Pulmonary Talc Granulomatosis- An Uncommon Finding at Autopsy

Abstract

Talc is chemically hydrous magnesium silicate and used as lubricant of consumer goods, as well as, in various oral prescribed medications due to its diluting nature. Pulmonary disease secondary to occupational exposure of talc have been named as talcosilicosis and talcoasbestosis, inhalational exposure results in talcosis whereas, talc granulomatosis found intravenous drug abusers who inject tablets intended for oral use. Herein, The authors present the case of a 25-year-old deceased male whose heart and pieces of lung, liver and kidney were received for histopathological examination sections from heart, liver, kidney were histologically unremarkable. Microsections from lung tissue revealed multiple non caseating epithelioid cells granuloma with foreign body type giant cells mainly in perivascular area. Under polarised light, crystalline needle shaped foreign bodies seen mainly in the centre of granuloma. Final diagnosis of talc granulomatosis was given. Because, pulmonary talcosis has a very low incidence, the diagnosis can be a challenge therefore, it is essential to suspect this entity in all cases of granulomatous inflammation of lung to prevent misdiagnosis.

Keywords

• epithelioid granuloma
• polarised light
• talcosilicosis