Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Lipoid pneumonia (exogenous)
- Radiologic Findings
- Fig 1. Chest PA shows GGO and consolidation in both lower lung fields.
Fig 2-5. CT scans reveals multifocal GGO and consolidation with interstitial thickening and some crazy-paving pattern areas in both lungs, mainly at dependent portions.
- Brief Review
- Lipoid pneumonia can be either exogenous or endogenous in cause based on the source of the lipid. Exogenous lipoid pneumonia usually occurs when animal fats or mineral or vegetable oils are aspirated or inhaled, whereas endogenous lipoid pneumonia results from lipid accumulation within intra-alveolar macrophages in the setting of bronchial obstruction, chronic pulmonary infection, pulmonary alveolar proteinosis, or fat storage diseases.
Radiologic findings include the pulmonary opacities with ground-glass or consolidative, bilateral, and segmental or lobar in distribution and predominantly involve the middle and lower lobes. CT can reveal areas of fat attenuation as low as -30HU within the consolidative opacities and nodules, a finding diagnostic of lipoid pneumonia. However, even though the attenuation of the opacities or nodules can be low at initial presentation, the presence of superimposed inflammation can be a confounding factor by increasing the attenuation so that the fat component becomes less conspicuous or obscured. In the chronic phase, architectural distortion and interlobular septal thickening with fibrosis could be accompanied due to the transposition of oils from the alveoli in the lung interstitium. Additionally, ground-glass opacities with associated interlobular septal thickening (crazy-paving pattern) with a basilar predominance have also been described.
The information of various ways that a patient can be exposed to lipid-containing material is essential in the diagnosis of exogenous lipoid pneumonia.
- Please refer to
Case 1261, Case 1069, Case 747, Case 639, Case 554, Case 134, Case 24, -
- References
- 1. Betancourt SL, Martinez-Jimenez S, Rossi SE, Truong MT, Carrillo J, Erasmus JJ. Lipoid pneumonia: spectrum of clinical and radiologic manifestations. American Journal of Roentgenology. 2010;194(1):103-9.
- Please refer to
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- Keywords
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lipoid pneumonia,