unit of Pathophysiology and Respiratory Rehabilitation, Monaldi Hospital, Azienda Ospedaliera dei Colli, Naples, Italy.
Fabio Procaccini
Department of Diagnostic Imaging, Polydiagnostic Center Vega s.r.l., Naples, Italy.
Gaetano Rea
Department of Diagnostic Imaging, Monaldi Hospital, Azienda Ospedaliera dei Colli, Naples, Italy.

A 59-year-old female ex-smoker with 40 pack year smoking history and a 5-year current e-cigarette (EC) use history, presented with progressive dyspnea on exertion and daily cough for 2 months. A CT scan showed a consolidation area with air bronchogram in the middle lobe and non-calcific bilateral nodules, which could be attributed to community-acquired pneumonia. The patient was treated with empiric antibiotics and systemic steroids for 10 days. Infectious, neoplastic and autoimmune pathologies were excluded, whereas a broncho-alveolar lavage revealed an accumulation of lipids in the cytoplasm of the alveolar macrophages. Despite the recommendation of vaping cessation, the patient continued to use EC. A new CT exam, carried out after 18 months, showed reversed halo sign (RHS), patchy ground-glass opacity (GGO), pleuro-parenchymal bands, and indeed perilobular pattern, suggestive of organizing pneumonia (OP). The final diagnosis was E-cigarette, or vaping, product use Associated Lung Injury (EVALI)- related OP.

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How to Cite

Guarino, Carmine, Ilaria Pedicelli, Francesco Perna, Valentina Di Spirito, Giuseppe Fiorentino, Fabio Procaccini, and Gaetano Rea. 2021. “E-Cigarette, or Vaping, Product Use Associated Lung Injury (EVALI): New Scenarios for Physicians and Radiologists”. Monaldi Archives for Chest Disease 92 (3). https://doi.org/10.4081/monaldi.2021.1962.
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