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Vol. 4. Issue 4.
Pages 413-419 (July - August 1998)
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Vol. 4. Issue 4.
Pages 413-419 (July - August 1998)
CASO CLÍNICO/CLINICAL CASE
Open Access
Pneumonia Lipídica Exógena – um diagnóstico não suspeito
Exogenous Lipoid Pneumonia – unsuspected diagnosis. A case report
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Nelson Diogo*, Cheong Tak Hong**, Pratas Peres***, Mio Wai Kuong****, Orlando Vieira*****, Filomena Coelho******
* Assistente Hospitalar Graduado de Pneumologia e Responsavel do Serviço de Pneumologia do Centro Hospitalar de Conde S. Januário em Macau
** Assistente Hospitalar de Pneumologia do Centro Hospitalar de Conde S. Januário em Macau
*** Assistente Hospitalar de Radiologia do Centro Hospitalar de Conde S. Januário em Macau
**** Interno Complementar de Radiologia do Centro Hospitalar de Conde S. Januário em Macau
***** Assistente Hospitalar de Cirurgiado Centro Hospitalar de Conde S. Januário em Macau
****** Assistente Hospitalar Graduada de Doçnas Infecciosas do Centro Hospitalar de Conde S. Januário em Macau
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RESUMO

Uma mulher de 49 anos de idade foi internada no Serviço de Pneumologia com febre, tosse e dispneia. A radiografia de tórax mostrava condensação bilateral, atingindo predominantemente os segmentos posteriores dos lobos superiores e inferiores. A tomografia axial computorizada do tórax revelava opacidades nodulares bilaterais cujos aspectos variavam desde um padrão em vidro fosco até um padrão alveolar confluente em áreas de maior densidade. A fibrobroncoscopia revelou sinais inflamatórios generalizados. O exame directo e cultural para o bacilo de Koch foram negativos. Após lavado brocoalveolar e biópsia pulmonar transbrônquica inconclusivos procedeuse a uma biópsia pulmonar cirurgica. O exame histológico revelou tratarse de uma pneumonia lipídica. Poste-riormente obtevese a informação de que a doente utilizava parafina líquida em gotas nasais desde há cerca de 10 anos.

REV PORT PNEUMOL 1998; IV (4): 413-419

Palavras-chave:
Pneumonia lipídica exógena
TAC toráica
Biópsia pulmonar
ABSTRACT

A 49-year-old woman was admitted to hospital with fever, cough and dyspnea. The chest radiographs showed bilateral consolidation, more severe on right side, predominantly affecting posterior segments of upper and lower lobes. The thoracic CT scan detected bilateral opacities ranging from ground glass pattern to alveolar nodules coalescing in larger areas of dense consolidation. Bronchoscope examination revealed generalised inflammatory signs. Stains and cultures were negative. After inconclusive bronchoalveolar lavage and transbronchial lung biopsy, an open lung biopsy was performed. Histological examination showed an unexpected finding of lipoid pneumonia and thereafter information of use of liquid paraffin nose drops, during the preceding 10 years, was obtained.

REV PORT PNEUMOL 1998; IV (4): 413-419

Key-words:
Exogenous lipoid pneumonia
Thoracic CT scan
Open lung biopsy
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Copyright © 1998. Sociedade Portuguesa de Pneumologia/SPP
Pulmonology
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