Chronic exogenous lipoid pneumonia

Last revised by Mostafa Elfeky on 29 Mar 2023

Chronic exogenous lipoid pneumonia is a subtype of exogenous lipoid pneumonia

Typically occurs in older patients but also has been reported in children as well as infants with usage of mineral oil as a lubricant to facilitate feeding. Can occur in patients without a predisposing anatomic or functional abnormality in swallowing.

This is thought to mostly result from repeated episodes of aspiration or inhalation of animal fat or mineral or vegetable oils over an extended period. Aspiration of fats or oils has been reported in patients with a history of chronic use of mineral oil or petroleum-based lubricants and decongestants.

As there can be imaging overlap over many other conditions, history of exposure to oil etc. and the presence of lipid-laden macrophages on sputum or BAL analysis can be useful in imaging interpretation. 

Imaging features of acute and chronic lipoid pneumonia can overlap with consolidation and lower lobe involvement present in both groups. However the presence of "mass-like areas of consolidation" may be more in favor of chronic forms while accompanying pleural effusions are "not" thought to be an associated feature 1. Areas of associated fibrosis may also be present.

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