Marijuana (cannabis or bong) lung refers to the presence of large apical bullae in patients who regularly smoke marijuana. A definite causative link between smoking marijuana and bullous lung disease has not been established, and the association may just be coincidental.
Smoking marijuana has been demonstrated to cause chronic bronchitis, airflow obstruction, impaired large airway function and hyperinflation. There is a dose-response relationship to marijuana's effect on the lungs, with one marijuana joint equivalent to 2.5-5 cigarettes, possibly due to different inhalation techniques and lack of filters 1.
Macroscopic emphysema is rarely seen although large apical bullae in a paraseptal distribution have been described 1,2 with secondary spontaneous pneumothorax as a complication 3. A definite causal link has yet to be established 5,7.
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- 2. Johnson MK, Smith RP, Morrison D et-al. Large lung bullae in marijuana smokers. Thorax. 2000;55 (4): 340-2. doi:10.1136/thorax.55.4.340 - Free text at pubmed - Pubmed citation
- 3. Berkowitz EA, Henry TS, Veeraraghavan S et-al. Pulmonary Effects of Synthetic Marijuana: Chest Radiography and CT Findings. AJR Am J Roentgenol. 2014; 1-8. doi:10.2214/AJR.14.13138 - Pubmed citation
- 4. Fiorello A, Vicidomini G, Santini M. Marijuana smokers and lung bullae. Eur J Cardiothorac Surg. 2008;34 (3): 706-7. doi:10.1016/j.ejcts.2008.06.033 - Pubmed citation
- 5. Tashkin DP. Effects of marijuana smoking on the lung. Ann Am Thorac Soc.10 (3): 239-47. Pubmed citation
- 6. Gill A. Bong lung: regular smokers of cannabis show relatively distinctive histologic changes that predispose to pneumothorax. Am. J. Surg. Pathol. 2005;29 (7): 980-2. Pubmed citation
- 7. Tan C, Hatam N, Treasure T. Bullous disease of the lung and cannabis smoking: insufficient evidence for a causative link. J R Soc Med. 2006;99 (2): 77-80. doi:10.1258/jrsm.99.2.77 - Free text at pubmed - Pubmed citation