Unusual cause of a fatal foreign body pulmonary granulomatosis

Pulmonary foreign body granulomatosis is a rare disease characterized by granuloma as a result of exposure to mineral substances. It has been reported in intravenous drug abusers who inject powdered medications. In the present case a 57-year-old female tourist with a history of cancer died in her hotel room. The autopsy revealed pulmonary fibrosis with granulomatosis containing birefringent particles (mainly talc). The cause of death was an acute right heart failure due to chronic pulmonary hypertension triggered by regular therapeutic use of painkillers after cancer occurring in previous years.