PURPOSE: Aspiration is defined as the inhalation of oropharyngeal or gastric contents into the larynx and lower respiratory tract. Although aspiration pulmonary syndromes including aspiration pneumonia and aspiration pneumonitis may occur after aspiration, the diagnosis have usually done by the clinical course with imaging and laboratory findings. However, the aspirated materials in the lungs have not been pathologically identified. We examined the clinico-pathological features of aspirated pulmonary diseases based on the transbronchial lung biopsy specimens.
METHODS: We selected 10 cases of pathologically determined aspirated food materials in the lungs from the 6105 patients being performed by transbronchial lung biopsy examinations.The aspirated food materials were identified with H-E sating and Fungi flora-Y staining, simultaneously. The Fungi flora-Y staining materials are considered to be vegetable matters rather than meat matters. We analyzed the clinical records and imaging and laboratory data of the 9 patients.
RESULTS: Seven patients were men, two were women. Mean age was 66.4 years old. Serum inflammatory reactions were found only in 3 of 9 patients. The pneumonia and pneumonitis lesions were distributed into three different lobes in both lungs. The patients risk/background was post-gastrectomy state, alcohol abuse, and post-strike state.
CONCLUSION: The pathologically determined aspiration pneumonia/pneumonitis were rare. However, the disease abnormal state presented various clinical features and imaging findings. The clinical and laboratory examinations may not be sufficient of the optical diagnosis of aspiration pneumonia/pneumonitis in a high risk patients with dysphagia.
CLINICAL IMPLICATIONS: Transbronchial lung biopsy examinations may be an option for the correct diagnosis of insidious aspiration pneumonia/pneumonitis in a high risk patients with dyspagia.
DISCLOSURE: Masahiro Shimada, No Financial Disclosure Information; No Product/Research Disclosure Information