Advertisement

Diffuse pulmonary meningotheliomatosis

      Highlights

      • DPM is a rare disease often incidentally diagnosed on biopsy or autopsy with unclear etiology to date.
      • On imaging, it presents as diffuse randomly distributed micro-nodules and can be confused with metastatic or infectious disease.
      • DPM should be considered in the differential, particularly when radiological features (such as long-term stability) and clinical context make other processes unlikely.

      Abstract

      We report the case of an 80-year-old woman presenting with randomly distributed ground glass nodules in the lungs. Since this imaging appearance can be confusing and can mimic other disease processes, it is important to have an organized approach. In this specific case, the distribution and appearance of nodules, their presence for a prolonged period as well as the clinical context were clues to the diagnosis of diffuse pulmonary meningotheliomatosis (DPM). The final diagnosis was established by surgical biopsy. This article reviews the current literature on DPM, imaging appearance, and an algorithmic approach to the presented case.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Clinical Imaging
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Kraushaar G.
        • Ajlan A.M.
        • English J.C.
        • Müller N.L.
        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
        • Suster S.
        • Moran C.A.
        Diffuse pulmonary meningotheliomatosis.
        Am J Surg Pathol. 2007; 31: 624-631
        • Korn D.
        • Bensch K.
        • Liebow A.A.
        • Castleman B.
        Multiple minute pulmonary tumors resembling chemodectomas.
        Am J Pathol. 1960; 37: 641
        • Churg A.M.
        • Warnock M.L.
        So-called “minute pulmonary chemodectoma”. A tumor not related to paragangliomas.
        Cancer. 1976; 37: 1759-1769
        • Niho S.
        • Yokose T.
        • Nishiwaki Y.
        • Mukai K.
        Immunohistochemical and clonal analysis of minute pulmonary meningothelial-like nodules.
        Hum Pathol. 1999; 30: 425-429
        • Weissferdt A.
        • Tang X.
        • Suster S.
        • Wistuba I.I.
        • Moran C.A.
        Pleuropulmonary meningothelial proliferations: evidence for a common histogenesis.
        Am J Surg Pathol. 2015; 39: 1673-1678
        • Gaffey M.J.
        • Mills S.E.
        • Askin F.B.
        Minute pulmonary meningothelial-like nodules. A clinicopathologic study of so-called minute pulmonary chemodectoma.
        Am J Surg Pathol. 1988; 12: 167-175
        • Mukhopadhyay S.
        • El-Zammar O.A.
        • Katzenstein A.-L.A.
        Pulmonary meningothelial-like nodules: new insights into a common but poorly understood entity.
        Am J Surg Pathol. 2009; 33: 487-495
        • Gaffey M.J.
        • Mills S.E.
        • Askin F.B.
        Minute pulmonary meningothelial-like nodules. A clinicopathologic study of so-called minute pulmonary chemodectoma.
        Am J Surg Pathol. 1988; 12: 167-175
        • Mizutani E.
        • Tsuta K.
        • Maeshima A.M.
        • Asamura H.
        • Matsuno Y.
        Minute pulmonary meningothelial-like nodules: clinicopathologic analysis of 121 patients.
        Hum Pathol. 2009; 40: 678-682
        • Ionescu D.N.
        • Sasatomi E.
        • Aldeeb D.
        • Omalu B.I.
        • Finkelstein S.D.
        • Swalsky P.A.
        • et al.
        Pulmonary meningothelial-like nodules: a genotypic comparison with meningiomas.
        Am J Surg Pathol. 2004; 28: 207-214
        • Bernabeu Mora R.
        • Sanchez Nieto J.M.
        • Hu C.
        • Alcaraz Mateos E.
        • Gimenez Bascunana A.
        • Rodriguez Rodriguez M.
        Diffuse pulmonary meningotheliomatosis diagnosed by transbronchial lung biopsy.
        Respiration. 2013; 86: 145-148
        • Gleason J.B.
        • Schroeder J.R.
        • Ramirez J.
        Meningotheliomatosis: a rare cause of diffuse miliary pattern pulmonary opacities.
        J Clin Diagn Res. 2016; 10: OJ05
        • Jayaschandran V.
        • Gjorgova-Gjeorgjievski S.
        • Siddique H.
        An uncommon cause of miliary pattern of pulmonary nodules-diffuse pulmonary meningotheliomatosis.
        Respirol Case Rep. 2017; 5: e00238
        • Sellami D.
        • Gotway M.B.
        • Hanks D.K.
        • Webb W.R.
        Minute pulmonary meningothelial-like nodules: thin-section CT appearance.
        J Comput Assist Tomogr. 2001; 25: 311-313
        • Park H.
        • Nishi Y.
        • Tabe K.
        • Yamamoto H.
        • Shibasaki M.
        • Sakata K.
        • et al.
        Minute pulmonary meningothelial-like nodules: a case report.
        Nihon Kokyuki Gakkai zasshi= the journal of the Japanese Respiratory Society. 2002; 40: 499-502