Neumonía lipoidea endógena en paciente con recaída de linfoma de Hodgkin. Reporte de caso

We present the case of endogenous lipoid pneumonia treated in a high-complexity hospital. A 26-year-old patient with a history of relapsed Hodgkin's lymphoma who consulted for a persistent dry cough with chest images showing a parahilar pulmonary mass on the right side; metabolically active. He undergoes a lung biopsy to rule out malignancy. In the histological sections, a distorted lung architecture is observed due to the occupation of alveolar spaces by lipid material degraded by multinucleated macrophages, which are characterized by cytoplasmic microvacuoles, confirming a pattern of endogenous lipoid pneumonia. After an exhaustive search for the etiology, it was considered by a multidisciplinary board that it was due to his underlying lymphoma. Segmental pulmonary lavage by bronchoscopy, combined with systemic steroids, is a therapeutic approach used in managing specific conditions. With the above, the symptoms are resolved, and partial improvement in the pulmonary infiltrates has been achieved. The patient is currently being followed up without relapse of pulmonary pathology. The presentation of endogenous lipoid pneumonia is the least common among lipoid pneumonias; the case report and review of the topic lend their value, given that the diagnosis is frequently overlooked due to its differential diagnosis with infectious and/or oncological processes.