대한흉부영상의학회 Weekly Chest Cases

Case No : 1413 Date 2024-11-18

Courtesy of Woon–Jung Kwon / UIsan University Hospital
Age/Sex 73 / F
Chief ComplaintDOE for 2 months

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Diagnosis With Brief Discussion

Diagnosis: Lipoid pneumonia
Radiologic Findings: Fig. 1-2. Chest PA and lateral images show diffuse ill-defined nodules and consolidations in both lower lung zones, which accompanied with air-bronchogram and both cardiac margins obliteration.
Fig. 3-7 Chest CT axial images (lung window setting) show multifocal ill-defined centrilobular nodules and diffuse ill-defined ground glass opacities in both lungs (both lower lobe predominant). Also, it is revealed minimal traction bronchiectasis and crazy-paving appearance within ill-defined ground glass opacities.
Brief Review: Since DOE symptom did not improve despite appropriate treatment, the TBLB was performed for patient histological examination. Histologic findings (H&E stain) represent mature adipose tissue present in bronchiole and lung parenchyme (red circle and blue arrows). This was a finding consistent with lipoid pneumonia. After the patient was diagnosed on lipoid pneumonia, when the patient's medical drug history was taken again, it was found that the patient had been taking squalene in a liquid pouch (not capsule form) by tearing open the plastic pouch and ingesting it during about 3 months. This type of squalene is thought to be much more likely (be larger amount of aspiration) to result in aspiration of the contents in elderly patients compared to the capsule type.
References
Keywords

No. of Applicants : 61

▶ Correct Answer : 39/61, 63.9%

- , Japan SUZUNE TSUKAMOTO
- Shiga University of Medical Science , Japan AKITOSHI INOUE
- Kyoto University , Japan AKIHIKO SAKATA
- McGill University Health Center , Canada ALEXANDRE SEMIONOV
- , Korea (South) DONG-HO BANG
- Healthy Longevity Medical Center , Japan SHIN-ICHI CHO
- Vita Hospital , Brazil DIOGO LAGO PINHEIRO
- Other , Korea (South) SEONGSU KANG
- , Korea (South) JIN YOUNG LEE
- Secomedic Hospital , Japan FUMINORI MIYOSHI
- Oita University, Faculty of Medicine , Japan FUMITO OKADA
- Seoul Medical Center , Korea (South) HYUK GI HONG
- university of montreal , Canada Andrei Bogdan Gorgos I
- University of Yamanashi , Japan TAKAAKI HASHIMOTO
- The University of Tokyo Hospital , Japan TOSHIHIRO FURUTA
- , Japan YOSHIKI ISHII
- University of Yamanashi , Japan HIROAKI WATANABE
- Nankai medical center , Japan NORITAKA KAMEI
- , Japan KENTARO KOTANI
- Ajou University Hospital , Korea (South) YOU NA KIM
- , Japan SHUNJIRO NOGUCHI
- , Korea (South) HEONSEOK LEE
- Osaka metropolitan university Hospital , Japan TATSUSHI OURA
- Mie university , Japan SHIKO OKABE
- Dokkyo Medical University , Japan HIROAKI ARAKAWA
- TB centre kasaragod. , India rikhy krishnan
- Korea University Anam Hospital , Korea (South) KYU-CHONG LEE
- Paras hospital, Panchkula , India SHALEEN RANA
- The First Affiliated Hospital of Nanjing Medical University , China TENG ZHANG
- SUNY Downstate , United States SAMUEL REISMAN
- Yonsei University,Severance Hospital , Korea (South) SEO BUM CHO
- Fukuoka university , Japan KEISUKE SATO
- Kantou Rousai Hospital , Japan KAORU SUMIDA
- Matsunami General Hospital , Japan TARO TAKEDA
- Toyota Kosei Hospital , Japan YUKI HAYASHI
- The Catholic University of Korea Yoeuido St. Mary , Korea (South) CHAWOONG JEON
- the first affiliatited hospital of nanjing medical univercity , China HAI XU
- , Japan JUN YOSHIDA
- Jiangsu province hospital , China WANGJIAN ZHA

▶ Correct Answer as Differential Diagnosis : 4/61, 6.6%

- Kyoto City Hospital , Japan YUSUKE UTSUNOMIYA
- NIMS, HYDERABAD , India BHASKAR K
- Jichi Medical University, School of Medicine , Japan MITSURU MATSUKI
- Kyoto University , Japan SHO KOYASU

대한흉부영상의학회 Korean Society of Thoracic Radiology

Archive of Old Cases

Case No : 1413 Date 2024-11-18

Discussion

No. of Applicants : 61