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Pérez-Accino J, Liuti T, Pecceu E, Cazzini P. Endogenous lipoid pneumonia associated with pulmonary neoplasia in three dogs. J Small Anim Pract 2020; 62:223-228. [PMID: 31943233 DOI: 10.1111/jsap.13101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Revised: 10/26/2018] [Accepted: 01/02/2019] [Indexed: 12/17/2022]
Abstract
Endogenous lipoid pneumonia is a poorly characterised condition in veterinary medicine, particularly in dogs, but it is well recognised in association with lung neoplasia in humans. This case series describes three unique cases of endogenous lipoid pneumonia associated with lung neoplasia, including clinical, imaging, cytological findings and outcome. Clinical presentation and imaging lesions can appear non-specific and may be obscured by neoplastic infiltrate and so diagnosis requires cytology or histopathology. Awareness of endogenous lipoid pneumonia in dogs with pulmonary neoplasia has an impact on staging and monitoring, treatment of clinical signs and quality of life and also aids appropriate use of antimicrobials.
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Affiliation(s)
- J Pérez-Accino
- Hospital for Small animals, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Roslin, EH25 9RG, UK
| | - T Liuti
- Hospital for Small animals, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Roslin, EH25 9RG, UK
| | - E Pecceu
- Hospital for Small animals, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Roslin, EH25 9RG, UK
| | - P Cazzini
- Easter Bush Pathology, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Roslin, EH25 9RG, UK
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2
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Cha SI, Choi SH, Kim HJ, Kim YJ, Lim JK, Yoo SS, Lee SY, Lee J, Kim CH, Park JY. Clinical and radiological manifestations of lipoid pneumonia according to etiology: Squalene, omega-3-acid ethyl esters, and idiopathic. CLINICAL RESPIRATORY JOURNAL 2019; 13:328-337. [PMID: 30821081 DOI: 10.1111/crj.13015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 01/26/2019] [Accepted: 02/24/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Clinical manifestations of lipoid pneumonia (LP) vary depending on the causative agents or underlying causes. The aim of the present study was to investigate the clinical and radiological features of LP, classified according to etiologic agents. METHODS The clinico-radiological characteristics of LP patients were retrospectively compared among groups: exogenous versus idiopathic and squalene versus omega-3-acid ethyl esters (O-3-AEE) versus idiopathic. Idiopathic group was defined as LP with no proven or reported etiological evidence. RESULTS Twenty-two patients met the diagnostic criteria for LP: squalene (9 [41%]), O-3-AEE (6 [27%]), olive oil (1 [5%]), and idiopathic (7 [32%]). Compared with the exogenous group, the idiopathic group showed a higher recurrence rate; higher frequencies of bronchial anthracofibrosis (BAF) and bronchoalveolar lavage (BAL) lymphocytosis; and a higher rate of crazy-paving pattern and lower rate of consolidation on computed tomography scan. In three-group tests, compared with the O-3-AEE group, the squalene group exhibited a significantly higher percentage of neutrophils and a higher rate of right middle lobe (RML) involvement. CONCLUSIONS In comparison with the exogenous group, the idiopathic group demonstrated BAL lymphocytosis, higher rates of recurrence and BAF, and a higher rate of crazy-paving pattern. Compared with the O-3-AEE group, the squlaene group showed a higher percentage of BAL neutrophils and predominant RML involvement.
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Affiliation(s)
- Seung-Ick Cha
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
| | - Sun Ha Choi
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - Hyun Jung Kim
- Department of Internal Medicine, Keimyung University Dongsan Hospital, Daegu, South Korea
| | - Yeon Jae Kim
- Department of Internal Medicine, Daegu Fatima Hospital, Daegu, South Korea
| | - Jae-Kwang Lim
- Department of Radiology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
| | - Seung-Soo Yoo
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
| | - Shin-Yup Lee
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
| | - Jaehee Lee
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
| | - Chang-Ho Kim
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
| | - Jae-Yong Park
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
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Sung S, Tazelaar HD, Crapanzano JP, Nassar A, Saqi A. Adult exogenous lipoid pneumonia: A rare and underrecognized entity in cytology - A case series. Cytojournal 2018; 15:17. [PMID: 30112015 PMCID: PMC6069323 DOI: 10.4103/cytojournal.cytojournal_29_17] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 07/21/2017] [Indexed: 01/15/2023] Open
Abstract
Background: Exogenous lipoid pneumonia (ELP) is a rare benign entity without specific clinical or imaging presentation. Although cytological studies – either bronchoalveolar lavage (BAL) or fine-needle aspiration (FNA) – may be pursued in patients with ELP, a definitive diagnosis is frequently rendered only on histology. The aim of this study is to highlight the cytological features of ELP. Methods: A search of cytopathology (CP) and surgical pathology (SP) diagnoses of ELP was conducted. The corresponding clinical and imaging features were obtained, and the morphology, particularly the presence and size of the intracytoplasmic vacuoles and background, was assessed. Results: Nine cases of ELP were identified, including eight with corresponding CP and SP. A neoplasm was suspected in three based on imaging, but ELP was not in the differential clinically or radiographically in any. Among the cases, six patients had BALs and three FNAs. All of the samples showed multiple large vacuoles within macrophages with at least some equal to or larger than the size of the cell nucleus. Similar vacuoles were noted extracellularly on smears. Conclusions: ELP is typically described in case reports in the clinical or radiological literature. To the best of our knowledge, this represents the largest series of adult ELP in CP. When large vacuoles are present in macrophages in cytology specimens, at least a suspicion of ELP can be suggested to initiate appropriate therapy, identify/remove the inciting agent, and preclude a more invasive procedure.
