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Weekly Chest CasesArchive of Old Cases

Case No : 1442 Date 2025-06-09

  • Courtesy of Ji Young Lee, Eui Jin Hwang / Seoul National University Hospital
  • Age/Sex 69 / F
  • Chief ComplaintIncidentally found abnormality
  • Figure 1
  • Figure 2
  • Figure 3

Diagnosis With Brief Discussion

Diagnosis
Diffuse pulmonary meningotheliomatosis
Radiologic Findings
Fig 1-3. Chest CT images show multiple radiography shows multiple small ground-glass nodules scattered in both lungs. Some of the nodules show central lucency.
Brief Review
Diffuse pulmonary meningotheliomatosis (DPM) is an extremely rare condition characterized by multiple minute meningothelial nodules of lungs. DPM has been reported in patients aged 22 to 84 (median, 62 years), with a female predominance (2.2:1). Most patients with DPM are asymptomatic and are discovered incidentally.
Imaging finding of DPM can be characterized by the presence of multiple nodules scattered in both lungs. Typically, the lung nodules are small (smaller than 1 cm) and predominantly involve peripheral one third of the lung. Some of the nodules show central lucency, called “Cheerio sign”.
DPM has benign clinical behavior, and no therapeutic intervention is required. Notably, minute meningothelial nodules are more common in patients with lung cancer. In case of DPM, a workup for unidentified malignancy can be considered on an individualized basis.
References
1. Kraushaar G et al. Minute pulmonary meningothelial-like nodules: a case of incidentally detected diffuse cystic micronodules on thih-section computed tomography. J Comput Assist Tomogr. 2010;34:780-782.
2. 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

No. of Applicants : 73

▶ Correct Answer : 49/73,  67.1%
  • - Funabashi General Hospital , Japan MANABU AKIMOTO
  • - Saitama-Sekishinkai Hosptal , Japan MIHOKO YAMAZAKI
  • - , Japan SUZUNE TSUKAMOTO
  • - medical scanning , Japan HIROAKI ARAKAWA
  • - IUHW Narita Hospital , Japan ISSEI FUKUDA
  • - Shiga University of Medical Science , Japan AKITOSHI INOUE
  • - Kyoto University , Japan AKIHIKO SAKATA
  • - Oita university , Japan AYUMI KAMEI
  • - Kyoto City Hospital , Japan YUSUKE UTSUNOMIYA
  • - , Italy PAOLO BALDASSARI
  • - Teikyo University Hospital , Japan CHIAKI SATO
  • - Secomedic Hospital , Japan FUMINORI MIYOSHI
  • - Oita University, Faculty of Medicine , Japan FUMITO OKADA
  • - university of montreal , Canada Andrei Bogdan Gorgos I
  • - University of Yamanashi , Japan TAKAAKI HASHIMOTO
  • - Osaka University , Japan AKINORI HATA
  • - University of Yamanashi , Japan HIROYUKI MORISAKA
  • - The University of Tokyo Hospital , Japan TOSHIHIRO FURUTA
  • - , Japan YOSHIKI ISHII
  • - University of Yamanashi , Japan HIROAKI WATANABE
  • - Ajou University Hospital , Korea (South) YOU NA KIM
  • - Other , Korea (South) MARI A
  • - Osaka Metropolitan University Hospital , Japan SHU MATSUSHITA
  • - , Japan SHUNJIRO NOGUCHI
  • - , Japan MARINO TANIGUCHI
  • - Jichi Medical University, School of Medicine , Japan MITSURU MATSUKI
  • - Shiga General Hospital , Japan YUSAKU MORIBATA
  • - Avrasya Hospital/ISTANBUL , Turkey MURAT ULUSOY
  • - Osaka metropolitan university Hospital , Japan TATSUSHI OURA
  • - Mie university , Japan SHIKO OKABE
  • - , Korea (South) DAWON PARK
  • - Dokkyo Medical University , Japan HIROAKI ARAKAWA
  • - TB centre kasaragod. , India rikhy krishnan
  • - , Japan MATSUNO MAI
  • - Kyoto University , Japan SHO KOYASU
  • - Kyung Hee University Medical Hospital , Korea (South) JEONG TAEK YOON
  • - CHA University, CHA Bundang Medical Center , Korea (South) HWANGSEON JU
  • - Yonsei University,Severance Hospital , Korea (South) SEO BUM CHO
  • - Fukuoka university , Japan KEISUKE SATO
  • - Kantou Rousai Hospital , Japan KAORU SUMIDA
  • - Matsunami General Hospital , Japan TARO TAKEDA
  • - Sotiria Hospital, Athens , Greece VASILIOS TZILAS
  • - , Japan YUMI MAEHARA
  • - , Japan TAKAHIRO WAKIDA
  • - Toyota Kosei Hospital , Japan YUKI HAYASHI
  • - University of Yamanashi , Japan KOJIRO ONOHARA
  • - , Japan JUN YOSHIDA
  • - Jiangsu province hospital , China WANGJIAN ZHA
  • - Huanggang Central Hospital , China ZHOU GANG
▶ Correct Answer as Differential Diagnosis : 1/73,  1.4%
  • - McGill University Health Center , Canada ALEXANDRE SEMIONOV
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