Positron Emission Tomography-Positive Squalene-induced Lipoid Pneumonia Confirmed by Gas Chromatography–Mass Spectrometry of Bronchoalveolar Lavage Fluid

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Positron Emission Tomography-Positive Squalene-induced Lipoid Pneumonia Confirmed by Gas Chromatography–Mass Spectrometry of Bronchoalveolar Lavage Fluid Nobuhiro Kanaji, MD, Shuji Bandoh, MD, Koshiro Takano, MD, Toshihiko Ishida, MD The American Journal of the Medical Sciences Volume 335, Issue 4, Pages 310-314 (April 2008) DOI: 10.1097/MAJ.0b013e31811ec1a0 Copyright © 2008 Southern Society for Clinical Investigation Terms and Conditions

Figure 1 (A) Chest CT showing a mass-like consolidation surrounded by ground-glass opacities in the posterior segment of the right upper lobe designated B2. (B) Significant uptake (SUV, 11.62) of F18-fluorodeoxyglucose (FDG) by the lipoid pneumonia is seen on positron emission tomography (PET). (C) Moderate uptake (SUV, 2.78) of F18-fluorodeoxythymidine (FLT) is seen on PET. The American Journal of the Medical Sciences 2008 335, 310-314DOI: (10.1097/MAJ.0b013e31811ec1a0) Copyright © 2008 Southern Society for Clinical Investigation Terms and Conditions

Figure 2 (A) Bronchoalveolar lavage fluid images showing that intracytoplasmic substances in alveolar macrophages are positive for Sudan III staining (main image, 40×; inset, 100×). (B) Numerous foamy macrophages and lymphocytes (arrow) are seen in alveolar spaces in a transbronchial lung specimen (HE stain, 40×). The American Journal of the Medical Sciences 2008 335, 310-314DOI: (10.1097/MAJ.0b013e31811ec1a0) Copyright © 2008 Southern Society for Clinical Investigation Terms and Conditions

Figure 3 Total ion chromatography of bronchoalveolar lavage fluid obtained from the patient showing the peak for squalene (arrow). The arrowhead shows the peak for lidocaine. The American Journal of the Medical Sciences 2008 335, 310-314DOI: (10.1097/MAJ.0b013e31811ec1a0) Copyright © 2008 Southern Society for Clinical Investigation Terms and Conditions