Steatosis of granular pneumocytes in alcoholics with acute alveolar injury

Accumulation of neutral lipid in the type II alveolar epithelial cells of the lung has been described in experiments involving animals with conditions such as hypoxia or on alcohol administration. In two cases involving human subjects, this change was observed at autopsy by histochemical stains and electron microscopy. In both instances, the patients had had severe alcoholic liver disease, as well as extreme hypoxia resulting from acute alveolar injury. The lungs of six alcoholic patients with liver disease but without acute alveolar injury showed no lipid vesicles on histochemical staining. These observations suggest that a metabolic insult or combination of insults, such as alcohol or hypoxia, might lead to accumulation of neutral lipid, especially in regenerating alveolar epithelial cells that may be more susceptible to such injury.