CTICasesExogenous Lipoid Pneumonia
Imaging findings
Chest CT in a patient with a history of self-injecting mineral oil intramuscularly into both arms demonstrates diffuse, bilateral ground-glass opacities, thick linear bands of consolidation in an arcading pattern, and small subpleural cystic spaces. The pectoralis muscles are significantly hypertrophied. Lung biopsy confirms exogenous lipoid pneumonia, showing intra-alveolar lipid-laden macrophages, foreign body giant cells, and mature fibrosis, associated with in situ pulmonary artery thrombosis.
Key takeaways
Exogenous lipoid pneumonia is caused by the inhalation or aspiration of lipid-containing substances, or rarely, by the systemic mobilization of injected lipids. Intramuscular injection of mineral oil or paraffin (used for cosmetic muscle bulking or 'synthol' bodybuilding) can enter the venous circulation via vascular muscles, leading to pulmonary lipid embolization. Histology demonstrates characteristic empty vacuoles within macrophages and giant cells.
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