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Updated: Feb 5, 2026

Ultrafast Lignin Extraction from Unusual Mediterranean Lignocellulosic Residues
Published on: March 9, 2021
An unusual cause of breathlessness and profuse micronodules
Srinivas Rajagopala1, Roopa Kancherla1, Nidhya Ganesan2
1Department of Pulmonary Medicine, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India.
Abstract:
We describe a 21-year-old male with a history of smoking and subacute onset of breathlessness with normal cardiorespiratory examination. The presence of "track marks" and digital infarcts prompted evaluation for infective endocarditis and confrontational history taking revealed anorexia, weight loss over 3 months along with intravenous drug abuse of reconstituted tablets of tapentadol. Echocardiography was normal and blood cultures were sterile; computed tomography showed bilateral, diffuse, small centrilobular nodules with "tree-in-bud" appearance. In this clinicopathologic conference, we discuss the clinical and radiological differential diagnosis of centrilobular nodules, lung biopsy findings, and management options for patients with such a presentation.
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