Medical Image of the Week: BAL Findings in Lipoid Pneumonia

 

Figure 1: Oil red O stain shows red-stained cytoplasm of several lipid-laden alveolar macrophages

A 66 year old woman presented with a two year history of recurrent pneumonias requiring multiple hospitalizations for treatment. A chest CT revealed bilateral multifocal opacities. The patient admitted regular use of a petroleum based product in her nose at night and severe gastroesophageal reflux disease. A bronchoalveolar lavage (BAL) was performed in the right lower lobe.  The BAL revealed significant Oil red O staining of alveolar macrophages (approximately 20% in Figure 1) consistent with exogenous lipid, suggesting recurrent microaspiration.

Aarthi Ganesh, MD; Rebecca Millius, MD and Linda Snyder, MD

Departments of Medicine and Pathology

University of Arizona

Tucson, Arizona

Reference as: Ganesh A, Millius R, Snyder L. Medical image of the week: findings in lipoid pneumonia. Southwest J Pulm Crit Care 2013;6(2):82. PDF