By early 2020, the CDC had reported over 2,000 hospitalizations and over 60 confirmed deaths due to E-cigarette or Vaping Product Use-Associated Lung Injury (EVALI). While research into the pathology of vaping-associated lung injury is in its early phases, pathologists at the Mayo Clinic published research in the New England Journal of Medicine in early October 2019 finding that lung injuries from vaping most likely are caused by direct toxicity or tissue damage from noxious chemical fumes. In addition, these researchers published subsequent correspondence in this same publication cautioning clinicians against performing lipid stains on bronchial fluid or lung tissue from adult patients.
Chat Discussion Questions
- Is vaping dangerous? What’s your perspective when people say that this all just a hoax by the tobacco companies to make more people smoke cigarettes?
- Isn’t it just people who smoke THC that get EVALI?
- True or False: only black market vapes are dangerous.
- Will there be long term complications of people who had EVALI? What will they be?
- Why should/shouldn’t pathologists order oil red O as a test for vaping (research is conflicting)?
- What are the histologic findings of EVALI on biopsy?
- Are there specific findings for EVALI on biopsy?
- What is the differential for EVALI?
- Some pathologists report hearing that fat washes out in processing – doesn’t that mean pathologists can’t see it and then wouldn’t be able to diagnose lipoid pneumonia?
- Let’s say a pathologist ordered an oil red O and it came back positive – doesn’t this mean the patient has EVALI? Should he or she stop other testing?
- What is meant by chemical pneumonitis?
- What is acute lung injury?
- The CDC says the cause of EVALI is vitamin E acetate. Does this fit with your findings?
- Does finding vitamin E acetate mean that lipoid pneumonia really is the cause of EVALI?
Note: This Twitter chat will be following a Q&A format. The host, tweeting from @Pathologists, will ask questions or post discussion topics (beginning with Q1, Q2, etc.); the leaders will post answers starting with “A” and the corresponding question number (A1, A2, etc.). Ask your question or comment on one of the discussion questions/answers by referencing the specific discussion question beginning your tweet with “QX”, with X referring to the question number.
How to Participate
- Follow along on the #capchat hashtag. Invite your followers to join the chat.
- Introduce yourself, where you are from, and any relevant professional details to the group.
- Respond to the Q’s using A1, A2, A3, etc.
Tip: Mute or block any bots taking over your feed. Ask questions and share your best tips and tricks with the group.