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Affiliation(s)
- Simon Sung
- Address: Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA
| | | | - John P Crapanzano
- Address: Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA
| | - Aziza Nassar
- Department of Pathology, Mayo Clinic, Jacksonville, FL, USA
| | - Anjali Saqi
- Address: Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA
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Chardin D, Nivaggioni G, Viau P, Butori C, Padovani B, Grangeaon C, Razzouk-Cadet M. False positive 18FDG PET-CT results due to exogenous lipoid pneumonia secondary to oily drug inhalation: A case report. Medicine (Baltimore) 2017; 96:e6889. [PMID: 28562539 PMCID: PMC5459704 DOI: 10.1097/md.0000000000006889] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Exogenous lipoid pneumonia is a rare condition due to abnormal presence of oily substances in the lungs. It is a rarely known cause for false positive FDG PET-CT results and can sometimes lead to invasive investigations. Searching and finding the source of the oily substance is one of the keys to the diagnosis. Inhalation of oily drugs during snorting has rarely been described. PATIENT CONCERNS A patient with well controlled HIV infection was referred for an FDG PET-CT to assess extension of Kaposi's disease, recently removed from his right foot. The patient had no particular symptoms. DIAGNOSES Abnormal uptake of FDG was found in a suspicious lung nodule. An experienced radiologist thought the nodule was due to lipoid pneumonia. INTERVENTIONS Bronchoalveolar lavage fluid did not contain lipid-laden macrophages but bronchoscopy showed violet lesions resembling Kaposi's disease lesions. Lobectomy was performed after a multidisciplinary discussion. OUTCOMES Anatomopathological analysis revealed the nodule was due to lipoid pneumonia. The patient's quality of life did not diminish after the operation and he is still in good health. The source of the oily substance causing lipoid pneumonia was found after the surgery: the patient used to snort oily drugs. LESSONS The presence of a suspicious lung nodule possibly due to lipoid pneumonia in a patient with known Kaposi's disease was difficult to untangle and lead to invasive surgery. It is possible that if a source of exogenous lipoid pneumonia had been found beforehand, surgery could have been prevented.
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Affiliation(s)
- David Chardin
- Department of Nuclear Medicine, Centre Hospitalier Régional et Universitaire de Nice, Hôpital Archet I
| | - Guillaume Nivaggioni
- Department of Nuclear Medicine, Centre Hospitalier Régional et Universitaire de Nice, Hôpital Archet I
| | - Philippe Viau
- Department of Nuclear Medicine, Centre Hospitalier Régional et Universitaire de Nice, Hôpital Archet I
| | | | - Bernard Padovani
- Department of Radiology, Centre Hospitalier Régional et Universitaire de Nice, Hôpital Pasteur II, Nice, France
| | - Caroline Grangeaon
- Department of Nuclear Medicine, Centre Hospitalier Régional et Universitaire de Nice, Hôpital Archet I
| | - Micheline Razzouk-Cadet
- Department of Nuclear Medicine, Centre Hospitalier Régional et Universitaire de Nice, Hôpital Archet I
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Moreau E, Rérolle C, Deveaux M, Paraf F, Saint-Martin P. Exogenous Lipoid Pneumonia as a Contributory Factor in a Drug-related Death. J Forensic Sci 2014; 60:514-7. [DOI: 10.1111/1556-4029.12677] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 01/20/2014] [Accepted: 03/13/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Emilie Moreau
- Institut Médico-Légal; CHRU de Tours; F-37044 Tours France
- Université François Rabelais; F-37020 Tours France
| | - Camille Rérolle
- Institut Médico-Légal; CHRU de Tours; F-37044 Tours France
- Université François Rabelais; F-37020 Tours France
| | - Marc Deveaux
- Toxlab; 7 rue Jacques Cartier F-75018 Paris France
| | - François Paraf
- Service de Médecine Légale; CHU Dupuytren; F-87042 Limoges France
| | - Pauline Saint-Martin
- Institut Médico-Légal; CHRU de Tours; F-37044 Tours France
- Université François Rabelais; F-37020 Tours France
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