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Case Reports
. 2019 Apr 26:27:100850.
doi: 10.1016/j.rmcr.2019.100850. eCollection 2019.

Exogenous lipid pneumonia in old people caused by aspiration: Two case reports and literature review

Maoqing Guo  1 , Jianguo Liu  2 , Bo Jiang  1
Affiliations
Case Reports

Exogenous lipid pneumonia in old people caused by aspiration: Two case reports and literature review

Maoqing Guo et al. Respir Med Case Rep. .

Abstract

Background: Exogenous lipoid pneumonia is a rare entity, the diagnosis is often missed or delayed.

Objective: To investigate the clinical characteristics of exogenous lipid pneumonia in elderly patients, improve the efficiency of early diagnosis and treatment of this disease.

Methods: Retrospectively analyzed the clinical information and imaging data of these 2 exogenous lipid pneumonia patients, reviewed related literature.

Results: Both of the 2 patients were over 60 with a history of gastrointestinal diseases. The clinical presentation is nonspecific. Chest CT showed many different manifestations. Histopathology analysis revealed the accumulation of lipid carrying macrophages, vacuolar cells and inflammation. A literature review indicated that 25 previous cases of exogenous lipid pneumonia were caused by aspiration. The most common site of the lesion was located in right lung, while mineral oil was the most common substances. We sought to discuss the patient's treatment and the corresponding outcomes.

Conclusion: The diagnosis of lipid pneumonia's mainly depends on medical history and histopathological morphology. The standard treatment for exogenous lipid pneumonia was composed of antibiotics, steroid, bronchoscopic lavage and a regular follow-up.

Keywords: Antibiotic; Chest CT; Exogenous lipid pneumonia; Pathology; Steroid.

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Figures

Fig. 1
Fig. 1
A. Pre-treatment Chest CT shows massive opacities in the right lung lobes, geographic distribution of ground-glass opacities and associated thickening of the interlobular septa mainly in middle and lower lobes, consolidation mainly in low lobe. B. Bronchoscopy showed that the wall of the air tube was edematous with a small amount of pus.C.One year after Steroid treatment, Chest CT Shows dramatic Improvement. D. Lung puncture biopsy specimen of right lung nodular area showed empty spaces and vacuoles correspond to lipid dissolved. Hematoxylin- and eosin-stained slide.
Fig. 2
Fig. 2
A Chest CT showed necrotic consolidations with air bronchograms in right middle lobe (lung window). B Six months after treatment, chest CT shows most of lung opacity has been resolved. C Edematous change was observed in the right middle and lower lobe with a lot of grayish purulent secretions. D Photomicrograph of lung biopsy with hematoxylin-eosin stain showed necrosis, granuloma.
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