Rationale: This case report elucidates the diagnostic challenges and natural progression of lipoid pneumonia (LP), a rare pulmonary condition, highlighting the critical importance of long-term monitoring. Patient concerns: An 82-year-old female presented with a 2-year history of chronic cough and an acute exacerbation. Diagnoses: Initial diagnosis was severe pneumonia. Definitive diagnosis of LP was confirmed by computed tomography -guided lung biopsy, which revealed lipid-laden macrophages. Interventions: Suspected lipid exposure was discontinued, and supportive conservative care was provided. Outcomes: Despite intervention, serial follow-up computed tomography scans showed slow radiographic progression of the pneumonia. Lessons: LP has nonspecific presentations, leading to underdiagnosis. Diagnosis requires suspicion, exposure history, and pathological confirmation. Management focuses on eliminating the cause and supportive care, yet progression may still occur, necessitating long-term monitoring.
Liu et al. (2026) studied this question.