[A case of exogenous lipoid pneumonia showing a coin lesion with cavities]

A 26-year-old male was referred to our department because of an abnormal chest X-ray, obtained during a routine physical examination in the hospital admitted after a traffic accident. The P-A chest film revealed a coin lesion with cavities in the left S9. He complained of no symptoms except for expectoration of bloody sputum. Transbronchial lung biopsy specimens showed destruction of normal alveolar pattern and collections of lipid-laden macrophages enclosed by fibrous tissue. The lipid material of macrophages in sputum was stained with Sudan III. He had no difficulty in swallowing and no history of regular use of oily drugs. Fiberoptic bronchoscopy and chest CT showed no obstruction of bronchi. He had been working in a repair shop for motorcycles for years, therefore the lesion could be an occupational exogenous lipoid pneumonia. The diameter of the coin lesion has decreased without any therapy.