DESCRIPTION

This case was a 44-year-old lady who had smoked canna-bis heavily for 3 years from age 41–44. Her situation was unusual for two reasons. She had been advised to smoke cannabis for some migraines she had experienced, by her previous local doctor. Other prophylactic treatments had not been tried. Second, she had unlimited access to can-nabis supply smoking up to 5 g (50 cones) daily via a bong. She had 6 months of increasing breathlessness and was no longer able to walk across a room. Her previous asthma had different symptomatology. This case is important for several reasons. First, while cystic lung disease is a suspected complication of heavy cannabis smoking, relatively few cases have been described of this manner ( fi gure 1). 1 – 4 Smoking cannabis via a bong with the breath-holding increases intrathoracic pressure and promotes cyst formation. Second, long-term cannabis is known to increase cough, sputum production and air-way infl ammation 2 – 3 5 which itself increases airway resist-ance exacerbating cyst formation and coalescence. This highlights the importance of tight asthma control. Third, at 19 cm diameter, this is the largest cyst described. Fourth, Images in... Giant cystic lung disease with mediastinal compression in a short-term heavy cannabis smoke