Ultrastructural changes in animal fat associated lipoid pneumonia: Report of two cases

Traditional or cultural practices in different parts of the world where oil s are used continue to produce lipoid pneumonia. We report the ultrastructu ral findings and observations in animal fat associated lipoid pneumonia fro m two children following a cultural practice of forced feeding with animal fat (ghee). Clinical findings showed an acute or chronic chest infection wh ich failed to respond to anti-microbial therapy. X-ray and chest CT scan re vealed collapse/consolidations of the right middle and left lower lobes. Hi stology and electron microscopy revealed thickening and destruction of the alveolar septa, filling of alveolar spaces with red blood cells and macroph age which contained both primary and secondary lysosomes. The alveolar wall s contained mostly type II pneumocyte with most of them surrounded by thick ened basement membranes with only a small portion of their surfaces exposed directly to the alveolar space where it showed numerous microvilli.