title: Positron emission tomography-positive squalene-induced lipoid pneumonia confirmed by gas chromatography-mass spectrometry of bronchoalveolar lavage fluid.
abstract: Squalene is a type of oil obtained from shark liver. We describe a 76-year-old man diagnosed with chronic exogenous lipoid pneumonia due to squalene. A chest CT scan revealed pulmonary consolidation with ground-glass opacities in the right upper lobe. Positron emission tomography (PET) revealed significant uptake of 2-deoxy-2-F-fluoro-d-glucose (FDG) and 3'-deoxy-3'-F-fluorothymidine (FLT). Bronchoalveolar lavage (BAL) fluid contained many lipid-laden macrophages, and a transbronchial lung biopsy specimen showed clusters of foamy macrophages in alveolar spaces and granulomatous lesions. In addition, the presence of squalene in the BAL fluid was confirmed by gas chromatography-mass spectrometry, leading to a diagnosis of squalene-induced lipoid pneumonia. To the best of our knowledge, this is the first report of squalene-induced lipoid pneumonia in which squalene itself was successfully detected. This case also suggests the possibility that lipoid pneumonia shows significant uptake in FDG-PET and FLT-PET.
authors.affiliation: Department of Internal Medicine, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University, 1750-1, Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan. kanaji@med.kagawa-u.ac.jp
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Kanaji
authors.forename: Shuji
authors.initials: S
authors.lastname: Bandoh
authors.forename: Koshiro
authors.initials: K
authors.lastname: Takano
authors.forename: Kyuichi
authors.initials: K
authors.lastname: Kadota
authors.forename: Reiji
authors.initials: R
authors.lastname: Haba
authors.forename: Toru
authors.initials: T
authors.lastname: Matsunaga
authors.forename: Kohoji
authors.initials: K
authors.lastname: Kohno
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Kushida
authors.forename: Yuka
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Ishida
mesh_terms: D000368:Aged; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry*; D015224:Dideoxynucleosides; D019788:Fluorodeoxyglucose F18; D008401:Gas Chromatography-Mass Spectrometry / Q000379:methods*; D006801:Humans; D008297:Male; D011017:Pneumonia, Lipid / Q000139:chemically induced / Q000175:diagnosis*; D049268:Positron-Emission Tomography / Q000379:methods*; D013185:Squalene / Q000009:adverse effects*
chemical_list: D015224:Dideoxynucleosides; D019788:Fluorodeoxyglucose F18; D013185:Squalene; C002854:alovudine