Presentation
Opacity in the right lower lobe of 2 years evolution, presents with cough, fever and desaturation.
Patient Data
Bilateral peribronchovascular consolidation predominantly in the right middle and posterobasal lower lobes. Attenuation within the consolidation (-98 HU) is similar to subcutaneous fat attenuation.
Cavities, bronchiectasis and tree-in-bud nodules in the lower lobes.
No lymphadenopathy.
Case Discussion
Lipoid pneumonia (LP) is a rare disease caused by inhalation and progressive accumulation of fatty compounds present in a variety of products, e.g. lubricants. The incidence is increasing due to the popularity of "vaping", which is the use of electronic cigarettes which sometimes contain oil.
Imaging is an important part of the diagnosis, especially CT. This case illustrates the main findings: bilateral dependent consolidation with fat attenuation (values between -150 and -30 HU). Lipid-laden macrophages obtained by biopsy or lavage are necessary for definitive diagnosis.
Currently, there is no consensus on treatment of these patients. This patient had to be admitted to critical care for management of respiratory failure.
Images courtesy of Dr Rosa Dosdá.
Unable to process the form. Check for errors and try again.