Lipoid pneumonia (LP) is a rare disease caused by inhalation and progressive accumulation of fatty compounds present in a variety of products, e.g. lubricants. The incidence is increasing due to the popularity of "vaping", which is the use of electronic cigarettes which sometimes contain oil.

Imaging is an important part of the diagnosis, especially CT. This case illustrates the main findings: bilateral dependent consolidation with fat attenuation (values between -150 and -30 HU). Lipid-laden macrophages obtained by biopsy or lavage are necessary for definitive diagnosis.

Currently, there is no consensus on treatment of these patients. This patient had to be admitted to critical care for management of respiratory failure.

Images courtesy of Dr Rosa Dosdá.