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Pediatric Radiology

, Volume 35, Issue 6, pp 619–623 | Cite as

Squalene aspiration pneumonia in children: radiographic and CT findings as the first clue to diagnosis

  • Kyoung Ho Lee
  • Woo Sun KimEmail author
  • Jung-Eun Cheon
  • Joon Beom Seo
  • In-One Kim
  • Kyung Mo Yeon
Original Article

Abstract

Background: The diagnosis of squalene aspiration pneumonia in children is often difficult because of minimal non-specific symptoms. Objective: To investigate the radiological findings of squalene aspiration pneumonia in children. Materials and methods: We reviewed the chest radiographs (n = 8) and CT scans (n = 7), including high-resolution CT (n = 3), of eight patients (four boys, four girls; age 3 months to 6 years) with squalene aspiration pneumonia. All patients presented minimal symptoms. Results: Chest radiographs showed right-sided predominantly parahilar infiltrations. The extent and the opacity of the lesions decreased slowly during the follow-up period (mean 5.4 months) after halting the exposure. On CT, affected areas appeared as dense consolidations surrounded by ground-glass opacities showing a crazy-paving pattern in a geographic lobular distribution in all patients. The lesions were predominantly in the right lung and dependent areas in all patients and extensively involved all pulmonary lobes in five patients. Conclusions: These radiological findings, although non-specific, can lead to an appropriate diagnosis, particularly when patients present few symptoms.

Keywords

Lung Lipoid pneumonia Radiography CT Children 

References

  1. 1.
    de Oliveira GA, Del Caro SR, Bender Lamago CM, et al (1985) Radiographic plain film and CT findings in lipoid pneumonia in infants following aspiration of mineral oil used in the treatment of partial small bowel obstruction by Ascaris Lumbricoides. Pediatr Radiol 15:157–160Google Scholar
  2. 2.
    Lee KS, Müller NL, Hale V, et al (1995) Lipoid pneumonia: CT findings. J Comput Assist Tomogr 19:48–51Google Scholar
  3. 3.
    Annobil SH, Ogunbiyi AO, Benjamin B (1993) Chest radiographic findings in childhood lipoid pneumonia following aspiration of animal fat. Eur J Radiol 16:217–220Google Scholar
  4. 4.
    Hugosson CO, Riff EJ, Moore CC, et al (1991) Lipoid pneumonia in infants: a radiographical-pathological study. Pediatr Radiol 21:193–197Google Scholar
  5. 5.
    Balakrishman S (1973) Lipoid pneumonia in infants and children in south India. BMJ 4:329–331Google Scholar
  6. 6.
    Lee JS, Im JG, Song KS, et al (1999) Exogenous lipoid pneumonia: high-resolution CT findings. Eur Radiol 9:287–291CrossRefPubMedGoogle Scholar
  7. 7.
    Asnis DS, Saltzman HP, Melchert A (1993) Shark oil pneumonia. An overlooked entity. Chest 103:976–977Google Scholar
  8. 8.
    Lee JY, Lee KS, Kim TS, et al (1999) Squalene-induced extrinsic lipoid pneumonia: serial radiological findings in nine patients. J Comput Assist Tomogr 23:730–735Google Scholar
  9. 9.
    Spickard A 3rd, Hirschmann JV (1994) Exogenous lipoid pneumonia. Arch Intern Med 154:686–692Google Scholar
  10. 10.
    Volk BW, Nathason L, Losner S, et al (1951) Incidence of lipoid pneumonia in survey of 389 chronically ill patients. Am J Med 10:316–324Google Scholar
  11. 11.
    Genereux GP (1970) Lipids in the lungs: radiologic-pathologic correlation. J Can Assoc Radiol 21:2–15Google Scholar
  12. 12.
    Wright BA, Jeffrey PH (1990) Lipoid pneumonia. Semin Respir Infect 5:314–321Google Scholar
  13. 13.
    Franquet T, Gimenez A, Bordes R, et al (1998) The crazy-paving pattern in exogenous lipoid pneumonia: CT-pathologic correlation. AJR 170:315–317Google Scholar
  14. 14.
    Laurent F, Philippe JC, Vergier B, et al (1999) Exogenous lipoid pneumonia: HRCT, MR, and pathologic findings. Eur Radiol 9:1190–1196CrossRefPubMedGoogle Scholar
  15. 15.
    Kennedy JD, Costello P, Balikian JP, et al (1981) Exogeneous lipoid pneumonia. AJR 136:1145–1149Google Scholar
  16. 16.
    Joshi RR, Cholankeril JV (1985) Computed tomography in lipoid pneumonia. J Comput Assist Tomogr 6:211–213Google Scholar
  17. 17.
    Seo JB, Im JG, Kim WS, et al (1999) Shark liver oil-induced lipoid pneumonia in pigs: correlation of high-resolution CT and histopathologic findings. Radiology 212:88–96Google Scholar
  18. 18.
    Van den Plas O, Trigaux JP, Van Beers B, et al (1990) Gravity-dependent infiltrates in a patient with lipoid pneumonia. Chest 98:1253–1254Google Scholar
  19. 19.
    Hampton SO, Bickham CE, Winship T (1955) Lipoid pneumonia. AJR 73:938–949Google Scholar
  20. 20.
    Pierson JW (1932) Some unusual pneumonias associated with the aspiration of fats and oils in the lungs. AJR 27:572–579Google Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Kyoung Ho Lee
    • 1
    • 2
  • Woo Sun Kim
    • 1
    Email author
  • Jung-Eun Cheon
    • 1
  • Joon Beom Seo
    • 1
    • 3
  • In-One Kim
    • 1
  • Kyung Mo Yeon
    • 1
  1. 1.Department of Radiology, Institute of Radiation MedicineSeoul National University College of Medicine, Clinical Research Institute, Seoul National University HospitalSeoulKorea
  2. 2.Department of RadiologySeoul National University Bundang HospitalGyeonggi-doKorea
  3. 3.Department of Radiology, Asan Medical CenterUniversity of UlsanSeoulKorea

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