Chute Dennis J, Rawley James, Cox John, Bready Robert J, Reiber Kari
Dutchess County Medical Examiner's Office, Poughkeepsie, NY 12601, USA.
Am J Forensic Med Pathol. 2010 Jun;31(2):146-50. doi: 10.1097/PAF.0b013e3181d3db65.
As part of a review of substance abuse deaths in Dutchess County, New York, the Dutchess County Medical Examiner's Office identified 3 cases of angiocentric systemic foreign-body granulomatosis discovered at autopsy. Our investigation disclosed that in all 3 cases patients surreptitiously injected crushed oral prescription medication. Of the patients, 2 obtained intravenous access through central venous lines, the other patient was found to have injected herself intramuscularly. Autopsy demonstrated lung abnormalities due to diffuse deposits of foreign material within and around vessels, associated with foreign-body granulomatous reaction. We also identified a systemic distribution of this foreign material deposited beyond the lungs in the brain, heart, kidneys, and spleen. We present these cases along with a review of the literature of systemic embolization of foreign material in previously documented cases of deaths due to parenteral abuse of oral medications.
作为对纽约达奇斯县药物滥用死亡情况审查的一部分，达奇斯县法医办公室在尸检时发现了3例血管中心性系统性异物肉芽肿病例。我们的调查显示，所有3例患者均偷偷注射了碾碎的口服处方药。其中2例患者通过中心静脉导管建立静脉通路，另1例患者是自行进行肌肉注射。尸检显示，由于血管内及血管周围存在弥漫性异物沉积，并伴有异物肉芽肿反应，肺部出现异常。我们还发现，这种异物在肺部以外的脑、心脏、肾脏和脾脏中也有系统性分布。我们展示这些病例，并回顾之前记录的因非肠道滥用口服药物导致死亡的病例中异物系统性栓塞的文献。
