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The ME mucosa transforms from a monolayer of simple squamous epithelium to a full-thickness pseudostratified columnar respiratory epithelium containing secretory and ciliated cells within a few days of developing OM, as seen in both animal models and humans 4,5,6,7,8,9

This patient did not have any known exposure to hard metal, so we identified the use of an e-cigarette as a possible cause. Hard-metal pneumoconiosis causes damaged lung cells to engulf other cells and form giant cells that can be seen clearly under a microscope

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LDW may not detect all lane markings or lane departures