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Related Experiment Video

Updated: Dec 10, 2025

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Radiologic and Pathologic Correlation in EVALI.

Prasad M Panse1, Fionna F Feller2, Yasmeen M Butt3

  • 1Department of Radiology, Mayo Clinic, Arizona, 5777 E Mayo Blvd PX_MH_01_RAD, Phoenix, AZ 85054.

AJR. American Journal of Roentgenology
|September 3, 2020
PubMed
Summary
This summary is machine-generated.

E-cigarette or vaping product use-associated lung injury (EVALI) on CT scans typically presents as acute lung injury with ground-glass opacities and consolidation. This imaging pattern often mimics hypersensitivity pneumonitis but correlates with histopathology showing acute lung injury.

Keywords:
EVALIacute lung injurye-cigarettesorganizing pneumoniapneumonitisvaping

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Area of Science:

  • Radiology
  • Pulmonology
  • Pathology

Background:

  • E-cigarette or vaping product use-associated lung injury (EVALI) is a serious respiratory condition linked to vaping products.
  • Characterizing the specific CT imaging findings of EVALI is crucial for diagnosis and management.
  • Histopathologic correlation is essential to confirm the diagnosis and understand the underlying lung pathology.

Purpose of the Study:

  • To characterize the computed tomography (CT) appearance of EVALI in patients with confirmed histopathologic evidence.
  • To correlate CT findings with specific histopathologic patterns of lung injury.
  • To identify common and distinguishing imaging features of EVALI.

Main Methods:

  • Retrospective review of chest CT examinations in 24 patients diagnosed with EVALI and histopathologic confirmation.
  • Two radiologists assessed CT findings, categorizing them into established patterns: acute lung injury (ALI), chronic eosinophilic pneumonia (CEP), organizing pneumonia (OP), acute eosinophilic pneumonia (AEP), alveolar hemorrhage, hypersensitivity pneumonitis (HP), lipoid pneumonia, or mixed/unclassifiable patterns.
  • CT findings were compared with corresponding lung biopsy results.

Main Results:

  • Ground-glass opacities were the most common CT finding (96%), present in 75% of patients.
  • Consolidation (42%) and interlobular septal thickening (29%) were also frequent.
  • The predominant CT pattern was ALI (42%), which correlated with histopathology in 75% of cases. A pattern resembling HP was seen in 33% of patients, but none showed HP on biopsy.

Conclusions:

  • EVALI on CT commonly manifests as acute lung injury with multifocal ground-glass opacities and organizing consolidation.
  • A centrilobular nodular pattern mimicking HP can be observed on CT, but histopathology often reveals ALI instead.
  • CT findings, particularly ALI patterns, show good concordance with histopathologic diagnoses in EVALI.