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日本呼吸器学会英文誌 Respiratory Investigation
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Abstract

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Article in Japanese

Case Report

A case of exogenous lipoid pneumonia detected in the course of an annual examination

Hiroki Ohkoshi  Yuki Hoshino  Kie Inomata  Yusuke Sogami  Masafumi Saiki  Hiroshi Ishihara 

Department of Internal Medicine II, University of Yamanashi, Faculty of Medicine

ABSTRACT

Asymptomatic exogenous lipoid pneumonia (ELP) is rarely reported in Japan where liquid paraffin is seldom used as a laxative. Here we report a Japanese patient with asymptomatic ELP incidentally detected by annual examination. A 72-year-old man accidentally sprayed home-use pesticide aerosol toward his face, but symptoms like cough and dyspnea did not follow. A few days later chest X-ray performed as part of an annual health examination detected bilateral consolidation. He was referred to our department. Pathological examination, including lipid stain, of transbronchial lung biopsy obtained from right-sided B4a and B8a showed numerous lipid particles and lipid-laden macrophages in alveolar spaces and the interstitium, leading to the diagnosis of exogenous lipoid pneumonia. Since pyrethroids, the active ingredient of the pesticide, are recognized as safe for humans, the causative agent seemed to be a petroleum solvent such as kerosene. We should be aware that pesticide-induced lipoid pneumonia can present as an asymptomatic chest X-ray abnormality. Moreover, caution should be exercised when performing lipid stain so as not to dissolve the lipids in the process of deparaffinization for hematoxylin-eosin (HE) staining.

KEYWORDS

Exogenous lipoid pneumonia (ELP)  Lipid stain  Chest X-ray abnormality 

Received 23 Mar 2019 / Accepted 17 Jun 2019

AJRS, 8(5): 354-358, 2019

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