© 2004 BMJ Publishing Group Ltd & British Thoracic Society
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Selective pulmonary fat aspiration complicating oesophageal achalasia
1 Oxford Centre for Respiratory Medicine, Churchill Hospital, Oxford OX3 7LJ, UK
2 Department of Radiology, Churchill Hospital, Oxford OX3 7LJ, UK
Correspondence to:
Correspondence to:
Dr G V Robinson
Oxford Centre for Respiratory Medicine, Churchill Hospital, Oxford OX3 7LJ, UK; gracevrobinson@yahoo.co.uk
| The first 150 words of the full text of this article appear below. |
A 53 year old woman was referred with an 18 month history of dry cough and exertional breathlessness. There was a past history of oesophageal achalasia. Examination revealed fine right sided inspiratory crepitations only, and pulmonary function tests showed a restrictive defect with a transfer factor of 59% predicted. A chest CT scan showed extensive bilateral ground glass opacification with interlobular septal thickening (fig 1
). A markedly dilated oesophagus was also seen, within which the retained food had separated from the fluid which was of low attenuation, in keeping with fat. Bronchoalveolar lavage (BAL) produced an orange fluid that separated into oil and aqueous layers. Oil red O staining of transbronchial biopsy specimens revealed fat droplets within alveolar macrophages (fig 2). A barium swallow showed a dilated oesophagus with a narrowed gastro-oesophageal junction.
[in a new window] Figure 1 Chest CT scan showing bilateral ground glass appearance with interlobular septal thickening.
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Figure 2 Transbronchial biopsy specimen | |||||||||
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