Kanaji Nobuhiro, Bandoh Shuji, Takano Koshiro, Kadota Kyuichi, Haba Reiji, Matsunaga Toru, Kohno Kohoji, Kushida Yoshio, Yamamoto Yuka, Ishida Toshihiko
Department of Internal Medicine, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University, 1750-1, Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan.
Am J Med Sci. 2008 Apr;335(4):310-4. doi: 10.1097/MAJ.0b013e31811ec1a0.
Squalene is a type of oil obtained from shark liver. We describe a 76-year-old man diagnosed with chronic exogenous lipoid pneumonia due to squalene. A chest CT scan revealed pulmonary consolidation with ground-glass opacities in the right upper lobe. Positron emission tomography (PET) revealed significant uptake of 2-deoxy-2-F-fluoro-d-glucose (FDG) and 3'-deoxy-3'-F-fluorothymidine (FLT). Bronchoalveolar lavage (BAL) fluid contained many lipid-laden macrophages, and a transbronchial lung biopsy specimen showed clusters of foamy macrophages in alveolar spaces and granulomatous lesions. In addition, the presence of squalene in the BAL fluid was confirmed by gas chromatography-mass spectrometry, leading to a diagnosis of squalene-induced lipoid pneumonia. To the best of our knowledge, this is the first report of squalene-induced lipoid pneumonia in which squalene itself was successfully detected. This case also suggests the possibility that lipoid pneumonia shows significant uptake in FDG-PET and FLT-PET.
角鲨烯是一种从鲨鱼肝脏中提取的油类。我们描述了一名76岁男性，被诊断为因角鲨烯导致的慢性外源性类脂性肺炎。胸部CT扫描显示右上叶有肺实变并伴有磨玻璃影。正电子发射断层扫描（PET）显示2-脱氧-2-F-氟-D-葡萄糖（FDG）和3'-脱氧-3'-F-氟胸苷（FLT）有明显摄取。支气管肺泡灌洗（BAL）液中含有许多充满脂质的巨噬细胞，经支气管肺活检标本显示肺泡腔内有泡沫状巨噬细胞簇和肉芽肿性病变。此外，通过气相色谱-质谱法证实了BAL液中存在角鲨烯，从而诊断为角鲨烯诱导的类脂性肺炎。据我们所知，这是首次成功检测到角鲨烯本身的角鲨烯诱导类脂性肺炎的报告。该病例还提示了类脂性肺炎在FDG-PET和FLT-PET中显示明显摄取的可能性。
