Why Has This Woman Had Oil In Her Lungs For Over 50 Years?

An X-ray of the woman's chest shows the oil in the left chest cavity. The New England Journal of Medicine ©2017.

An 86-year-old woman went for a fairly routine trip to the doctors only to discover she's had oil – most likely paraffin oil, mineral oil, or olive oil – in her lung cavity for at least 50 years.

Confused? Fortunately, all is explained in the New England Journal of Medicine this week.

The woman visited the doctors in Florida after complaining of a burning chest sensation. Weirdly enough, she had not experienced any breathing problems. She was diagnosed with acid reflux and her symptoms improved. However, she also received a chest radiograph, which showed a "dense opacity" in the upper area of the left lung.

It turns out the elderly woman received a treatment known as “oleothorax” in the 1950s to treat pulmonary tuberculous. It involves injecting oils into the pleural space (the thin, fluid-filled space between the lungs) in an attempt to collapse and inactivate the problem lung. As you can probably tell by how this sounds, the treatment has not been officially practiced in the Western world for decades. The types of oils varied, but the doctors regularly used liquid paraffin, mineral oil, olive oil, cod liver oil, peanut oil, or cottonseed oil. 

"Unfortunately, we cannot say what type of oil it was just by looking at the chest X-ray," Abhilash Koratala, an assistant professor of Medicine who investigated the case, explained to IFLScience. "Preference varied among different parts of the world. As far as I know, olive oil was the most popular one."

The doctors at the University of Florida say patients were typically required to return to the doctor to have the oil aspirated and removed. However, if patients were having no symptoms, some forgot or chose not to return. They finished by simply saying the patient had no complications caused by the oil.

"She did not get any treatment," Koratala added. "As she has been asymptomatic for years, there is no indication to do any invasive procedure to aspirate the oil at this time. The risk of such a procedure outweighs the benefit in this elderly lady."

"In fact, the most important thing physicians can learn from this case is to avoid unnecessary procedures when they encounter 'asymptomatic' oleothorax. On the other hand, we have to be aware of the complications – such as infection and expansion causing respiratory distress - so that we treat them appropriately, in a timely manner."

 

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