Exogenous lipoid pneumonia induced by nasal decongestant. (20th October 2016)

• Record Type: Journal Article
• Authors: Osman, Giorgia A.; Ricci, Alberto; Terzo, Fabrizio; Falasca, Carlo; Giovagnoli, Maria R.; Bruno, Pierdonato; Vecchione, Andrea; Raffa, Salvatore; Valente, Sabatino; Torrisi, Maria R.; De Dominicis, Chiara; Giovagnoli, Simonetta; Mariotta, Salvatore
• Is Part Of: Clinical respiratory journal. Volume 12:Number 2(2018)
• Page Start: 524
• Page End: 531
• Publication Date: 2016-10-20
• Subjects: bronchoalveolar lavage -- chest CT scan -- electron microscopic examination -- foamy macrophages -- lipoid pneumonia; Respiratory organs -- Diseases -- Periodicals; Respiratory organs -- Periodicals; 616.24
• DOI: 10.1111/crj.12557
• Languages: English
• ISSNs: 1752-6981

Abstract

Abstract: Introduction: Lipoid pneumonia is a clinical condition that may be initially asymptomatic or confused with an infectious or malignant lung disease. Objectives: We report four cases of this pathological condition. Methods: The first case concerned an 85‐year old woman with bilateral confluent pulmonary opacities, ground‐glass type. Diagnosis was based on the cytology of the bronchoalveolar lavage (BAL) fluid followed by its ultrastructural examination. The second case was a 47‐year‐old man with an isolated pulmonary nodule, which was surgically removed; the diagnosis of lipoid pneumonia was formulated on the basis of the histological and electron microscopy examination. The third case concerned a 73‐year‐old woman, with bilateral hypodense areas at the bases of the lungs where FDG PET/CT scan showed an increased uptake. Diagnosis was formulated by BAL cytology and electron microscopy examination. The fourth case was a 69‐year‐old man, who performed a virtual colonoscopy for diverticulosis putting in evidence a round mass (3 cm in diameter) with two small peripheral nodules, located in the pulmonary left lower lobe. The histopathological examination of transthoracic biopsy confirmed a lipoid pneumonia. Results and conclusion: In all four cases, it was put in evidence a prolonged use of a nasal decongestant containing mineral oils. In literature, the most cases described are characterized by a subclinical evolution and were presented as ground glass opacities which evolve, in the later phases, in an interstitial involvement or in a peripheral mass, simulating a lung tumour.