대한흉부영상의학회 Korean Society of Thoracic Radiology

Discussion

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,