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Images in thorax
Whole lung lavage for lipoid pneumonia
  1. Chris Lau1,
  2. Basem B Abdelmalak2,
  3. Carol F Farver3,
  4. Daniel A Culver1
  1. 1Respiratory Institute, Cleveland Clinic, Cleveland, Ohio, USA
  2. 2Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio, USA
  3. 3Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio, USA
  1. Correspondence to Dr Chris Lau, Respiratory Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, USA; lauc{at}

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We evaluated a 49-year-old woman who had worsening shortness of breath, non-productive cough and recurrent low-grade fevers over 6 months despite several courses of antibiotics. Her medical history was remarkable for suspected immunodeficiency that had been treated with intravenous immunoglobulin and recurrent pneumonia, including methicillin-resistant Staphylococcus aureus empyema requiring left decortication 2 years earlier. Repeated CT scans of her lung showed progressive patchy ground-glass and consolidative opacities bilaterally with septal prominence (figure 1A).

Figure 1

CT of the lung showing (white arrow) consolidation with (black triangle) patchy ground-glass opacities and (black arrows) septal thickening (A) before and (B) after whole lung lavage.

We performed bronchoscopy. Bronchoalveolar lavage cultures and special stains for bacteria, acid-fast bacilli and fungi were negative. Transbronchial biopsies revealed clusters of alveolar macrophages with …

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