A Cancer That Went Up in Smoke: Pulmonary Reaction to e-Cigarettes Imitating Metastatic Cancer

Chest. 2016 Mar;149(3):e65-7. doi: 10.1016/j.chest.2015.09.003.

Abstract

e-Cigarettes have gained worldwide popularity as a substitute for smoking, but concern has been raised regarding the long-term effects associated with their use. We report a case of a 45-year-old female consumer of e-cigarettes who presented with 4 months of abdominal pain and fever. Initial imaging discovered multiple pulmonary nodules and liver lesions suspicious of widespread metastases; however, an extensive evaluation found no evidence of malignancy. Results of a lung biopsy revealed an area with multinucleated giant cells suggestive of a foreign body reaction to a lipophilic material. Upon cessation of e-cigarette use (known as vaping), the lung nodules disappeared, and the liver lesions regressed. Our case report suggests that vaping can induce an inflammatory reaction mimicking metastatic cancer.

Keywords: biopsy (lung); chest imaging; foreign bodies; inflammation; smoking.

Publication types

  • Case Reports

MeSH terms

  • Diagnosis, Differential
  • Electronic Nicotine Delivery Systems / adverse effects*
  • Female
  • Foreign-Body Reaction / diagnosis*
  • Foreign-Body Reaction / etiology
  • Humans
  • Liver Neoplasms / diagnosis*
  • Liver Neoplasms / secondary
  • Lung / diagnostic imaging
  • Lung / pathology*
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / secondary
  • Middle Aged
  • Multiple Pulmonary Nodules / diagnosis*
  • Multiple Pulmonary Nodules / etiology
  • Radionuclide Imaging
  • Tomography, X-Ray Computed