What vaping does to the lungs

Toxic chemical burns may be behind the hundreds of vaping-linked illnesses spiking across the country, according to new images of lung tissue taken from people who got sick after vaping.

The images and resulting analysis from pathologists were published Wednesday in the New England Journal of Medicine.

The findings provide a better understanding of what’s actually happening to the lungs in these cases. They’re also meant to give other doctors a frame of reference for what the vaping-related lung injuries look like under a microscope, as well as help in diagnosis.

It looks like the kind of injury that we normally see when a person is exposed to a spilled drum of toxic chemicals at their workplace.

“It looks like the kind of injury that we normally see when a person is exposed to a spilled drum of toxic chemicals at their workplace,” said Dr. Brandon Larsen, an author of the study and a surgical pathologist at the Mayo Clinic in Scottsdale, Arizona. He and his team are often called upon to examine lung tissue for a second opinion, or in cases that have perplexed other physicians.

These images of lung tissue show severe chemical injuries caused by vaping unknown substances. On the top right is a cross section of a small airway. The pink circular structure is the airway wall. Pathologists explain there should be nothing in the middle of that structure so air can flow easily. Instead, the image shows widespread inflammation and injury, inhibiting oxygen flow. The New England Journal of Medicine

Larsen and colleagues examined lung biopsy samples from 17 patients with lung illnesses linked to vaping, a small portion of the 805 cases confirmed by the Centers for Disease Control and Prevention.

But their sample is similar to what’s seen nationwide: Most of the patients in the Mayo Clinic study were men, between the ages of 19 and 67. And nearly three-quarters had vaped marijuana or cannabis oil.

Previous investigations suggested that an accumulation of oil in the lungs was to blame, and many patients were diagnosed with a condition called lipoid pneumonia. That occurs when inflammatory cells with abnormally high levels of fatty substances, called lipids, collect in the lungs.

But the Mayo researchers found no evidence to suggest lipoid pneumonia, at least in those 17 cases.