Of Lungs, Lipids, and Lollipops

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Presentation transcript:

Of Lungs, Lipids, and Lollipops Susan K. Mathai, MD, Ami N. Rubinowitz, MD, Robert J. Homer, MD, PhD, Frank Detterbeck, MD, FCCP, Erica L. Herzog, MD, PhD CHEST Volume 136, Issue 5, Pages 1420-1423 (November 2009) DOI: 10.1378/chest.08-2133 Copyright © 2009 The American College of Chest Physicians Terms and Conditions

Figure 1 Posteroanterior (A) and lateral (B) chest radiographs demonstrate airspace consolidation within the middle lobe and both lower lobes (left greater than right). CHEST 2009 136, 1420-1423DOI: (10.1378/chest.08-2133) Copyright © 2009 The American College of Chest Physicians Terms and Conditions

Figure 2 A: a coned-down, magnified, high-resolution CT scan image (of the left lower lobe) viewed with lung windows shows ground-glass attenuation in the left lower lobe. Within the ground-glass attenuation are reticular markings consistent with thickened interlobular and intralobular septae (arrows), an appearance known as crazy paving. B: an axial CT image viewed with lung windows shows an irregular, mass-like area of consolidation in the middle lobe (white arrow), and ground-glass attenuation is noted in the medial basilar segment of the right lower lobe (black arrow). C: an axial CT scan image at the same level as in B but viewed with soft-tissue windows shows the mass-like area of consolidation in the middle lobe with a low attenuation. CHEST 2009 136, 1420-1423DOI: (10.1378/chest.08-2133) Copyright © 2009 The American College of Chest Physicians Terms and Conditions

Figure 3 A: lung histology shows a large lipid droplet in the interstitium adjacent to granulomatous inflammation with giant cells. Smaller droplets are also seen. Features favoring exogenous over endogenous lipoid pneumonia include the presence of giant cells, interstitial location of the lipid, and large size of the fat droplets (original ×20). B: an oil red O stain highlights the presence of lipid within macrophages. CHEST 2009 136, 1420-1423DOI: (10.1378/chest.08-2133) Copyright © 2009 The American College of Chest Physicians Terms and Conditions