Squalene aspiration pneumonia in children: radiographic and CT findings as the first clue to diagnosis

Background: The diagnosis of squalene aspiration pneumonia in children is often difficult because of minimal non-specific symptoms. Objective: To investigate the radiological findings of squalene aspiration pneumonia in children. Materials and methods: We reviewed the chest radiographs (n = 8) and CT scans (n = 7), including high-resolution CT (n = 3), of eight patients (four boys, four girls; age 3 months to 6 years) with squalene aspiration pneumonia. All patients presented minimal symptoms. Results: Chest radiographs showed right-sided predominantly parahilar infiltrations. The extent and the opacity of the lesions decreased slowly during the follow-up period (mean 5.4 months) after halting the exposure. On CT, affected areas appeared as dense consolidations surrounded by ground-glass opacities showing a crazy-paving pattern in a geographic lobular distribution in all patients. The lesions were predominantly in the right lung and dependent areas in all patients and extensively involved all pulmonary lobes in five patients. Conclusions: These radiological findings, although non-specific, can lead to an appropriate diagnosis, particularly when patients present few symptoms.