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Lipoid Pneumonia

 

  • Exogenous accumulation of fat in the lung most often from mineral oil:

  • Older people who are constipated, have a swallowing disorder 2° neurologic disease

  • In infants with feeding difficulties

  • In the past, could be from oily nose drops

  • Accumulation of fat in the lung may also occur from endogenous sources such as fat embolism, alveolar proteinosis lipid storage diseases

  • Animal fatty acids (like fat embolus) produces hemorrhagic bronchopneumonia

  • Mineral oil produces a giant cell foreign body reaction

  • Starts as an alveolar infiltrate

  • Moves to thicken interstitial septa, then

  • Into macrophages enlarging lymphatics

  • Finally produces a fibrosing reaction

X-ray

  • Usually lower lobes with predilection for the right

  • Alveolar consolidation, may be well-circumscribed

  • May present as a peripheral mass with fuzzy or distinct margins simulating BrCa

Clinical

  • Usually asymptomatic

Diagnosis

  • Best method of DX is direct Bx

  • Fat-laden macrophages are non-specific since they can be found in sputum of normals as well

 WH/‘91,‘93  

 

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