Pulmonary talc granulomatosis
Pulmonary talc granulomatosis is one of the forms of talc-induced pulmonary disease and one of the excipient lung diseases. It is caused by talc particles mainly seen in patients injecting crushed methadone tablets intravenously.
As pulmonary talc granulomatosis is clinically and radiologically indistinct from patterns observed in response to other excipients such as microcrystalline cellulose, crospovidone, and starch, please refer to the main article on excipient lung diseases for further discussion regarding those aspects.
It is characterized by the development of foreign body granuloma secondary to talc exposure.
The exact pathophysiological mechanism for this is not well known. Talc embolization is thought to result in initial inflammatory arteritis, associated with a rapid influx of neutrophils around talc particles. Migration of particles to the surrounding perivascular and pulmonary interstitial tissue with subsequent foreign body granuloma development.