Diffuse Pulmonary Meningotheliomatosis Diagnosed by Transbronchial Lung Biopsy

Abstract

Minute pulmonary meningothelial-like nodules (MPMNs) are usually unique lesions in the lung parenchyma. Diffuse pulmonary meningotheliomatosis, which is presented as multiple MPMNs, has been less frequently described. MPMNs are mainly asymptomatic and are diagnosed after lung surgery or during autopsy. We report on a patient with multiple and bilateral pulmonary nodules, some of which were cavitated, diagnosed with diffuse pulmonary meningotheliomatosis by transbronchial lung biopsy. Diffuse pulmonary meningotheliomatosis should be included in the differential diagnosis of bilateral lung nodules.

Minute Pulmonary Meningothelial-like Nodules Showing Multiple Ring-shaped Opacities

“…Our case was rare in that chest CT showed multiple, bilateral, randomly distributed tiny ground glass nodules, some of which showed central lucency, appearing as ring-shaped opacities. Such chest CT findings have been reported in only two other cases (8,9). Although MPMNs are incidental pathological findings of no clinical significance, recent advances and the increased use of chest CT will increase the likelihood of such minute lesions being detected.…”

“…Recent advances and the increased use of computed tomography (CT) have led to the early detection of this condition. Chest CT findings of MPMNs usually show tiny nodules (2-5 mm in diameter) of ground-glass attenuation (2,6-13), but diffuse thin-walled cavities have rarely been reported (8,9). We herein report a patient with MPMNs who showed diffuse, thin-walled cystic lesions on thin-section CT of the lungs.…”

An uncommon cause of miliary pattern of pulmonary nodules—diffuse pulmonary meningotheliomatosis

“…Diagnostic tissue was obtained with transbronchial biopsy in our patient. One additional case report used a similar approach . This highlights the potential value of a less invasive approach to establishing a DPM diagnosis.…”

“…Fatigue and dyspnoea have been reported, although comorbidities such as ischaemic heart disease, pneumothorax, and lung cancer may explain the presence of symptoms . DPM is not consistently associated with a prior smoking history .…”

Diffuse pulmonary meningotheliomatosis: A diagnostically challenging entity on fine‐needle aspiration cytology

“…MPMNs have a female predominance and are usually present as asymptomatic, solitary, or multiple nodules that are incidentally found during pathologic evaluation of lung specimens . In a rare subset of patients, however, these lesions are sufficiently profuse to cause diffuse radiologic abnormalities and occasionally a syndrome of restrictive lung disease, which has been referred to as diffuse pulmonary meningotheliomatosis (DPM) . To the best of our knowledge, this is the first cytologic description of DPM from a fine‐needle aspiration (FNA) sample.…”