title: Severe endobronchitis and airway stricture caused by inhalation of cosmetic talc.
abstract: Pulmonary disease caused by talc is well described, but previous reports mainly describe lung parenchymal involvement. We describe what is, to our knowledge, the first case in which inhalation of cosmetic talc led to intense endobronchitis and airway stricture. A 70-year-old woman presented with new-onset wheezing and was found to have right upper lobe collapse on chest radiography. CT imaging of the thorax showed right upper lobe collapse with occlusion of the right upper lobe. Bronchoscopy showed severe endobronchitis with thickened mucosa throughout the right and left main stem bronchi and a fibrotic stricture occluding the right upper lobe. Bronchial biopsy specimens showed foreign-body granulomatosis encasing birefringent crystalline material. Spectral analysis confirmed the crystals to be consistent with cosmetic talc used by the patient. We hypothesize that the patient inhaled a large amount of talc, which was trapped in the larger airways and resulted in intense foreign-body granulomatosis, leading to an airway stricture.
authors.affiliation: Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore. Electronic address: ong.thun.how@sgh.com.sg.
authors.forename: Thun How
authors.initials: TH
authors.lastname: Ong
authors.affiliation: Department of Pathology, Singapore General Hospital, Singapore.
authors.forename: Angela
authors.initials: A
authors.lastname: Takano
mesh_terms: D000368:Aged; D000402:Airway Obstruction / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D001991:Bronchitis / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D003358:Cosmetics / Q000009:adverse effects*; D005260:Female; D015745:Granuloma, Foreign-Body / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D013627:Talc / Q000009:adverse effects*
chemical_list: D003358:Cosmetics; D013627:Talc