대한흉부영상의학회 Korean Society of Thoracic Radiology GuerBet

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대한흉부영상의학회 Weekly Case 검색
대한흉부영상의학회 Weekly Case 검색
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Weekly Chest CasesArchive of Old Cases

Case No : 24 Date 1998-03-13

  • Courtesy of Jin Seong Lee, M.D., Hyae Young Kim, M.D. / Asan Medical Center
  • Age/Sex 72 / M
  • Chief Complaintdry cough and mild dyspnea for 1 month
  • Figure 1
  • Figure 2
  • Figure 3

Diagnosis With Brief Discussion

Diagnosis
Lipoid pneumonia due to Squalene aspiration
Radiologic Findings
Exogenous lipoid pneumonia is a rare disorder caused by the aspiration of mineral, vegetable, or animal oils present in food, radiographic contrast media, or oil-based medications. Predisposing factors such as neuromuscular disorders or structural abnormalities of the pharynx and esophagus are frequently associated with this condition. Clinically, the patients present with a cough, shortness of breath, mild fever, and chest discomfort.
Pathologic findings are intra-alveolar infiltrate of macrophages, which rapidly phagocytize the oil in acute stage. With time, these macrophages become predominantly interstitial in location and decrease in number. Because the oil is carried from the alveoli into the interstitial space by macrophages, a predominantly interstitial pattern can develop in the chronic stages.
HRCT findings are geographic distribution of ground-glass opacities and air-space consolidation, sometimes showing crazy paving appearance. The lesions are mostly located in dependent portions. Differential diagnosis includes alveolar proteinosis.
The diagnosis of lipoid pneumonia can be appropriately made by clinical history of squalene aspiration and HRCT findings.
Brief Review
References
1. Webb RW, Muller NL, Naidich DP. HRCT of the lung. 2nd ed, New York: Lippincott- Raven, 1996:210-212.
2. Franquet T. Gimenez A, Bordes R et al. The crazy-paving pattern in exogenous lipoid pneumonia: CT-Pathologic correlation. AJR 1998:170:315-317.
Keywords
Lung, Inhalation and aspiration disease,

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