title: Endogenous lipoid pneumonia in a cachectic patient after brain injury.
abstract: Endogenous lipoid pneumonia (EnLP) is an uncommon non-life-threatening inflammatory lung disease that usually occurs in patients with conditions such as lung cancers, primary sclerosing cholangitis, and undifferentiated connective tissue disease. Here we report a case of EnLP in a paralytic and cachectic patient with bronchopneumonia after brain injury. A 40-year-old man experienced a severe brain injury in an automobile accident. He was treated for 1 month and his status plateaued. However, he became paralyzed and developed cachexia and ultimately died 145 days after the accident. Macroscopically, multifocal yellowish firm nodules were visible on scattered gross lesions throughout the lungs. Histologically, many foam cells had accumulated within the alveoli and alveolar walls accompanied by a surrounding interstitial infiltration of lymphocytes. The findings were in accordance with a diagnosis of EnLP. Bronchopneumonia was also noted. To our knowledge, there have been few reports of EnLP associated with bronchopneumonia and cachexia after brain injury. This uncommon pathogenesis should be well recognized by clinicians and forensic pathologists. The case reported here should prompt medical staff to increase the nutritional status and fight pulmonary infections in patients with brain injury to prevent the development of EnLP.
authors.affiliation: Department of Forensic Medicine, Tongji Medical College of Huazhong University of Science and Technology No. 13 Hangkong Road, Wuhan 430030, Hubei, PR China.
authors.forename: Ji
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Forensic Medicine, Tongji Medical College of Huazhong University of Science and Technology No. 13 Hangkong Road, Wuhan 430030, Hubei, PR China ; Department of Pathology, Hebei North University No. 11 Zuanshinan Road, Zhangjiakou 075000, Hebei, PR China.
authors.forename: Jiao
authors.initials: J
authors.lastname: Mu
authors.affiliation: Department of Forensic Medicine, Tongji Medical College of Huazhong University of Science and Technology No. 13 Hangkong Road, Wuhan 430030, Hubei, PR China.
authors.forename: Wei
authors.initials: W
authors.lastname: Lin
authors.affiliation: Department of Forensic Medicine, Tongji Medical College of Huazhong University of Science and Technology No. 13 Hangkong Road, Wuhan 430030, Hubei, PR China.
authors.forename: Hongmei
authors.initials: H
authors.lastname: Dong
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D001344:Autopsy; D001930:Brain Injuries / Q000150:complications* / Q000175:diagnosis; D001996:Bronchopneumonia / Q000209:etiology / Q000473:pathology; D002100:Cachexia / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D017809:Fatal Outcome; D005487:Foam Cells / Q000473:pathology; D006801:Humans; D008168:Lung / Q000473:pathology*; D008214:Lymphocytes / Q000473:pathology; D008297:Male; D009752:Nutritional Status; D011017:Pneumonia, Lipid / Q000209:etiology* / Q000473:pathology; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors
keywords: Endogenous lipid pneumonia; brain injury; cachexia; infection