• Sanjay Mukhopadhyay, Mitra Mehrad, Pedro Dammert, Andrea V Arrossi, Rakesh Sarda, David S Brenner, Fabien Maldonado, Humberto Choi, and Michael Ghobrial.
• Department of Pathology, Cleveland Clinic, Cleveland, OH.
• Am. J. Clin. Pathol. 2020 Jan 1; 153 (1): 30-39.

ObjectivesThe aim of this report is to describe the lung biopsy findings in vaping-associated pulmonary illness.MethodsLung biopsies from eight patients with vaping-associated pulmonary illness were reviewed.ResultsThe biopsies were from eight men (aged 19-61 years) with respiratory symptoms following e-cigarette use (vaping). Workup for infection was negative in all cases, and there was no evidence for other etiologies. Imaging showed diffuse bilateral ground-glass opacities in all patients. Most recovered with corticosteroid therapy, while one died. Lung biopsies (seven transbronchial, one surgical) showed acute lung injury, including organizing pneumonia and/or diffuse alveolar damage. Common features were fibroblast plugs, hyaline membranes, fibrinous exudates, type 2 pneumocyte hyperplasia, and interstitial organization. Some cases featured a sparse interstitial chronic inflammatory infiltrate. Although macrophages were present within the airspaces in all cases, this feature was not prominent, and findings typical of exogenous lipoid pneumonia were absent.ConclusionsThe histopathology of acute pulmonary illness related to e-cigarette use (vaping) is characterized by acute lung injury patterns, supporting the contention that vaping can cause severe lung damage.© American Society for Clinical Pathology, 2019. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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