8953                LIPOID PNEUMONITIS (OIL GRANULOMA)

The patient was a man aged 45 who complained of pain in the right lower chest for 5 months and an irritating cough for 2 months.  There was no sputum and no haemoptysis.  He had been taking paraffin oil regularly at night for 7 years for haemorrhoids.  Clinical examination revealed no abnormality but X-ray showed consolidation in the medial segment of the right middle lobe which had not been present on X-ray 2 years previously.  Bronchoscopy was normal.  The Mantoux test was negative.  Because tumour could not be excluded a segmental resection was performed.

The specimen shows the resected segment cut to reveal an area of yellow lipoid pneumonitis with rather irregular borders and soft consistency.  The surrounding lung appears normal.  The overlying pleura is not affected.  Histology shows an oil granuloma of long standing, with a good deal of interstitial fibrosis.