Lipoid pneumonia differential diagnosis: Difference between revisions
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* Lipod pneumonia must be differentiated from other diseases that cause Cough with basilar infiltrates, such as bacterial pneumonia, viral pneumonia, congestive heart failure, pulmonary fibrosis, and aspiration pneumonia.<ref name="pmid26371101">{{cite journal| author=Bell MM| title=Lipoid pneumonia: An unusual and preventable illness in elderly patients. | journal=Can Fam Physician | year= 2015 | volume= 61 | issue= 9 | pages= 775-7 | pmid=26371101 | doi= | pmc=4569110 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26371101 }}</ref> | * Lipod pneumonia must be differentiated from other diseases that cause Cough with basilar infiltrates, such as bacterial pneumonia, viral pneumonia, congestive heart failure, pulmonary fibrosis, and aspiration pneumonia.<ref name="pmid26371101">{{cite journal| author=Bell MM| title=Lipoid pneumonia: An unusual and preventable illness in elderly patients. | journal=Can Fam Physician | year= 2015 | volume= 61 | issue= 9 | pages= 775-7 | pmid=26371101 | doi= | pmc=4569110 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26371101 }}</ref> | ||
* Differentiating exogenous lipoid pneumonia from other diseases on the basis of radiologic features and specimen histologic features:<ref name="ParameswaranAnvari2000">{{cite journal|last1=Parameswaran|first1=K.|last2=Anvari|first2=M.|last3=Efthimiadis|first3=A.|last4=Kamada|first4=D.|last5=Hargreave|first5=F.e|last6=Allen|first6=C.j|title=Lipid-laden macrophages in induced sputum are a marker of oropharyngeal reflux and possible gastric aspiration|journal=European Respiratory Journal|volume=16|issue=6|year=2000|pages=1119–1122|issn=0903-1936|doi=10.1034/j.1399-3003.2000.16f17.x}}</ref><ref name="pmid3559482">{{cite journal| author=Levade T, Salvayre R, Dongay G, Dang QQ, Vieu C, Bessac A et al.| title=Chemical analysis of the bronchoalveolar washing fluid in the diagnosis of liquid paraffin pneumonia. | journal=J Clin Chem Clin Biochem | year= 1987 | volume= 25 | issue= 1 | pages= 45-8 | pmid=3559482 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3559482 }}</ref> | * Differentiating exogenous lipoid pneumonia from other diseases on the basis of radiologic features and specimen histologic features:<ref name="ParameswaranAnvari2000">{{cite journal|last1=Parameswaran|first1=K.|last2=Anvari|first2=M.|last3=Efthimiadis|first3=A.|last4=Kamada|first4=D.|last5=Hargreave|first5=F.e|last6=Allen|first6=C.j|title=Lipid-laden macrophages in induced sputum are a marker of oropharyngeal reflux and possible gastric aspiration|journal=European Respiratory Journal|volume=16|issue=6|year=2000|pages=1119–1122|issn=0903-1936|doi=10.1034/j.1399-3003.2000.16f17.x}}</ref><ref name="pmid3559482">{{cite journal| author=Levade T, Salvayre R, Dongay G, Dang QQ, Vieu C, Bessac A et al.| title=Chemical analysis of the bronchoalveolar washing fluid in the diagnosis of liquid paraffin pneumonia. | journal=J Clin Chem Clin Biochem | year= 1987 | volume= 25 | issue= 1 | pages= 45-8 | pmid=3559482 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3559482 }}</ref><ref name="pmid1801953">{{cite journal| author=Gattuso P, Reddy VB, Castelli MJ| title=Exogenous lipoid pneumonitis due to Vicks Vaporub inhalation diagnosed by fine needle aspiration cytology. | journal=Cytopathology | year= 1991 | volume= 2 | issue= 6 | pages= 315-6 | pmid=1801953 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1801953 }}</ref> | ||
** Exogenous lipoid pneumonia is usually misdiagnosed as community-acquired pneumonia. | ** Exogenous lipoid pneumonia is usually misdiagnosed as community-acquired pneumonia. | ||
** It is considered usually as the initial diagnosis that does not lead to appropriate therapy. | ** It is considered usually as the initial diagnosis that does not lead to appropriate therapy. | ||
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**# compatible radiological findings | **# compatible radiological findings | ||
**# presence of intra-alveolar lipids and/or lipid-laden macrophages | **# presence of intra-alveolar lipids and/or lipid-laden macrophages | ||
[[File:PMC5124667 CRIPU2016-1035601.003.png|center | [[File:PMC5124667 CRIPU2016-1035601.003.png|center|thumbnail| Photomicrographs of lung biopsy with hematoxylin-eosin stain. (a) 100x, chronic interstitial inflammation consisting of dense bronchocentric lymphoplasmacytic infiltrates, with significant interstitial fibrosis. (b, c) 200x, intra-alveolar lipids and lipid-laden macrophages (arrows). (d) 400x, a multinucleated giant cell with a cholesterol cleft (arrow); an early manifestation in the development of cholesterol granulomas.<ref name="RahaghiVarasteh2016">{{cite journal|last1=Rahaghi|first1=Franck|last2=Varasteh|first2=Ali|last3=Memarpour|first3=Roya|last4=Tashtoush|first4=Basheer|title=Teppanyaki/Hibachi Pneumonitis: An Exotic Cause of Exogenous Lipoid Pneumonia|journal=Case Reports in Pulmonology|volume=2016|year=2016|pages=1–5|issn=2090-6846|doi=10.1155/2016/1035601}}</ref>]] | ||
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Revision as of 13:55, 15 October 2019
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Lipoid pneumonia Microchapters |
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Diagnosis |
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Lipoid pneumonia differential diagnosis On the Web |
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American Roentgen Ray Society Images of Lipoid pneumonia differential diagnosis |
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Risk calculators and risk factors for Lipoid pneumonia differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ramyar Ghandriz MD[2]
Overview
[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].
