PMC9467876_01
Right femur fracture.
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Imaging showed a right femoral fracture (Fig. 1).
Initial admission chest radiograph showing normal lung parenchyma.
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Initial CXR was unremarkable (Fig. 2).
Subsequent chest radiograph showing interval development of alveolar opacities.
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CXR that day showed new infiltrates (Fig. 3).
Chest computed tomography images showing extensive ground glass throughout the lung parenchyma with patchy consolidations and areas of crazy paving.
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CT angiography of the chest was negative for pulmonary embolism but notable for extensive ground glass opacities throughout the lung parenchyma with patchy consolidations and areas of crazy paving (Fig. 4).
Serial bronchoalveolar lavage samples (Tubes 1-3 from left to right).
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Bronchoscopy with bronchoalveolar lavage was performed, with progressively bloody aliquots (Fig. 5).
Pathology images showing abundant lipid-laden macrophages by Oil-red-O stain.
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Cytology from the BAL was notable for abundant lipid-laden macrophages by Oil-red-O stain (see Fig. 6).
Final chest radiograph after administration of steroids and albumin showing resolution of alveolar opacities.
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He was started on methylprednisolone and albumin with significant improvement in his radiographic findings (Fig. 7).