title: Pulmonary "mainline" granulomatosis: talcosis secondary to intravenous heroin abuse with characteristic x-ray findings of asbestosis.
abstract: A 50-year-old man, a "mainline" heroin abuser for 25 years, with a five-year history of x-ray findings compatible with asbestosis is presented. Multiple open biopsies failed to prove a diagnosis of asbestosis. The microscopic analyses of tissues revealed the presence of granulomatosis, secondary to talc from chronic intravenous heroin abuse. The need for open lung biopsy in establishing a diagnosis is emphasized, as x-ray findings can be and often are misleading. A tissue diagnosis is necessary, particularly in cases in which drug abuse is suspected.
mesh_terms: D001195:Asbestosis / Q000000981:diagnostic imaging* / Q000473:pathology; D003937:Diagnosis, Differential; D006099:Granuloma / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D003932:Heroin; D006801:Humans; D007275:Injections, Intravenous; D008171:Lung Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011859:Radiography; D019966:Substance-Related Disorders / Q000150:complications*; D013627:Talc / Q000009:adverse effects*
chemical_list: D013627:Talc; D003932:Heroin