Exogenous Lipoid Pneumonia Following Ingestion of Liquid Paraffin.

Abstract

An asymptomatic patient with exogenous lipoid pneumonia (ELP) due to silent aspiration of liquid paraffin ingested as a lubricant was diagnosed by bronchoalveolar lavage (BAL). BAL fluid separated into oily upper phase and lower aqueous phase spontaneously. Microscopic analysis of BAL cells revealed the presence of lipid-laden alveolar macrophages. Classic histochemical staining and electron microscope examination indicated that neutral lipid was dominant but phospholipid was also present in the lipidladen macrophages. Together with the history of ingestion of liquid paraffin, we identified that the ingested liquid paraffin was the origin of the neutral lipid in the lipid-laden macrophages observed in the BAL fluid. (Internal Medicine 41: 483-486, 2002)

Lung Macrophages Accumulate Novel Cytosolic Inclusions With Vaping: A Case Report From an Asymptomatic Habitual Vaper

“…Historically, cytology-based studies utilizing Oil Red O staining have been used to demonstrate the presence of lipid-laden macrophages in the lung (7,11,14,15) There are limited ultrastructural studies showing lipid-like cytosolic inclusions in lung macrophages from BAL uid. M. tuberculosis infection studies (16,17), mineral oil-exposure related (18,19) or petroleum aspiration (20) reports come closest to describing similar inclusions, nonetheless these structures are clearly not the heterogeneous structures we have observed here in the vaping subject.…”

Clinic and radiological improvement of lipoid pneumonia with multiple bronchoalveolar lavages

“…7,10,18 BAL fluid in LP typically has a milky appearance due to the presence of extracellular fat floating globules and alveolar macrophages containing cytoplasm vacuoles that stain orange with Sudan. 6,13,20 Lipid-laden macrophages per se however, are a nonspecific finding, also being found in a variety of other conditions including bronchiectasis, idiopathic pulmonary fibrosis, obstructive pneumonia, fat embolism, alveolar proteinosis, lipid storage diseases, and gastroesophageal reflux. Extracellular oily droplets are more specific for exogenous LP.…”

“…Exogenous LP is an uncommon pulmonary disorder that results from repetitive oil aspiration often observed in children under treatment for constipation. 4,6,8,10,20 Risk factors for exogenous LP include infancy and elderly; anatomic or functional pharyngeal and esophageal abnormalities such as Zenker diverticulum, hiatus hernia, achalasia, gastroesophageal reflux; neurologic or neuromuscular disorders that result in pharyngeal dysmotility or affect the cough reflex. [1][2][3]10 In many countries, an infant are routinely forced to receive oil substances as traditional habits for hygienic purposes but in Brazil is used to treat partial small-bowel obstruction by A. lumbricoides in small children.…”

Exogenous Lipoid Pneumonia as a Contributory Factor in a Drug‐related Death

“…Ohwada et al. highlighted the difficulties of abruptly stopping dependence on oil exposure, especially for patients who have used fatty remedies for a long time. The other course of treatment is poorly defined and discussed in the literature.…”