A Rare Case of Diffuse Bilateral Minute Pulmonary Meningothelial-like Nodules Increasing over the Short Term and Resembling Metastatic Lung Cancer

Murata, Daiki; Zaizen, Yoshiaki; Tokisawa, Saeko; Matama, Goushi; Chikasue, Tomonori; Nishii, Yuuya; Ohno, Shuuhei; Tsumura, Kenji; Tominaga, Masaki; Fukuoka, Junya; Fujimoto, Kiminori; Hoshino, Tomoaki

doi:10.2169/internalmedicine.0343-22

Cited by 3 publications

(2 citation statements)

References 13 publications

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“…Pulmonary minute meningothelial-like nodules (MMNs) are tiny nests of spindledto-epithelioid cells generally centered on small pulmonary veins, representing common incidental findings acquired during life in the lung, although their functional significance is still uncertain [1][2][3][4][5][6]. The incidence of multiple MMNs in pulmonary resections ranges from 1.1% to 9.5% [5,6,36]. Some authors have suggested that MMNs may be present in all abnormal lungs with chronic lung disease if sufficiently sampled, particularly in women in their sixth decade of life, in whom hormonal stimulation and chronic lung diseases with hypoxemic conditions possibly induce the growth of interstitial meningothelial cells [5].…”

Section: Discussionmentioning

confidence: 99%

Diffuse Pulmonary Meningotheliomatosis: Clinic-Pathologic Entity or Indolent Metastasis from Meningioma (or Both)?

et al. 2023

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Pulmonary minute meningothelial-like nodules (MMNs) are common incidental findings in surgical specimens, consisting of tiny proliferation (usually no larger than 5–6 mm) of bland-looking meningothelial cells showing a perivenular and interstitial distribution, sharing morphologic, ultrastructural, and immunohistochemical profiles with meningiomas. The identification of multiple bilateral MMNs leading to an interstitial lung disease characterized by diffuse and micronodular/miliariform patterns radiologically allows the diagnosis of diffuse pulmonary meningotheliomatosis (DPM). Nevertheless, the lung is the most common site of metastatic primary intracranial meningioma, and differential diagnosis with DPM may be impossible without clinic–radiologic integration. Herein, we report four cases (three females; mean age, 57.5 years) fitting the criteria of DPM, all incidentally discovered and histologically evidenced on transbronchial biopsy (2) and surgical resection (2). All cases showed immunohistochemical expression of epithelial membrane antigen (EMA), progesterone receptor, and CD56. Notably, three of these patients had a proven or radiologically suspected intracranial meningioma; in two cases, it was discovered before, and in one case, after the diagnosis of DPM. An extensive literature review (44 patients with DPM) revealed similar cases with imaging studies excluding intracranial meningioma in only 9% (4 of 44 cases studied). The diagnosis of DPM requires close correlation with the clinic–radiologic data since a subset of cases coexist with or follow a previously diagnosed intracranial meningioma and, thus, may represent incidental and indolent metastatic deposits of meningioma.

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Section: Discussionmentioning

confidence: 99%

Diffuse Pulmonary Meningotheliomatosis: Clinic-Pathologic Entity or Indolent Metastasis from Meningioma (or Both)?

et al. 2023

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“…There have been few reports of an increase in the number of MPMN in multiple lesions over time. Although rare, Murata et al 6 reported an increase in the number of diffuse GGN at 4 months, which were difficult to distinguish from metastatic lung tumours on CT imaging.…”

Section: Discussionmentioning

confidence: 99%

Minute pulmonary meningothelial‐like nodule that was difficult to differentiate from lung adenocarcinoma due to specific computed tomography findings changes: A case report

Ohashi,

Kawago,

Iguchi

et al. 2023

Respirology Case Reports

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Minute pulmonary meningothelial‐like nodules (MPMNs) are benign lesions characterized by the appearance of ground‐glass nodules (GGN) on computed tomography (CT). In the present case, an MPMN gradually developed into a substantial component during chest CT follow‐up, and the GGN gradually transformed into a part‐solid nodule. The imaging course described in this case is quite unique. Such CT images are characteristic of malignant tumours, especially, highly differentiated adenocarcinomas, which are difficult to differentiate preoperatively. Therefore, it is important to report this case.

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Diffuse pulmonary meningotheliomatosis: A case report

Oh,

Lim,

Kim

et al. 2024

Respiratory Medicine Case Reports

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A Rare Case of Diffuse Bilateral Minute Pulmonary Meningothelial-like Nodules Increasing over the Short Term and Resembling Metastatic Lung Cancer

Cited by 3 publications

References 13 publications

Diffuse Pulmonary Meningotheliomatosis: Clinic-Pathologic Entity or Indolent Metastasis from Meningioma (or Both)?

Diffuse Pulmonary Meningotheliomatosis: Clinic-Pathologic Entity or Indolent Metastasis from Meningioma (or Both)?

Minute pulmonary meningothelial‐like nodule that was difficult to differentiate from lung adenocarcinoma due to specific computed tomography findings changes: A case report

Diffuse pulmonary meningotheliomatosis: A case report

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