Journal List > Tuberc Respir Dis > v.65(5) > 1001307

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Park, Jung, Lee, Lee, Park, Seo, Kim, Lee, Huh, and Sohn: A Case of Exogenous Lipoid Pneumonia after Ingestion of Squalene in Patients with Achalasia
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2008; 65(5): 421-425.

Published online: 30 November 2008

DOI: https://doi.org/10.4046/trd.2008.65.5.421

A Case of Exogenous Lipoid Pneumonia after Ingestion of Squalene in Patients with Achalasia

Jung Chul Park, M.D.1, Chi Young Jung, M.D.1, Jae Kwang Lee, M.D.1, Yu Jin Lee, M.D.1, Seung Chan Park, M.D.1, Hye Jin Seo, M.D.1, Yeon Jae Kim, M.D.1, Byung Ki Lee, M.D.1, Dong Myung Huh, M.D.2, Kyung Rak Sohn, M.D.3

1Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea.

2Department of Thoracic and Cardiovascular Surgery, Daegu Fatima Hospital, Daegu, Korea.

3Department of Pathology, Daegu Fatima Hospital, Daegu, Korea.

Address for correspondence: Chi Young Jung, M.D. Department of Internal Medicine, Daegu Fatima Hospital, 576-31, Sinam-dong, Dong-gu, Daegu 701-110, Korea. Phone: 82-53-940-7223, Fax: 82-53-954-7417, jcy2475@hanmail.net

Received 6 August 2008       Accepted 10 September 2008

Copyright © 2008 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Exogenous lipoid pneumonia (ELP) is a chronic inflammatory reaction of the lungs resulting from the aspiration of vegetable, animal or mineral oils. Squalene, is a derivative of shark liver oil that is taken as a traditional remedy in some Asian countries, and is used widely also in cosmetics. Similar to the symptoms in most cases of oil aspiration, the symptoms of squalene-induced lipoid pneumonia are either absent or nonspecific. Hence, the disease is generally detected incidentally. Although many cases with predisposing factors have been reported, ELP with achalasia is quite rare. We report a 47-year old woman with achalasia who developed ELP after ingesting squalene. The patient was treated successfully by supportive care and surgical treatment of the achalasia.

Keywords: Lipoid pneumonia, Achalasia, Squalene

Figures and Tables

Figure 1
(A) On admission, chest radiography shows ground-glass appearance on right upper and lower lung field. (B) 6 month later, chest radiography shows improvement.
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Figure 2
High resolution computed tomography scan of the chest shows multifocal GGA and nodule with crazy paving appearance on right upper lobe and esophageal dilatation.
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Figure 3
(A) Esophagogram shows dilated aperistalitic esophagus and beaklike narrowing near gastroesophageal junction. (B) Esophageal manometry shows incomplete LES relaxation, simultaneous contraction and aperistalsis at distal body.
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Figure 4
(A) Light microscopic finding from VATs biopsy shows alveolar macrophage with prominent vacuolar change (H&E stain, ×100). (B) Light microscopic finding from VATs biopsy shows numerous red staining fat materials (Oil Red O Stain, ×100).
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