Exogenous lipoid pneumonia secondary to Vaseline application to the tracheostomy in a laryngectomy patient: PET/CT and MR imaging findings

Exogenous lipoid pneumonia induced by nasal decongestant

“…In this latter finding is due to the often spiculated margins of the lesions secondary to perilesional inflammation and fibrosis. 10 The suspected diagnosis, with a personal story and radiological data concordant, can be confirmed performing a BAL for a cytological exam which shows a differential cell count consisting mainly of alveolar macrophages with many large intracytoplasmic vacuoles full of fat material. In other cases, the radiological findings have a specific appearance in the form of ground-glass, crazy-paving type areas with or without associated parenchymal consolidation of normal density.…”

“…6 The patients most at risk are those with swallowing disorders or impaired consciousness and especially those patients who repeatedly use substances to counter mucosal dryness, tracheostomized patients who use endotracheal tube lubrication oils, 9,10 patients making chronic use of nasal sprays and decongestants containing mineral oils and in particular children and the elderly. Exogenous lipoid pneumonia is an inflammatory parenchymal condition caused by an accumulation of fats in the alveoli, due to inhalation or aspiration of animal, vegetable or mineral substances containing oils.…”

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] The reaction to the inhaled oil is initially characterized by an intraalveolar infiltration of macrophages accompanied from an acute inflammatory reaction. Fats from both endogenous and exogenous sources can build up in the lungs.…”

“…The clinical presentations vary from acute forms that present with symptoms similar to an infectious pneumonia with dyspnoea, cough and fever to chronic forms that may initially be asymptomatic or pauci-symptomatic with chronic cough and can occasionally be observed when chest X-rays are performed for screening purposes. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] The reaction to the inhaled oil is initially characterized by an intraalveolar infiltration of macrophages accompanied from an acute inflammatory reaction. The oil is rapidly phagocytized, resulting in a vacuolation of the macrophages.…”

Hallazgos radiológicos de la neumonía lipoidea exógena en pacientes laringectomizados

“…Por ello, en algunos pacientes se realizan pruebas diagnósticas complementarias como la PET/TC. En la NLE puede existir un aumento inespecífico de la captación de FDG secundario a cambios inflamatorios asociados, por lo que estos estudios deben interpretarse integrando los hallazgos morfológicos de la TC, para no incurrir en falsos positivos 2,9,10 . Aunque la RM no es una técnica de elección para evaluar el parénquima pulmonar, puede resultar útil en el diagnóstico, demostrando el contenido graso de las lesiones en secuencias potenciadas en T1 y la cancelación de su señal en secuencias de supresión grasa (por ejemplo, la secuencia STIR) 2 .…”