Pulmonary lipid nodules after intralipid infusion in a child with rhabdomyosarcoma and Staphylococcus epidermidis sepsis.

Pulmonary lipid accumulation associated with intralipid infusion has been observed in autopsies of premature babies and a few adults. We report a 6-year-old boy with radiographically identifiable bilateral pulmonary nodules while he had Staphylococcus epidermidis sepsis. At the time, the child was receiving intralipid as a part of total parenteral nutritional support and was undergoing chemotherapy and radiotherapy for abdominal rhabdomyosarcoma. Pathological studies of the biopsied nodules revealed lipid deposits and foreign body type granulomatous vasculitis. Possible mechanisms for intralipid nodules in the lungs are discussed. Pulmonary intralipid accumulation can occur antemortem and should be included in the differential diagnosis of pulmonary nodules in patients with malignant tumors who are receiving intralipid infusion.