Unit of Bronchology, Monaldi Hospital, Azienda Ospedaliera dei Colli, Naples.
Respiratory Medicine Division, Department of Clinical Medicine and Surgery, Federico II University, Naples.
Monaldi Arch Chest Dis. 2021 Dec 3;92(3). doi: 10.4081/monaldi.2021.1962.
A 59-year-old female ex-smoker with 40 pack year smoking history and a 5-year current e-cigarette (EC) use history, presented with progressive dyspnea on exertion and daily cough for 2 months. A CT scan showed a consolidation area with air bronchogram in the middle lobe and non-calcific bilateral nodules, which could be attributed to community-acquired pneumonia. The patient was treated with empiric antibiotics and systemic steroids for 10 days. Infectious, neoplastic and autoimmune pathologies were excluded, whereas a broncho-alveolar lavage revealed an accumulation of lipids in the cytoplasm of the alveolar macrophages. Despite the recommendation of vaping cessation, the patient continued to use EC. A new CT exam, carried out after 18 months, showed reversed halo sign (RHS), patchy ground-glass opacity (GGO), pleuro-parenchymal bands, and indeed perilobular pattern, suggestive of organizing pneumonia (OP). The final diagnosis was E-cigarette, or vaping, product use Associated Lung Injury (EVALI)- related OP.
一位 59 岁的女性既往吸烟者，吸烟史 40 包年，目前有 5 年电子烟使用史，出现进行性活动后呼吸困难和每日咳嗽 2 个月。CT 扫描显示中叶实变区伴空气支气管征和双侧非钙化结节，可能归因于社区获得性肺炎。患者接受经验性抗生素和全身类固醇治疗 10 天。排除了感染、肿瘤和自身免疫性疾病，而支气管肺泡灌洗显示肺泡巨噬细胞质内脂质堆积。尽管建议停止使用电子烟，但患者仍继续使用电子烟。18 个月后进行的新 CT 检查显示反转晕征（RHS）、斑片状磨玻璃影（GGO）、胸膜-肺实质带，实际上是小叶周围模式，提示机化性肺炎（OP）。最终诊断为电子烟或蒸气产品使用相关的肺损伤（EVALI）相关 OP。
