Squalene aspiration pneumonia in children: radiographic and CT findings as the first clue to diagnosis

Pediatr Radiol (2005) 35: 619623DOI 10.1007/s00247-005-1439-1 ORIGINAL ARTICLE

Kyoung Ho Lee Woo Sun Kim Jung-Eun Cheon Joon Beom Seo In-One Kim Kyung Mo Yeon

Squalene aspiration pneumonia in children: radiographic and CT ndings as the rst clue to diagnosis

in all patients. The lesions were predominantly in the right lung and dependent areas in all patients and extensively involved all pulmonary lobes in ve patients. Conclusions: These radiological ndings, although non-specic, can lead to an appropriate diagnosis, particularly when patients present few symptoms.

Keywords Lung Lipoid pneumonia Radiography CT Children

Received: 13 November 2004 Revised: 19 December 2004 Accepted: 20 December 2004 Published online: 2 April 2005 Springer-Verlag 2005

Abstract Background: The diagnosis of squalene aspiration pneumonia in children is often dicult because of minimal non-specic symptoms. Objective: To investigate the radiological ndings of squalene aspiration pneumonia in children. Materials and methods: We reviewed the chest radiographs (n = 8) and CT scans (n = 7), including high-resolution CT (n = 3), of eight patients (four boys, four girls; age 3 months to 6 years) with squalene aspiration pneumonia. All patients presented minimal symptoms. Results: Chest radiographs showed right-sided predominantly parahilar inltrations. The extent and the opacity of the lesions decreased slowly during the follow-up period (mean 5.4 months) after halting the exposure. On CT, aected areas appeared as dense consolidations surrounded by ground-glass opacities showing a crazy-paving pattern in a geographic lobular distribution

K. H. Lee W. S. Kim (&)J.-E. Cheon J. B. Seo I.-O. KimK. M. Yeon Department of Radiology, Institute of Radiation Medicine, Seoul National University College of Medicine, Clinical Research Institute, Seoul National University Hospital, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea E-mail: [email protected].: [phone]Fax: [phone]

K. H. LeeDepartment of Radiology, Seoul National University Bundang Hospital, Gyeonggi-do, Korea

J. B. SeoDepartment of Radiology, Asan Medical Center, University of Ulsan, Seoul, Korea

Introduction Exogenous lipoid pneumonia is an uncommon condition resulting from the aspiration of mineral, vegetable or animal oils. There have been reports of exogenous lipoid pneumonia originating from traditional folk remedies based on mineral oil, ghee (animal fat) or other substances [15]. Squalene, which is a kind of lipid derived from shark liver oil and taken as a folk remedy in some

Asian countries, may be one of these causative...