DISCUSSION: Pulmonary talcosis is a result of occupational inhalation of asbestos, silica or other talc-containing material as well as a result of IVDU. Talc is a filler used in medications. If crushed and injected intravenously, it can embolize and lead to granuloma formation in the pulmonary vasculature. CT findings include hyperdense centrilobular micronodules, ground glass opacities, conglomerate masses and panlobular emphysema. Biopsy shows granulomas containing birefringent material under polarized light. Clinically, this can manifest acutely or gradually with dyspnea, cough, fevers, night sweats and spontaneous pneumothorax. Chronic respiratory failure, emphysema, pulmonary hypertension and cor pulmonale can develop over time.