Aims and objectives
Lipoid pneumonia is an uncommon condition caused by pulmonary accumulation of fat-like compounds of animal,
vegetable or mineal origin.
It is classified in "endogenous" and "exogenous": the endogenousonesis caused by the accumulation of lipic substances (cholesterol and its esther) in lung tissues or due to lipidic storages diseases.
Chronic Exogenous lipoid pneumonia (ELP) usually results from repeated episodes of aspiration/inhalation of animal fat or mineral/vegetable oils over an extended period.
Also an acute formexists,
secondary to accidental (or not) inhalation of large quantity of lipid...
Methods and materials
Chest CT scans of 10 patients with non-specific clinical recalls (chronic cough,
dyspnoea,
fever) and history of chronic use of oily substances wereretrospectivelyevaluated in this study.
Period: May 2013 -October 2018.
Patients
Patients were 7 males and 3 females (aged 42-94,
mean age 74 years).
All patients performed abronchiolo-alveolar lavage (BAL) and they were also subjected to a careful medical anamnesis and pneumological examination.
CT examinations and images interpretation
CT exams were performed at baseline and after contrast medium administration (arterious and venous phase).
The...
Results
ELP has been found in:
4 laryngectomized patients (use of lubricants for tracheostomy)
6 dysphagic patients (4 use of paraffin oil for constipation; 2 use of oily-nasal spray).
CT findings showed:
in 8/10 lung consolidation with adipose density (attenuation values <-40 HU);
in 10/10 multiple areas of ground glass opacity (GGO)
in 6/10 smooth thickening of interlobular septa and GGO ("crazy paving" pattern)
in 2/10 nodules > 2.5 cm with spiculated margins (tumor-like)
in 5/10 reactive lymph nodes enlargement
Pulmonary alterations are localized in the...
Conclusion
Pathognomonic signs for ELP are consolidation areas with negative HU and "crazy paving" pattern; ELP is one of the differential diagnosis of this pattern.
Therefore,
it is essential to focus the attention on the anamnesis searching for potential sources of oily-substances inhalation,
in order to escape from diagnostic errors.
Personal information
Dr.
Diletta Cozzi
Department of Emergency Radiology
Careggi University Hospital
L.go Brambilla,
3
50134 Florence
Italy (IT)
[email protected]
Dr.
Maurizio Bartolucci: Department of Emergency Radiology - Careggi University Hospital,
Florence
Dr.
Federico Giannelli: Department of Emergency Radiology - Careggi University Hospital,
Florence
Dr.
Chiara Moroni: Department of Emergency Radiology - Careggi University Hospital,
Florence
Dr.
Edoardo Cavigli: Department of Emergency Radiology - Careggi University Hospital,
Florence
Dr.
Alessandra Bindi: Department of Emergency Radiology - Careggi University Hospital,
Florence
Dr.
Annamaria Grosso: Department of Pneumology and...
References
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MR,
and pathologic findings.
Eur Radiol 9;1190-1196.
Franquet T,
Gimènez A,
Bordes R et al (1997) The crazy-paving pattern in exogenous lipoid pneumonia: CT-pathologic correlation.
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Marchiori E,
Zanetti G,
Mano CM et al (2011) Exogenous lipoid pneumonia.
Clinical and radiological manifestations.
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Hadda V,
Khilnani GC (2010) Lipoid pneumonia: an overview.
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Betancourt SL,
Martinez-Gimenez S,
Rossi SE et al (2009) Lipoid...