대한흉부영상의학회 Korean Society of Thoracic Radiology GuerBet

대한흉부영상의학회 Weekly Case 메뉴

Close

대한흉부영상의학회 Weekly Case 검색
대한흉부영상의학회 Weekly Case 검색
Advanced Search..

Close

Weekly Chest CasesArchive of Old Cases

Case No : 853 Date 2014-03-03

  • Courtesy of Hyun Jung Yoon, Ho Yun Lee / Samsung Medical Center
  • Age/Sex 47 / F
  • Chief Complaintchest discomfort for 2 months
  • Figure 1
  • Figure 2
  • Figure 3

Diagnosis With Brief Discussion

Diagnosis
Diffuse pulmonary meningotheliomatosis
Radiologic Findings
Plain chest radiograph shows no abnormal finding.
Chest CT demonstrates multiple bilateral randomly distributed ground-glass attenuation micronodules. Many nodules show central cavitation. No zonal predominance is seen.
VATS biopsy was done in the right middle and lower lobe and diffuse pulmonary meningotheliomatosis was confirmed.
Brief Review
Pulmonary meningothelial-like nodules (PMLNs) have been found in patients ranging in age from 12 to 91 years, mostly in the seventh decade of life with a marked female predilection. Pathologically, PMLNs are small (100 um to a few mm) nodules which are composed of cells similar with meningothelial cells. Most PMLNs are usually solitary and found incidentally without related clinical manifestations during testing for other diseases. However, multiple lesions can be encountered and have occurred in up to 41% of all patients with PMLNs. If these lesions are small and numerous, this condition has been termed as diffuse pulmonary meningotheliomatosis (DPM).
Radiologic features of DPM are nonspecific, but, scattered minute areas of ground-glass attenuation are characteristic. The lesions presented in a random distribution but had a tendency to be located in the periphery of the lung. There is an assumption that the spread of the lesion along the alveolar walls likely results in the ground-glass attenuation on HRCT.
It has benign course, thus, conservative treatment is favorable. Therefore, this entity should be distinguished from metastatic carcinomas with prominent lymphatic spread in the lungs. However, recent studies reported that DPM have been associated with a variety of pulmonary abnormalities including pulmonary thromboembolism, and neoplasm, particularly pulmonary adenocarcinoma.
References
1. An J, et al. Diffuse pulmonary meningotheliomatosis. Korean J Pathol. 2011; 45(S1): S32-35.
2. Suster S, Moran CA. Diffuse pulmonary meningotheliomatosis. Am J Surg Pathol. 2007 Apr;31(4):624-31.
3. Kraushaar G, et al. Minute pulmonary meningothelial-like nodules: a case of incidentally detected diffuse cystic micronodules on thin-section computed tomography. J Comput Assist Tomogr. 2010;34: 780-782.
4. Kuroki M, et al. Minute pulmonary meningothelial-like nodules: high-resolution computed tomography and pathologic correlations. J Thorac Imaging. 2002;17(3):227-229.
Keywords
Lung,

No. of Applicants : 81

▶ Correct Answer : 2/81,  2.5%
  • - Oita University, Faculty of Medicine , Japan Fumito Okada
  • - Oita University , Japan Haruka Sato
▶ Correct Answer as Differential Diagnosis : 2/81,  2.5%
  • - Tokyo Metropolitan Police Hospital , Japan Akifumi Hagiwara
  • - Nagasaki University Hospital, Department of Pathology , Japan TOMONORI TANAKA
  • Top
  • Back

Each Case of This Site Supplied by the Members of KSTR.
Copyright of the Images is in the KSTR and Original Supplier.
Current Editor : Sung Shine Shim, MD, PhD. Email : sinisim@ewha.ac.kr

This website is optimized for IE 10 and above.