The constellation of chronic cough, dyspnea, and hemoptysis can include a broad range of differential diagnoses. Although uncommon, exogenous lipoid pneumonia (ELP) should be considered when patients present with this symptom complex. We report a case of a 72-year-old female who presented with hemoptysis, cough, and dyspnea. The admission computed tomography scan of the chest revealed progressive interstitial infiltrates. Bronchoscopy revealed diffuse erythema without bleeding. Culture and cytology of lavage fluid were negative. Open-lung biopsy revealed numerous lipid-laden macrophages and multinucleated foreign-body giant cells. On further questioning, the patient admitted to the daily use of mineral oil for constipation. The diagnosis of ELP was made. The literature review revealed that many cases typically present with chronic cough with or without dyspnea. Our case illustrates an unusual presenting symptom of hemoptysis and the need to identify patients who can be at risk of developing this rare condition.
exogenous lipoid pneumonia mineral oil laxative
I would like to acknowledge the Department of Pathology at the University of Kansas for providing the slides on our patient. There was no funding for the writing of this manuscript.
Conflict of Interest Statement
Hoffman LR, Yen E, et al. Lipoid pneumonia due to Mexican folk remedy. Arch Pediatr Adolesc Med. 2005;159:11 (Nov).CrossRefGoogle Scholar
Costa, et al. Exogenous lipoid pneumonia—a case report. Rev Port Pneumol. 2005;11(6):567–72 (Nov–Dec).PubMedGoogle Scholar
Chaveau M., et al. Exogenous lipoid pneumonia: a simple diagnosis? Rev Med Liege. 2005;60(10):799–804 (Oct).Google Scholar
Gondouin A, Manzoni P, et al. Exogenous lipoid pneumonia: a retrospective multicentre study of 44 cases in France. Eur Respir J 1996;9(7):1463–9 (Jul).PubMedCrossRefGoogle Scholar
Bhagat R, Holmes IH, et al. Self-Injection with olive oil. A cause of lipoid pneumonia. Chest. 1995;107(3):875–6 (Mar).PubMedGoogle Scholar
Hirata M, Morita M, Maebou A, Hara H, Yoshimoto T, Hirao F. A case of exogenous lipoid pneumonia probably due to domestic insecticide. Nihon Kyobu Shikkan Gakkai Zasshi. 1993;31(10):1317–21 (Oct).PubMedGoogle Scholar
Alaminos Garcia P, Colodro Ruiz A, Menduina Guillen MJ, Banez Sanchez F, Perez Chica G. Exogenous lipoid pneumonia. Presentation of a new case. An Med Interna. 2005;22(6):283–4 (Jun).PubMedGoogle Scholar
Meltzer E, Guranda L, et al. Lipoid pneumonia : a preventable complication. IMAJ. 2006;8:33–5.PubMedGoogle Scholar
Cohen M, Galbut B, Kerdel F. Exogenous lipoid pneumonia caused by facial application of petroleum. J Am Acad Dermatology. 2003;49:1128–30.CrossRefGoogle Scholar
Wong CA, Wilsher ML. Treatment of exogenous lipoid pneumonia by whole lung lavage. Aust N Z J Med. 1994;24(6):734–5 (Dec).PubMedGoogle Scholar
Chiang IC, Lin YT, Liu GC, Chiu CC, Tsai MS, Kao EL. Exogenous lipoid pneumonia: serial chest plan roentgenography and high-resolution computerized tomography findings. Kaohsiung J Med Sci. 2003;19(12):593–8 (Dec).PubMedCrossRefGoogle Scholar
Bandla HP, Davis SH, Hopkins NE. Lipoid pneumonia: a silent complication of mineral oil aspiration. Pediatrics. 1999;103(2):E19 (Feb).PubMedCrossRefGoogle Scholar