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Lipoid pneumonia in infants: a radiological-pathological study
C O Hugosson1, E J Riff, C C Moore
1Department of Radiology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Insights
Infants fed fats early after birth developed lung consolidation and failure to thrive. Diagnosis involved biopsies revealing lymphocytic infiltration and lipid deposits in granulomas.
Area of Science:
- Pediatric Pulmonology
- Neonatal Nutrition
- Diagnostic Pathology
Background:
- Early postnatal intake of animal or vegetable fats in infants has been linked to adverse health outcomes.
- Respiratory problems and failure to thrive are critical indicators of infant health decline.
Purpose of the Study:
- To investigate the clinical presentation, imaging findings, and histopathological characteristics of infants with lung consolidation following early fat intake.
- To establish diagnostic criteria for this condition.
Main Methods:
- Case series of nine infants (2-8 months) with a history of early fat intake.
- Utilized plain radiography and computed tomography (CT) for lung imaging.
- Employed fine needle aspiration biopsy, tru-cut biopsy, open lung biopsy, and bronchopulmonary lavage for histopathological analysis.
Main Results:
- Infants presented with respiratory distress and failure to thrive.
- CT revealed consolidation in the medial-posterior lungs with varied patterns.
- Biopsies showed intense lymphocytic infiltration, granulomas, and lipid deposits; CT attenuation did not detect fat.
Conclusions:
- Early postnatal fat intake can lead to a distinct form of lung disease in infants.
- Diagnosis requires a combination of clinical suspicion, imaging, and histopathological examination.
- The findings highlight the potential risks associated with early fat exposure in neonates.
Abstract:
A series of nine infants, 2-8 months of age, with a history of animal or vegetable fat intake within 10 days after birth, is presented. The infants developed respiratory problems and failure to thrive. Plain films and computed tomography showed areas of consolidation in the medial-posterior parts of the lungs. The areas of consolidation showed three types of changes at computed tomography. Attenuation measurements did not reveal fat. To establish the diagnosis, fine needle aspiration biopsy, tru-cut biopsy and/or open lung biopsy was done in eight infants and bronchopulmonary lavage in one patient. The pathological findings were an intense lymphocytic infiltration with scattered granulomas which contained lipid deposit.