Institute of Forensic Medicine, Justus-Liebig-University of Giessen, Giessen, Germany.
Forensic Sci Int. 2010 Apr 15;197(1-3):e27-30. doi: 10.1016/j.forsciint.2009.12.066.
Foreign body granulomas in the lungs following acute singular or long time intravenous drug abuse are frequent findings during microscopic investigation of the lungs. Most cases present single granulomas. Cases with multiple foreign body granulomas, already palpable during autopsy and leading to pulmonary granulomatosis with multiple granulomas are less frequent. We report the case of a 32-year old man, dying suddenly and unexpectedly after a well-known history of drug abuse for more than a decade. The granulomas are caused by foreign particle embolization immediately after intravenous injection of not only the drug itself but also of adulterants, e.g. cotton fibers, potato starch or microcrystalline cellulose. At the end, a reduction in the size of the pulmonary bed had occurred followed by pulmonary hypertension. For the first time, lung dust in such a case was characterised by energy dispersive X-ray (EDX).
在对肺部进行显微镜检查时，经常会发现急性单一或长期静脉药物滥用后肺部的异物肉芽肿。大多数病例表现为单个肉芽肿。在尸检中已经可以摸到多个异物肉芽肿，并导致多发性肺肉芽肿的病例则较少见。我们报告了一个 32 岁男子的病例，他在滥用药物十多年后突然意外死亡。这些肉芽肿是由于静脉注射毒品本身以及杂质（如棉纤维、土豆淀粉或微晶纤维素）后立即发生的异物栓塞引起的。最终，肺床的大小缩小，随后出现肺动脉高压。在此类病例中，肺部灰尘首次通过能量色散 X 射线（EDX）进行了特征描述。
