A 54-year-old man with progressive dyspnoea. A chest radiograph and CT were undertaken. The chest radiograph showed decreased translucency with an air bronchogram in the right lower lobe. There were no signs of interstitial lung disease (Fig 7a) . Chest CT showed a crazypaving pattern with areas of increased lung attenuation and with thickening of the interlobular septa, even thickening of the intralobular interstitium in the right middle and lower lobe (Fig. 7b) . Histological examination showed alveoli filled with lipid particles, some of them ingested in macrophages with the formation of lipid granulomas (Fig.7c) .