title: Cocaine-induced pulmonary changes: HRCT findings.
abstract: OBJECTIVE
  To evaluate HRCT scans of the chest in 22 patients with cocaine-induced pulmonary disease.
  
  
  METHODS
  We included patients between 19 and 52 years of age. The HRCT scans were evaluated by two radiologists independently, discordant results being resolved by consensus. The inclusion criterion was an HRCT scan showing abnormalities that were temporally related to cocaine use, with no other apparent causal factors.
  
  
  RESULTS
  In 8 patients (36.4%), the clinical and tomographic findings were consistent with "crack lung", those cases being studied separately. The major HRCT findings in that subgroup of patients included ground-glass opacities, in 100% of the cases; consolidations, in 50%; and the halo sign, in 25%. In 12.5% of the cases, smooth septal thickening, paraseptal emphysema, centrilobular nodules, and the tree-in-bud pattern were identified. Among the remaining 14 patients (63.6%), barotrauma was identified in 3 cases, presenting as pneumomediastinum, pneumothorax, and hemopneumothorax, respectively. Talcosis, characterized as perihilar conglomerate masses, architectural distortion, and emphysema, was diagnosed in 3 patients. Other patterns were found less frequently: organizing pneumonia and bullous emphysema, in 2 patients each; and pulmonary infarction, septic embolism, eosinophilic pneumonia, and cardiogenic pulmonary edema, in 1 patient each.
  
  
  CONCLUSIONS
  Pulmonary changes induced by cocaine use are varied and nonspecific. The diagnostic suspicion of cocaine-induced pulmonary disease depends, in most of the cases, on a careful drawing of correlations between clinical and radiological findings.
authors.affiliation: Universidade Federal do Rio de Janeiro, Rio de Janeiro, BR.
authors.forename: Renata Rocha de
authors.initials: RR
authors.lastname: Almeida
authors.affiliation: Universidade Federal do Rio de Janeiro, Rio de Janeiro, BR.
authors.forename: Gláucia
authors.initials: G
authors.lastname: Zanetti
authors.affiliation: Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, BR.
authors.forename: Arthur Soares
authors.initials: AS
authors.lastname: Souza
authors.affiliation: Ultra-X, São José do Rio Preto, BR.
authors.forename: Luciana Soares de
authors.initials: LS
authors.lastname: Souza
authors.affiliation: Departamento de Medicina e Apoio Diagnóstico, Universidade Federal da Bahia, Salvador, BR.
authors.forename: Jorge Luiz Pereira E
authors.initials: JL
authors.lastname: Silva
authors.affiliation: Departamento de Clínica Médica, Universidade Federal do Paraná, Curitiba, BR.
authors.forename: Dante Luiz
authors.initials: DL
authors.lastname: Escuissato
authors.affiliation: Liverpool Heart and Chest Hospital, NHS Foundation Trust, Liverpool, GB.
authors.forename: Klaus Loureiro
authors.initials: KL
authors.lastname: Irion
authors.affiliation: Hospital Anchieta, Taguatinga, BR.
authors.forename: Alexandre Dias
authors.initials: AD
authors.lastname: Mançano
authors.affiliation: Universidade Federal de Santa Catarina, Florianópolis, BR.
authors.forename: Luiz Felipe
authors.initials: LF
authors.lastname: Nobre
authors.affiliation: Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, BR.
authors.forename: Bruno
authors.initials: B
authors.lastname: Hochhegger
authors.affiliation: Universidade Federal do Rio de Janeiro, Rio de Janeiro, BR.
authors.forename: Edson
authors.initials: E
authors.lastname: Marchiori
mesh_terms: D000328:Adult; D001938:Brazil; D003042:Cocaine / Q000009:adverse effects*; D019970:Cocaine-Related Disorders / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D055370:Lung Injury / Q000139:chemically induced* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D036542:Tomography, Spiral Computed; D055815:Young Adult
chemical_list: D003042:Cocaine