Computed tomographic and radiological analysis of HCl injury in human lungs

Although hydrochloric acid (HCl) inhalation-induced lung injury occurs often, its imaging findings are not well-known. In the present study, we retrospectively reviewed imaging studies and clinical data from seven patients who were treated for HCl inhalation, after estimation of in vitro toxicological effects of several strong acids in human lung cells. Cell death in the lungs which increased with prolonged incubation time and concentration of HCl, was predominantly associated with the apoptosis, compared with the necrosis. HCl inhalation-induced lung injuries showed three patterns of computed tomography (CT) findings: ground glass opacities with interstitial thickening suggesting permeability pulmonary edema, irregular linear abnormalities, and centrilobular nodules. These abnormalities tended to improve within 1 week of exposure, leaving only minimal changes. These patterns of imaging illustrations, according to the time frame, may help physicians and radiologists comprehend the pathophysiology of these injuries, and to predict the prognosis of HCl inhalation-induced lung injury.