Endogenous lipoid pneumonia
Endogenous lipoid pneumonia, also known as idiopathic lipoid pneumonia, is of the of the two types of lipoid pneumonias. It is also sometimes known as “cholesterol pneumonia” or “golden pneumonia”
Please refer to the main article for a broad discussion, including clinical presentation, radiographic features, and treatment and prognosis.
With lipoid pneumonia in general, there is the classic "exogenous type" most commonly seen in people who aspirate mineral oil. There is also the lesser known, and actually more common "endogenous type" or "cholesterol pneumonia" that s the result of localised accumulation of lipid laden macrophages within alveolar spaces distal to an obstructed airway.
Its estimated prevalence is thought to be around 1-2.5% of autopsies.
Endogenous lipoid pneumonia occurs from obstruction of the airway which results in the accumulation of cellular breakdown debris, including cholesterol from destroyed alveolar cell walls. These lipids are difficult to digest and the macrophages, which attempt to phagocytose them, accumulate within the alveolar spaces.
The classic scenario is in the setting of an obstruction by a tumour, bronchiolitis obliterans, or after chemotherapy / radiation therapy. Other reported associations include:
- 1. Betancourt SL, Martinez-Jimenez S, Rossi SE et-al. Lipoid pneumonia: spectrum of clinical and radiologic manifestations. AJR Am J Roentgenol. 2010;194 (1): 103-9. doi:10.2214/AJR.09.3040 - Pubmed citation
- 2. Hadda V, Khilnani GC. Lipoid pneumonia: an overview. Expert Rev Respir Med. 2010;4 (6): 799-807. doi:10.1586/ers.10.74 - Pubmed citation