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The aim of this study was to evaluate the high-resolution CT findings in 53 patients (33 males and 20 females) with exogenous lipoid pneumonia following aspiration of mineral oil, and to compare the imaging features between adults and children. The retrospective study included 35 children with ages ranging from 1 month to 12 years old, and 18 adults with ages ranging from 25 to 94 years old. Regarding the risk factors, neurological disorders were present in 22 of our patients; fourteen had gastroesophageal reflux disease. Thirteen patients did not reveal any risk factors. The most frequent symptoms were cough, fever and dyspnea. The high-resolution CT images were reviewed by two radiologists who reached decisions by consensus. Inclusion criteria were an abnormal radiograph, history of mineral oil ingestion and the presence of intrapulmonary lipids proven by bronchoalveolar lavage or open lung biopsy. The groups were compared using the Fisher exact test. The main high-resolution CT findings included airspace consolidations (86.8%), areas of ground-glass attenuation (37.7%), airspace nodules (22.6%), and crazy-paving pattern (20.7%). The abnormalities were bilateral in 51 cases (96.2%), and predominated in the posterior zones of the lungs in 48 patients (90.5%). In 35 patients (66.0%) the right lung was more extensively involved than the left lung. The right lower lobe was most likely to show severe involvement (>50% of the lobe) (n = 46; 86.8%), followed by the left lower lobe (n = 39; 73.6%) and the right upper lobe (n = 31; 58.5%). By comparison, children showed airspace consolidations much more frequently, whereas the crazy-paving pattern was more commonly observed in adults. The presence of both ground-glass opacities or airspace nodules was not significantly different between the two groups. Right upper lobe involvement was more frequent in children, whereas the involvement of middle lobe and lingula was more frequent in adults. The involvement of the left upper lobe and both lower lobes is similar between the two groups.

Tomografia computadorizada de alta resolução na avaliação de pacientes com pneumonia lipoídica exógena