Presentation
Shortness of breath
Patient Data
- Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.
Bilateral hyperlucent lower lungs and mild flattening of the diaphragmatic domes.
Diffuse hyperinflation of bilateral lower lobes with anterior/superior displacement of major fissures. Lingular atelectasis due to displaced left major fissure.
Findings are compatible with panlobular emphysema (also known as panacinar emphysema).
Case Discussion
Panlobular emphysema of the bilateral lower lobes due to complete destruction of secondary pulmonary lobules. Lower lobe predominance indicates a hematogenous insult.
The differential diagnosis for bilateral lower lung panlobular emphysema is alpha-1-antitrypsin deficiency and talc-containing Ritalin (methylphenidate) injection.
This patient had a documented history of Ritalin injection, causing the so-called Ritalin lung.