Hirata M, Morita M, Maebou A, Hara H, Yoshimoto T, Hirao F
Division of Internal Medicine, Nishinomiya Municipal Central Hospital, Osaka.
Nihon Kyobu Shikkan Gakkai Zasshi. 1993 Oct;31(10):1317-21.
A 61-year-old female was admitted to our hospital because of cough, hemosputum and right chest pain. The P-A and L-R chest films revealed focal consolidation in the right upper filed and mass-like shadow in the right S3. Transbronchial lung biopsy specimens showed collections of lipid-laden macrophages. The lipid material of macrophages in broncholaveolar lavage fluid was stained yellow-orange with Sudan IV. The patient had no difficulty in swallowing and had no history of regular use of oily drugs. Fiberoptic bronchoscopy and chest CT showed no obstruction of bronchi. She had used much domestic insecticide with the doors closed before going to bed every summer and autumn for 10 years. We concluded that the domestic insecticide containing mineral oil had resulted in exogenous lipoid pneumonia. Her symptoms and abnormal shadows in chest X-ray film disappeared soon after antimicrobial chemotherapy was started. She is now healthy without recurrence.
一名61岁女性因咳嗽、咯血和右胸痛入住我院。正位和侧位胸片显示右上肺野局灶性实变及右肺上叶前段肿块样阴影。经支气管肺活检标本显示有充满脂质的巨噬细胞聚集。支气管肺泡灌洗 fluid中巨噬细胞的脂质物质经苏丹IV染色呈橙黄色。患者吞咽无困难,无长期使用油性药物史。纤维支气管镜检查和胸部CT显示支气管无阻塞。她在每年夏秋季节睡前关闭门窗使用家用杀虫剂达10年之久。我们得出结论,含矿物油的家用杀虫剂导致了外源性类脂性肺炎。开始抗菌化疗后,她的症状及胸部X线片上的异常阴影很快消失。她现在健康,未复发。