Diagnosis of lipoid pneumonia

Abstract

1. 1. Lipoid pneumonia occurs not only in chronically debilitated adults or in physically handicapped children, but also has been observed in apparently healthy individuals. Mineral oil is the most common cause of this condition since it is widely used as a mild laxative as well as a vehicle for oily nose drops, thorat lubricants or various oil-containing medications. 2. 2. The differential diagnosis of lipoid pneumonia frequently causes considerable difficulty since this condition may be confused with other pulmonary diseases such as low grade infections, tuberculosis, fungus disease, sarcoidosis or benign and malignant neoplasms. 3. 3. The recognition of lipoid pneumonia is of particular importance in those patients in whom a diagnosis of bronchogenic carcinoma is entertained because needless surgical intervention may be avoided. 4. 4. The clinical findings are not characteristic, and include productive cough, dyspnea, febrile exacerbations and chest findings associated with pulmonary consolidation. In many instances the patients are asymptomatic. 5. 5. The diagnosis of lipoid pneumonia can be established clinically with a considerable degree of accuracy by correlating the roentgenographic findings with cytologic studies of the sputum as well as of material aspirated transthoracically from the lung. 6. 6. The positive sputum contains lipophages and abundant amounts of free sudanophilic material, while the material aspirated from the lung is considered positive when the characteristic lipophages, single or arranged in clusters and frequently transformed into giant cells, are found. 7. 7. The roentgenographic features indicative of lipoid pneumonia are discussed. 8. 8. The mechanism of the progressive nature of the disease after discontinuance of the inciting liquid petrolatum is suggested as being due to reaspiration of disintegrated lipophages. 9. 9. Early clinical recognition of lipoid pneumonia may prevent extensive spread of the pulmonary involvement by discontinuing the intake of mineral oil or other oil-containing medications.