Exogenous lipoid pneumonia occurs with aspiration or inhalation of oils. The classic clinical scenario is one of prolonged laxative ingestion or use of oil-based nose drops. Less common causes include accidental aspiration in children, ingestion in fire eaters, and chronic use of lubricants such as vaporub and lip gloss. Chronic inhalation of oils can also occur in certain occupations, such as those involved in the lubrication and cleaning of machinery and the spraying of pesticides or paints.
Endogenous lipoid pneumonia (cholesterol pneumonia, golden pneumonia), is classically caused by obstruction, resulting in consolidation with accumulation of lipid-filled macrophages and eosinophilic proteinaceous material (e.g., surfactant) from degenerating cells.
Non-obstructive processes may also result in endogenous lipoid pneumonia. These include fungal infections, pulmonary alveolar proteinosis, and lipid-storage disorders (e.g., Niemann-Pick disease).
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