Presentation
Increasing shortness of breath. Background history of colon adenocarcinoma.
Patient Data
Frontal semierect chest radiograph demonstrating ill-defined opacities in the left hilum.
Bibasal atelectasis.
No pleural effusions.
Repeat radiographs 7 and 14 days post treatment demonstrated no resolution of left hilar changes.
Corresponding to the findings on chest radiograph there are ill-defined airspace opacity adjacent to the left hilum.
Incidental note of cholelithiasis and a small hiatus hernia.
Case Discussion
Given patient's background and symptoms metastatic disease was of biggest concern and core biopsy was performed. Results of the histology as follows:
Left lung, core needle biopsy
Clinical details: 18 gauge core biopsy of left lung. Irregular mass like lesion. Background history right hemicolectomy for adenocarcinoma.
Gross description
Specimen container
Left lung core biopsy four cores of tissue ranging from 0.7 cm to 2 cm
Microscopy
Cores of lung parenchyma with a diffuse interstitial and intra-alveolar. Infiltrate of adipocytes and lipid-laden macrophages. A foreign body giant cell reaction is also present. There is no evidence of dysplasia or malignancy. The histological features are consistent with a lipoid pneumonia.
Lipoid pneumonia is a rare entity and mimics malignancy. It is often associated with aspiration as in this case (exogenous). Diagnosis is established with biopsy and histopathological analysis.
Unable to process the form. Check for errors and try again.