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<\/a><\/p>\nHere are a couple of higher power shots:<\/p>\n
Here are a couple of simple photomics of lipid emboli in the lungs.\u00a0 This is from a case of a young adult woman who died of methamphetamine and fentanyl intoxication. She was provided resuscitative efforts for about 30 minutes, including a mechanical resuscitator.\u00a0 \u00a0At autopsy, she had small fractures of ribs 3-6 anterolaterally on the left.<\/p>\n
On histologic examination of the lungs. numerous small arteries contained small clear vacuoles.\u00a0 These are characteristic of small lipid droplets that are leaked into the blood when a bone breaks.\u00a0 Sometimes (but not this time), sizeable pieces of bone marrow are leaked into the blood and you can see hematopoietic elements in the lungs as well.\u00a0 \u00a0When large bones are broken or there is massive blunt trauma, enough lipid can leak into the blood to cause respiratory distress or even death.\u00a0 \u00a0In cases such as this, however, that’s not a problem.<\/p>\n
Other things can look like this, of course.\u00a0 The most common is air embolism.\u00a0 I had a case some years ago where air was inadvertently injected into the blood by a nurse, and the lungs looked a bit like this.\u00a0 However, when there are obvious broken ribs and nothing to suggest air or other competing cause,\u00a0 it’s almost certainly lipid.\u00a0 \u00a0Back in the day, I would always confirm the lipid with Oil Red O or osmium stain.\u00a0 But… nobody seems to offer osmium staining any more (it’s dangerous, apparently), and few places will do Oil Red O.\u00a0 Plus, cost is always a bigger factor now that it used to be.\u00a0 So, today, I just call it lipid and move on.<\/p>\n
Here’s a low power view:<\/p>\n
Here are a couple of higher power shots:<\/p>\n<\/a><\/p>\n