ABSTRACT
Exogenous lipoid pneumonia is an uncommon medical condition resulting from aspiration or inhalation of oily material. Generally, lipoid pneumonia has nonspecific clinical and radiological presentations, and may be misdiagnosed as bacterial pneumonia or lung cancer. We describe an unusual case of exogenous lipoid pneumonia accompanied by peripheral blood and pulmonary eosinophilia. A 63-year-old man was admitted with progressively worsening exertional dyspnea and productive cough for 5 days. A chest radiograph showed abnormalities in the lower lobe of the right lung, and a diagnosis of community-acquired pneumonia was made; intravenous antibiotics were administered. However, dyspnea and hypoxia gradually worsened and peripheral blood eosinophilia developed. A bronchoscopy was performed and bronchoalveolar lavage fluid analysis showed markedly increased numbers of eosinophils (40%). Subsequently, a comprehensive review of history revealed that he fell asleep with camellia oil in his mouth for 2 weeks to relieve foreign body sensation of the throat. Sputum and bronchoalveolar lavage fluid cytology showed the presence of lipid-laden macrophages. He was diagnosed with lipoid pneumonia and acute eosinophilic pneumonia. Chest radiograph and symptom were rapidly improved after treatment with intravenous methylprednisolone.
Subject(s)
Humans , Middle Aged , Hypoxia , Anti-Bacterial Agents , Bronchoalveolar Lavage Fluid , Bronchoscopy , Camellia , Cough , Diagnosis , Dyspnea , Eosinophilia , Eosinophils , Foreign Bodies , Inhalation , Lung , Lung Neoplasms , Macrophages , Methylprednisolone , Mouth , Pharynx , Pneumonia , Pneumonia, Bacterial , Pneumonia, Lipid , Pulmonary Eosinophilia , Radiography, Thoracic , Respiratory Aspiration , Sensation , SputumABSTRACT
Endogenous lipid pneumonia was found in 11 out of 15 (73.3%) opossums (Didelphis virginiana) captured in six municipalities from the state of Colima, Mexico. Macroscopically, multifocal yellow white subpleural plaques were found in the dorsocaudal region of both lungs. These lesions were extended to the pulmonary parenchyma. Microscopically, they were characterized by aggregates of macrophages in the alveolar walls and spaces. These macrophages had small lipid vacuoles in the cytoplasm. Also, hyperplasia of pneumocytes type II, perivascular lymphoid hyperplasia, emphysema and fibrosis were discovered. Based on these findings, endogenous lipid pneumonia was diagnosed, which seemed to be associated in 11 (73.3%) opossums with the presence of Didelphostrongylus hayesi in lungs.
Se encontró neumonía lipídica endógena en 11 (73.3%) de 15 tlacuaches (Didelphis virginiana) capturados en seis municipios del estado de Colima, México. Macroscópicamente se observaron placas subpleurales multifocales (1-5 mm) de color amarillo pálido en la región dorso caudal de ambos pulmones. Estas lesiones se extendían al parénquima pulmonar. Microscópicamente se caracterizaban por agregados de macrófagos en los espacios y paredes alveolares. Los macrófagos tenían abundantes vacuolas pequeñas lipídicas en el citoplasma. También se observó hiperplasia de neumocitos tipo II, hiperplasia linfoide perivascular, enfisema y fibrosis. Con base en estos hallazgos se diagnosticó neumonía lipídica endógena, la cual parecía estar asociada en 11 de los tlacuaches, con la presencia de Didelphostrongylus hayesi en los pulmones.
ABSTRACT
An example of lymphoblastic lymphosarcoma was found in a 7-year-old male brown bear (Ursus arctos) that died after having a 7-month history of depression, anorexia and watery diarrhea. Grossly the mesenteric lymph nodes were enlarged to approximately 4 to 6 times their normal size and histologically diagnosed as lymphoblastic lymphosarcoma. The small intestinal mucosa was corrugated and had severe mural thickening due to infiltrated neoplastic cells. Hepatic metastasis was also noted. This is the first reported case of lymphosarcoma in Ursidae in Korea. As an incidental finding, endogenous lipid pneumonia was noted in the lung.