title: Does cannabis smoking predispose to lung bulla formation?
abstract: OBJECTIVE
  The data of a consecutive series of habitual marijuana smokers were retrospectively evaluated and compared with that of non-marijuana smokers to assess differences between the 2 groups.
  
  
  METHODS
  13 consecutive habitual marijuana smokers were referred for treatment of spontaneous pneumothorax. The demographic, clinical, radiological, and pathological findings of these patients were reviewed and compared with 140 non-marijuana smokers treated for the same pathology at the same time.
  
  
  RESULTS
  Bullae were seen in 8/13 (62%) and 110/140 (78%) of marijuana smokers and non-marijuana smokers, respectively. However, when patients less than 35-years old were considered, the incidence of bulla was higher in marijuana smokers than non-marijuana smokers (7/10 vs. 3/10, p < 0.05). The pathological findings showed a greater presence of inflammatory cells in specimens from marijuana smokers than those of non-marijuana smokers (8/11 vs. 2/42, respectively, p < 0.05). No significant differences in hospital stay and clinical outcome were registered between the 2 groups.
  
  
  CONCLUSIONS
  Despite the fact that we were unable to demonstrate that marijuana had a causal role in the development of emphysema, our study showed that marijuana smokers had a higher incidence of inflammatory cells in pathological specimens, which may favor lung injury, thus predisposing to bulla formation.
authors.affiliation: Thoracic Surgery Unit, Second University of Naples, Naples, Italy.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Fiorelli
authors.forename: Marina
authors.initials: M
authors.lastname: Accardo
authors.forename: Giovanni
authors.initials: G
authors.lastname: Vicidomini
authors.forename: Gaetana
authors.initials: G
authors.lastname: Messina
authors.forename: Paolo
authors.initials: P
authors.lastname: Laperuta
authors.forename: Mario
authors.initials: M
authors.lastname: Santini
mesh_terms: D000328:Adult; D001706:Biopsy; D001768:Blister / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000150:complications*; D008385:Marijuana Smoking / Q000009:adverse effects*; D008875:Middle Aged; D011030:Pneumothorax / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D011656:Pulmonary Emphysema / Q000175:diagnosis / Q000209:etiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Blister; Lung diseases; Marijuana smoking; Pneumothorax; Pulmonary emphysema