ArticleFrontiers in medicine2026
Case Report: Application of bronchoalveolar lavage fluid morphology in the diagnosis of pulmonary fat embolism.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Pulmonary fat embolism (PFE) is a serious complication of liposuction surgery, characterized by atypical clinical presentation and considerable diagnostic difficulty. Morphological examination of Bronchoalveolar Lavage Fluid (BALF) can provide critical evidence for diagnosis. This article reports a rare delayed-onset case, highlighting the diagnostic value of this examination and the importance of risk prevention and management in plastic surgery. Case presentation: A 25-year-old female was admitted with a 4-day history of chest tightness, which worsened after eating and at night. The patient had undergone liposuction surgery half a month prior. Laboratory findings revealed elevated D-dimer levels and decreased total protein and albumin. Chest Computed Tomography (CT) suggested chronic inflammation with fibroproliferative changes in the left lower lobe. Bronchiectasis was initially diagnosed; however, anti-infective therapy was ineffective. Microscopic examination of BALF revealed fat droplets and macrophages phagocytosing fat particles, with positive Sudan III staining. In conjunction with contrast-enhanced pulmonary CTA, the patient was ultimately diagnosed with pulmonary fat embolism secondary to liposuction. After receiving symptomatic and supportive treatment, the patient's symptoms resolved, and she was discharged. Conclusion: This case indicates that pulmonary fat embolism following liposuction is prone to being misdiagnosed. BALF morphological examination can effectively assist in early diagnosis and gain valuable time for treatment. Meanwhile, this case also reminds us of the significance of risk assessment in aesthetic and plastic surgery. Clinicians should remain vigilant regarding atypical postoperative symptoms to prevent missed diagnoses and misdiagnoses.
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