Subacute Lung Injury Associated with Heated Tobacco Products

Heated tobacco products release nicotine without burning with an electronically controlled heating system. 56-year-old male patient admitted sudden onset of chest pain and shortness breath. He had been using a heated product (I quit ordinary smoking, IQOS) for 2.5 years. Thoracic computed tomography scan revealed pleural-based atelectasis fibroatelectatic changes in the lower lobe right lung, pleural fluid upper lobe, thickening left lung. Biopsy taken video-assisted thoracic surgery (VATS) showed lymphoid aggregation nodular form widespread anthracosis around fibrillar material that double-refracting light alveoli, hyaline membrane-like type 2 pneumocyte hyperplasia, interstitial organization, subacute lung injury picture exogenous lipoid material. These findings were evaluated accordance toxic substance-induced chemical pneumonia. It was thought it might be related to years product.