Pneumonia in a Patient With Gastroesophageal Reflux and Chronic Constipation: Lipoid Pneumonia

Abstract

In Brief Lipoid pneumonia is an uncommon and often underrecognized form of pneumonia. It results from accumulation of lipid material in the lung. Based on the source of the lipid, lipoid pneumonia may be classified as either exogenous or endogenous. Exogenous lipoid pneumonia results when lipid from an external source reaches the lungs usually either by aspiration or inhalation. Mineral, vegetable, or animal oils are the most frequent agents. The mainstay of treatment is supportive with discontinuation of further exposure to the offending agent. Endogenous lipoid pneumonia occurs when lipids that are produced by the body are deposited in the lung. Often, lipids escape from alveolar cells when they are destroyed in a suppurative or obstructive process leading to cholesterol pneumonitis.3,4 Fat emboli, disorders of lipid storage, and pulmonary alveolar proteinosis are other ways lipids may accumulate in the lung.3 We describe a case of exogenous lipoid pneumonia in a patient using mineral oil to relieve chronic constipation. Lipoid pneumonia is an uncommon finding on thoracic imaging. We present a patient with exogenous lipoid pneumonia resulting from the aspiration of mineral oil used for chronic constipation with a review of diagnostic and imaging considerations.