Lipid granuloma

Purified mineral oils have been used medicinally and in foods. Subchronic toxicity studies of selected mixtures of mineral oil hydrocarbons (composed primarily of branched chain alkanes or cyclic alkanes) in F344 rats have identified the liver and the mesenteric lymph nodes as potential targets of toxicity for these mineral oils. The TPHCWG (1997c) derived chronic RfDs for low and high molecular weight mineral oils based on the hepatic effects (lipid granulomas) seen in these studies. 

Hepatic lipid granulomas have also been seen in humans exposed to mineral oils through the diet and by ingestion of medicinal mineral oils, but doses associated with the effect in humans are not known. According to TPHCWG (1997c), the granulomas in humans were circumscribed lesions with no... 

There are data from animal studies in mice, rats, and pigs that indicate that both carbohydrate metabolism and lipid metabolism may be affected by exposure to heptachlor or heptachlor epoxide (Enan et al. 1982 Halacka et al. 1974 Kacew and Singhal 1973 Pelikan 1971). Alterations in gluconeogenic enzymes and an increase in cellular steatosis in the liver have been reported. Granulomas and fibrotic liver have also been observed. In addition, hepatocellular carcinoma was identified as causally related to heptachlor in the diet in a mouse study conducted by the National Cancer Institute (NCI 1977). The existing evidence suggests that heptachlor and heptachlor epoxide are hepatic toxicants. 

Mucolipidoses are characterized by a combined metabolic disorder of mucopolysaccharides, lipids, and glycoproteins. Lysosomal storage and foamy swollen Kupffer cells with hepatomegaly may be seen. In some of the numerous types, the underlying enzymatic defects have not yet been detected. Type II is also called Leroy syndrome (J.G. Leroy et al., 1967). Due to distinctive cytoplasmic inclusions in fibroblast cultures, this disorder is also known as inclusion cell disease (J.G. Leroy et al., 1971). Foamy altered stellate cells, macrophages and also epithelioid foam cell granulomas are found. 

Petrolatum has also been tentatively implicated in the formation of spherulosis of the upper respiratory tract following use of a petrolatum-based ointment packing after surgery, and lipoid pneumonia following excessive use in the perinasal area. Other adverse reactions to petrolatum include granulomas (paraffinomas) following injection into soft tissue. Also, when taken orally, petrolatum acts as a mild laxative and may inhibit the absorption of lipids and lipid-soluble nutrients. 

Mediastinal granulomas Severe diffuse pulmonary disease 1-50 Most lesions resolve spontaneously surgery or antifungal therapy with amphotericin B 40-50 mgf day X 2-3 weeks or itraconazole 400 mgfday orally x 6-12 months may be beneficial in some severe cases mild to moderate disease may be treated with itraconazole for 6-12 months Amphotericin B 0.7 mgfkgfday, for a total dose of <35 mg/kg (or 3 mg/kg/day of one of the lipid preparations) -I- prednisone 60 mg daily tapered over 2 weeks, followed by itraconazole 200 mg twice daily for 6-12 weeks in patients who do not require hospitalization, itraconazole 200 mg once or twice daily for 6-12 weeks can be used... 

Fig. 126. Macrophage polykaryon with many microvilli, numerous cisternae of the endoplasmatic reticulum, polysomes, mitochondria, bundles of filaments and lipid droplets. Marhagelan -induced (7 days) resorption granuloma (block 171) of a male Sprague-Dawley rat (No. 10) treated for 14 days with intragastric application of 15 mg carbocromene per kg body weight x day. Perfused under pentobarbital anaesthesia (30 mg/kg) from the abdominal aorta with 2.5 % glutaralde-hyde in 0.1 M sodium cacodylate buffer (pH 7.4). Postfixation with 1 % osmium tetroxide in cacodylate buffer. Embedded in Epon 812 and sectioned at 50 run. Lead citrate and uranyl acetate. Plate 2846. Detail from Pig. 155...

Occasional multinucleated giant cells or ill-formed granulomas are embedded in the lymphoid infdtrate in up to 50% of cases (1). The giant cells may contain cholesterol clefts. Why giant cells occur is unclear, but they are also seen in MALT lymphomas of the lung (66). Possibly, they are a reaction to lipid released by cellular breakdown. 

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