Ryu AJ, Navin PJ, Hu X, et al. - Researchers explored the spectrum of clinico-radiologic presentations related to aspiration-associated lung diseases. Obtained from Mayo Clinic, Rochester, Minnesota, USA, all cases of aspiration recognized on lung biopsy were reviewed. Surgical biopsy-identified cases were 65%, and transbronchial biopsy-detected cases were 37%, of overall 52 consecutive adult cases of aspiration detected on lung biopsy. At least one detectable risk factor for aspiration was present in 90% of individuals; the most common (62%) was gastroesophageal reflux disease, followed by structurally abnormal esophago-gastric tract and the use of consciousness-impairing medications. Dysphagia or choking was reported by only 27% of patients. On chest CT, bronchiolitis (42%), patchy consolidation (19%), and mass (15%) were identified as parenchymal patterns. Overall, a wide spectrum of clinico-radiologic presentations related to aspiration can be seen, and the occurrence of aspiration is possible even in the absence of subjective or evident swallowing problems.