OR
[Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].
Differentiating lipoid pneumonia from other Diseases
- Lipod pneumonia must be differentiated from other diseases that cause Cough with basilar infiltrates, such as bacterial pneumonia, viral pneumonia, congestive heart failure, pulmonary fibrosis, and aspiration pneumonia.[1]
- Differentiating exogenous lipoid pneumonia from other diseases on the basis of radiologic features and specimen histologic features:[2][3][4]
- Exogenous lipoid pneumonia is usually misdiagnosed as community-acquired pneumonia.
- It is considered usually as the initial diagnosis that does not lead to appropriate therapy.
- In patients at risk of aspiration early CT scan is very useful for further diagnosis of lipoid pneumonia.
- Diagnosis is confirmed by detecting intra-alveolar lipid and lipid-laden macrophages.
- specimens could be brought by:
- BAL (Broncho Alveolar Lavage)
- Transthoracic fine-needle aspiration cytology
- Biopsy from lesion
- Sputum examination has questionable reliability because lipid-laden macrophages in sputum have been demonstrated in the absence of lipoid pneumonia.
- BAL is widely available and the choice of specimen taking today.
- Frozen samples must be stained in order to determine the type of oil.
- Since lipid-laden pneumonia is is very sensitive but may not be very specific, the diagnosis of exogenous lipoid pneumonia is based on the triad of:
- History of mineral oil ingestion or vaping
- compatible radiological findings
- presence of intra-alveolar lipids and/or lipid-laden macrophages
| Diseases | Diagnostic tests | Physical Examination | Symptoms | Past medical history | Other Findings | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CT scan and MRI | EKG | Chest X-ray | Tachypnea | Tachycardia | Fever | Chest Pain | Hemoptysis | Dyspnea on Exertion | Wheezing | Chest Tenderness | Nasalopharyngeal Ulceration | Carotid Bruit | |||
| Pulmonary embolism |
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✔ | ✔ | ✔ (Low grade) | ✔ | ✔ (In case of massive PE) | ✔ | - | - | - | - |
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| Congestive heart failure |
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✔ | ✔ | ✔ | - | - | ✔ | - | - | - | - |
|
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| Percarditis |
|
|
|
✔ | ✔ | ✔ (Low grade) | ✔ (Relieved by sitting up and leaning forward) | - | ✔ | - | - | - | - |
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| Pneumonia |
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|
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✔ | ✔ | ✔ | ✔ | - | ✔ | ✔ | - | - | - |
|
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| Vasculitis |
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✔ | ✔ | ✔ | ✔ | ✔ | ✔ | - | ✔ | ✔ | ✔ |
|
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| Chronic obstructive pulmonary disease (COPD) |
|
|
✔ | ✔ | - | - | - | ✔ | ✔ | - | - | - |
|
| |
References
- ↑ Bell MM (2015). "Lipoid pneumonia: An unusual and preventable illness in elderly patients". Can Fam Physician. 61 (9): 775–7. PMC 4569110. PMID 26371101.
- ↑ Parameswaran, K.; Anvari, M.; Efthimiadis, A.; Kamada, D.; Hargreave, F.e; Allen, C.j (2000). "Lipid-laden macrophages in induced sputum are a marker of oropharyngeal reflux and possible gastric aspiration". European Respiratory Journal. 16 (6): 1119–1122. doi:10.1034/j.1399-3003.2000.16f17.x. ISSN 0903-1936.
- ↑ Levade T, Salvayre R, Dongay G, Dang QQ, Vieu C, Bessac A; et al. (1987). "Chemical analysis of the bronchoalveolar washing fluid in the diagnosis of liquid paraffin pneumonia". J Clin Chem Clin Biochem. 25 (1): 45–8. PMID 3559482.
- ↑ Gattuso P, Reddy VB, Castelli MJ (1991). "Exogenous lipoid pneumonitis due to Vicks Vaporub inhalation diagnosed by fine needle aspiration cytology". Cytopathology. 2 (6): 315–6. PMID 1801953.
- ↑ Rahaghi, Franck; Varasteh, Ali; Memarpour, Roya; Tashtoush, Basheer (2016). "Teppanyaki/Hibachi Pneumonitis: An Exotic Cause of Exogenous Lipoid Pneumonia". Case Reports in Pulmonology. 2016: 1–5. doi:10.1155/2016/1035601. ISSN 2090-6846.