Idiopathic cholesterol pneumonitis

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Abstract
The 50th case of idiopathic cholesterol pneumonitis (ICP) is presented, and the 49 previously reported cases were reviewed. This review focuses attention on the following: marked male predominance, single lobe involvement, lesion distribution, dense pleural fibrosis, smoking history and the close histological association between giant cells and disrupted elastic fibers of the alveolar walls. The clinical and radiological similarity between ICP and primary bronchogenic carcinoma is described. Various etiology theories are discussed, and the similarity between ICP and spontaneous lipid pneumonia in the mongoose is noted; ICP, like the mongoose pneumonia, is apparently an expression of disordered production or disposal of excessive surfactant.

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