Reaction of human lungs to aspirated animal fat (ghee): a clinicopathological study

Annobil, Samuel H.; Morad, Nader; Khurana, Praful; Kameswaran, Mohan; Oa, Ogunbiyi; Al-Malki, Talal

doi:10.1007/bf00191368

Cited by 15 publications

(14 citation statements)

References 13 publications

(10 reference statements)

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“…Sometimes fat is entrapped in the interstitium [1,2,4,15]. In our series lesions of various ages were identified in the specimens of the four patients whose pathological features could a b…”

Section: Discussionmentioning

confidence: 78%

“…In many cases excessive use of an oily substance is the presumed cause. Unlike animal oils, which elicit a very active inflammatory response [15], mineral oils are fairly inert because they have no fatty acids and are rapidly emulsified and consumed by pulmonary macrophages. Vegetable oils are emulsified and not hydrolyzed by the lung lipase and result in a foreign-body reaction.…”

Section: Discussionmentioning

confidence: 99%

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Exogenous lipoid pneumonia: HRCT, MR, and pathologic findings

et al. 1999

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The objective of this study was to describe high-resolution CT (HRCT) and MR findings of exogenous lipoid pneumonia and to correlate them with pathologic findings. A retrospective review of the medical records of our institution revealed seven patients with a diagnosis of lipoid pneumonia based on clinical data, chest films, bronchoalveolar lavage, and follow-up. Both HRCT and MR imaging were reviewed by two readers. Pathologic examination of the resected specimen or surgical biopsies were also reviewed in the four available cases. The HRCT findings were pulmonary consolidations (n = 6) with fatty (n = 3) or unspecific but low attenuation values (n = 3), areas of ground-glass opacities (n = 5), septal lines, and centrilobular interstitial thickening (n = 5). In five of the seven cases, a crazy-paving pattern of various spread was also present, either isolated (n = 1) or surrounding a pulmonary consolidation. In two cases traction bronchiectasis and cystic changes consistent with fibrosis were seen. At MR imaging (n = 2) a pulmonary consolidation of high signal intensity on T1-weighted image consistent with lipid content was present in one case. Pathologic examination (n = 4) showed the coexistence of lobules with lesions of various ages, sometimes in contiguous lobules, within the same patient. Recent lesions were those with alveolar fill-in by spumous macrophages and almost normal alveolar walls and septae. In more advanced lesions, lobules were filled in with larger vacuoles often surrounded by inflammatory infiltrates of alveolar walls, bronchiolar walls, and septa. The oldest lesions were characterized by fibrosis and parenchymal distortion around large lipid-containing vacuoles. The HRCT findings reflect pathologic findings in exogenous lipoid pneumonia. Although non-specific, consolidation areas of low attenuation values and crazy-paving pattern are frequently associated in exogenous lipoid pneumonia and are indicative of the diagnosis.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Exogenous lipoid pneumonia: HRCT, MR, and pathologic findings

et al. 1999

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“…They are released into the alveoli in a timely fashion following disruption of the macrophages, inciting a giant cell response leading to fibrosis and disruption of bronchial and alveolar structure. [78] Diesel is a complex hydrocarbon mixture produced from the fractional distillation of crude oil, to which various chemical additives are added.…”

Section: Discussionmentioning

confidence: 99%

"Diesel siphoner′s lung": Exogenous lipoid pneumonia following hydrocarbon aspiration

et al. 2014

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Lipoid pneumonia is an unusual and uncommon form of pneumonia caused by aspiration of fatty substances. Hydrocarbon pneumonitis following aspiration of diesel is a form of exogenous lipoid pneumonia wherein, aspirated diesel reaches the alveoli rapidly without evoking any significant cough, but initiates an intense inflammatory reaction in the pulmonary parenchyma. This is a rarely described clinical scenario, although the practice of diesel siphonage from automobiles is a common practice in developing countries. We herein describe a 40-year-old male patient, in whom the diagnosis of lipoid pneumonia was delayed for a long duration and highlight the importance of taking a detailed occupational exposure history in patients with non-resolving pneumonia to rule out the underlying possibility of this rare clinical entity.

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“…These oils were used for three main reasons: (1) cultural (2) medical or (3) behavioural. Ghee (rendered animal fat) and olive oil were commonly documented in studies from Saudi Arabia and India for which they were used culturally for oral/nasal cleansing purposes in oil baths, as a laxative, for nutritional supplements, to prevent coughs and colds and to generally promote good health [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. Shark liver oil was mainly reported in South Korea for cultural reasons [23].…”

Section: Oil Use and Rationalementioning

confidence: 99%

Exogenous lipoid pneumonia in children: A systematic review

Marangu

Gray

Vanker

et al. 2020

Paediatric Respiratory Reviews

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Educational aimsTo recognize that exogenous lipoid pneumonia (ELP) in children resulting from cultural and medical practices is a rare albeit preventable interstitial lung disease. To review the clinical-radiological patterns of paediatric ELP which vary widely making this diagnosis indistinguishable from other causes of persistent pneumonia. To describe the association of non-tuberculous mycobacteria (NTM) infections and paediatric ELP resulting in significant comorbidity. To rank studies on ELP in children in the existing literature based on diagnostic certainty and propose standardized case definitions and consistent reporting of treatment outcomes and efficacy. a b s t r a c tObjectives: To describe the clinical-radiological-pathological characteristics and treatment outcomes of children with suspected exogenous lipoid pneumonia (ELP). Design: Systematic review. We searched electronic databases and reference lists published between 1967 and 2018, restricted to non-accidental cases. Results: Forty-four studies including 489 participants aged 1 day to 17 years from 13 countries were included. Cultural, medical, and behavioural rationale for oil-use was described. The clinicalradiological presentation varied widely. Diagnostic certainty was deemed highest if ELP was confirmed on bronchoalveolar lavage/frozen section lung biopsy with documented extracellular lipid on cytological staining and/or fat analysis. Non-tuberculous mycobacteria infection was identified in six studies: Mycobacterium fortuitum/chelonei, Mycobacterium smegmatis and Mycobacterium abscessus. Treatment comprised supportive therapy, corticosteroids, stopping oil, therapeutic lung-lavage and surgical resection. Outcomes were reported inconsistently. Conclusion: Paediatric ELP resulting from cultural and medical practices continues to be described globally. Preventive interventions, standardized reporting, and treatment efficacy studies for cases not averted, are lacking.Protocol registration: PROSPERO CRD42017068313.

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Reaction of human lungs to aspirated animal fat (ghee): a clinicopathological study

Cited by 15 publications

References 13 publications

Exogenous lipoid pneumonia: HRCT, MR, and pathologic findings

Exogenous lipoid pneumonia: HRCT, MR, and pathologic findings

"Diesel siphoner′s lung": Exogenous lipoid pneumonia following hydrocarbon aspiration

Exogenous lipoid pneumonia in children: A systematic review

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