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Unusual cause of a fatal foreign body pulmonary granulomatosis

Ungewöhnliche Ursache einer pulmonalen Fremdkörpergranulomatose der Lungen

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Abstract

Pulmonary foreign body granulomatosis is a rare disease characterized by granuloma as a result of exposure to mineral substances. It has been reported in intravenous drug abusers who inject powdered medications. In the present case a 57-year-old female tourist with a history of cancer died in her hotel room. The autopsy revealed pulmonary fibrosis with granulomatosis containing birefringent particles (mainly talc). The cause of death was an acute right heart failure due to chronic pulmonary hypertension triggered by regular therapeutic use of painkillers after cancer occurring in previous years.

Zusammenfassung

Die pulmonale Fremdkörpergranulomatose ist eine seltene Erkrankung, die durch Granulome infolge der Exposition gegenüber Mineralstoffen gekennzeichnet ist. Über die Erkrankung wurde bei i.v.-Drogen-Abhängigen berichtet, die pulverisierte Medikamente injizieren. Im vorliegenden Fall starb eine 57-jährige Touristin mit Krebsvorgeschichte in ihrem Hotelzimmer. Die Obduktion ergab eine Lungenfibrose mit Granulomatose, die doppelbrechende Partikel (hauptsächlich Talkum) enthielt. Todesursache war eine akute Rechtsherzinsuffizienz aufgrund chronischer pulmonaler Hypertonie, ausgelöst durch regelmäßige therapeutische Anwendung von Schmerzmitteln nach einer Krebserkrankung in der Vorgeschichte.

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Acknowledgements

We thank Ashleigh Fox, MSc, from Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript.

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Authors and Affiliations

  1. Department of Public Health and Pediatrics, Section of Legal Medicine, University of Turin, Corso Galileo Galilei 22, 10126, Torino, Italy

    L. Tattoli

  2. Institute of Neuropathology, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1 (Virchowweg 15), 10117, Berlin, Germany

    H. Martin

  3. Institute of Legal Medicine and Forensic Sciences, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Turmstr. 21, Building N, 10559, Berlin, Germany

    C. Buschmann

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  1. L. Tattoli
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Correspondence to L. Tattoli.

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L. Tattoli, H. Martin and C. Buschmann declare that they have no competing interests.

This article does not contain any studies with human participants or animals performed by any of the authors.

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Tattoli, L., Martin, H. & Buschmann, C. Unusual cause of a fatal foreign body pulmonary granulomatosis. Rechtsmedizin 28, 420–422 (2018). https://doi.org/10.1007/s00194-018-0253-7

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