A42-02 Lipoid Pneumonia Associated With Occupational Exposure to Industrial Coating Materials
Abstract
Lipoid pneumonia is a rare, underdiagnosed inflammatory lung disease characterized by lipid accumulation in the alveoli. It may be exogenous, due to aspiration or inhalation of lipid-containing substances, or endogenous, secondary to lipid release from degenerating cells. Occupational exposure to volatile organic or oily materials can occasionally lead to exogenous lipoid pneumonia.
A 31-year-old male presented with a two-month history of cough and dizziness. He denied systemic illness or medication use. He was a light smoker (10 pack-years) and had worked for six years in industrial surface coating involving organic solvent-based materials. Physical examination revealed bilateral inspiratory crackles. High-resolution chest CT showed diffuse ground-glass and nodular opacities in all lobes, initially interpreted as atypical pneumonia. Empiric moxifloxacin (400 mg/day) for one week produced no improvement. Autoimmune and infectious workup were unremarkable. To further evaluate the diffuse pulmonary opacities, bronchoscopy with bronchoalveolar lavage (BAL) was performed. Cytologic analysis showed a macrophage-predominant pattern with numerous lipid-laden macrophages staining positive with Oil Red O, confirming alveolar lipid accumulation. No acid-fast bacilli, fungi, or malignant cells were detected, and microbial cultures and PCR were negative for infectious agents. Pulmonary function testing demonstrated FEV1 75%, FVC 76%, and DLCO/VA 71%. The patient received…
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