CTICasesExogenous Lipoid Pneumonia
Imaging findings
Chest CT in a patient with a history of chronic mineral oil enema use shows progressive, bilateral, and lower-lobe-predominant ground-glass opacities, crazy-paving, and consolidative masses that contain macroscopic fat attenuation (-40 to -90 HU) on soft-tissue windows.
Key takeaways
Exogenous lipoid pneumonia can result from the chronic aspiration of mineral oil, which can occur retrograde via gastroesophageal reflux following mineral oil enema use or laxative ingestion. Mineral oil is inert and does not trigger a cough reflex, allowing silent aspiration. The presence of macroscopic fat attenuation within areas of crazy-paving or consolidation on CT is highly specific and diagnostic.
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