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Article in Japanese
Abstract
Case Report
A case of peculiar lipoid pneumonia induced by recurrent microaspiration after gastrectomy
Norihiko Nakanishia Yuji Ohtsukib Kazuhiko Saekia Sayaka Tachibanaa Masaaki Shiojiria Koji Inouea
aDepartment of Respirology, Ehime Prefecture Central Hospital
bDepartment of Diagnostic Pathology, Matsuyama Shimin Hospital
ABSTRACT
A 75-year-old man was admitted to our hospital because of bilateral chest abnormal shadows. He had a past history of gastrectomy associated with repeated bowel obstruction, and chest computed tomography showed ground-glass opacities (GGO) in both lower lobes. Bronchoalveolar lavage fluid showed lymphocytosis. Pathological examination of pulmonary tissue obtained by video-assisted thoracoscopic surgery showed numerous foamy macrophages and cholesterin clefts in alveolar spaces associating eosinophilic fluid. These cells and fluid are positive for diastase-digested periodic acid-Schiff reaction, antibodies to both SP-A and KL-6, mimicking pulmonary alveolar proteinosis (PAP). The reported case is then diagnosed as one of peculiar lipoid pneumonia, revealing PAP-like changes. To suspect lipoid pneumonia with only GGO is difficult.
KEYWORDS
Lipoid pneumonia Pulmonary alveolar proteinosis Bowel obstruction Gastroesophageal reflux disease
Received 17 Feb 2015 ／ Accepted 24 Aug 2015
AJRS, 5(1): 46-51, 2016
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