Unexpected identification of bilateral masses in an asymptomatic heavy smoker.

A 47-year-old male heavy smoker who was an ex-intravenous drugs user presented with gallstones; a preoperatived chest radiograph showed hazy opacity in the right lower lobe. Chest CT revealed in the lower posterior lobes two almost symmetrical areas of consolidation with fat attenuation values ( 50 Hounsfield units, figure 1). A broncholaveolar lavage did not provide pathological findings. A transthoracic core needle biopsy showed the pattern of chronic exogenous lipoid pneumonia, with numerous lipid-laden macrophages (figure 2). Upon further investigation, the patient revealed that he had been taking 200 ml of mineral oil daily for 5 years to treat chronic constipation related to methadone treatment.