[Exogenous lipoid pneumonia associated with pulmonary and hepatic sarcoidosis]

Area of Science:

• Pulmonology
• Gastroenterology
• Immunology

Background:

• Exogenous lipoid pneumonia (ELP) diagnosis requires a history of liquid paraffin ingestion and specific findings in bronchial lavage.
• Radiological abnormalities beyond typical ELP may indicate co-existing conditions like infection or cancer.

Observation:

• A 50-year-old woman presented with alveolar shadowing, mediastinal lymphadenopathy, pleural effusion, and hepatic nodules.
• Initial diagnosis of ELP did not fully explain the extensive radiological findings.
• Thoracotomy and biopsies were performed for definitive diagnosis.

Findings:

• Histological examination ruled out malignancy and mycobacterial disease.
• Biopsies revealed a granulomatous foreign body reaction consistent with pulmonary and hepatic sarcoidosis alongside ELP.
• Treatment with oral corticosteroids led to resolution of mediastinal lymphadenopathy, pleural effusion, and hepatic nodules.

Implications:

• This case demonstrates a rare co-occurrence of exogenous lipoid pneumonia and systemic sarcoidosis with hepatic involvement.
• Corticosteroid therapy can be effective in managing the systemic manifestations of this combined condition.
• Highlights the importance of considering systemic diseases when radiological findings are atypical for ELP.