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1
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Oh SJ, Lim JH, Kim L, Kim YS. Diffuse pulmonary meningotheliomatosis: A case report. Respir Med Case Rep 2024; 52:102105. [PMID: 39323987 PMCID: PMC11420633 DOI: 10.1016/j.rmcr.2024.102105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Revised: 08/26/2024] [Accepted: 09/10/2024] [Indexed: 09/27/2024] Open
Abstract
A 57-year-old female presented with chest discomfort and exertional dyspnea but no other respiratory symptoms or history of malignancy. Chest CT revealed multifocal centrilobular nodules with ground-glass opacity in both lungs. Thoracoscopic wedge resection was done, and histological examination confirmed interstitial meningothelial-like nodules, consistent with diffuse meningotheliomatosis. The patient was discharged without complications and showed no disease progression on follow-up CT at 3 months, maintaining stability during 6 months of outpatient observation. Diffuse pulmonary meningotheliomatosis is an exceedingly rare condition, but this may be one of the causative etiologies in patients with diffuse bilateral pulmonary nodules.
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Affiliation(s)
- Su Ji Oh
- Department of Thoracic and Cardiovascular Surgery, Inha University Hospital, Inha University College of Medicine, Incheon, South Korea
| | - Jun Hyeok Lim
- Center for Lung Cancer, Division of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University College of Medicine, Incheon, South Korea
| | - Lucia Kim
- Department of Pathology, Inha University Hospital, Inha University College of Medicine, Incheon, South Korea
| | - Young Sam Kim
- Department of Thoracic and Cardiovascular Surgery, Inha University Hospital, Inha University College of Medicine, Incheon, South Korea
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2
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Ruan X, Wu LS, Fan ZY, Liu Q, Yan J, Li XQ. Pathological diagnosis and immunohistochemical analysis of minute pulmonary meningothelial-like nodules: A case report. World J Clin Cases 2023; 11:8022-8029. [DOI: 10.12998/wjcc.v11.i33.8022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 10/10/2023] [Accepted: 10/30/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Minute Pulmonary Meningothelial-like Nodules (MPMNs) are rare benign pulmonary nodules, which are more common in elderly women and have a higher detection rate in lung tissues of patients with lung malignant diseases. Its origin is not yet clear. At present, there are few reports on the diagnostic methods such as imaging and pathological manifestations of MPMNs. This article reports a 70-year-old female patient with pulmonary adenocarcinoma combined with MPMNs and reviews of the relevant literature.
CASE SUMMARY A 70-year-old women was admitted to our institution with feeling sour in her back and occasional cough for more than 2 mo. Computerized electronic scanning scan and 3D reconstruction images in our institution showed there were multiple ground-glass nodules in both of her two lungs. The biggest one was in the apicoposterior segment of left upper lobe, about 2.5 mm × 9 mm in size. We performed thoracoscopic resection of the left upper lung apicoposterior segment of the patient, and the final pathological report was minimally invasive adenocarcinoma. Re-examination of high resolution computed tomography 21 mo after surgery showed multiple ground-glass nodules in both lungs, and a new ground-glass nodule was found in the superior segment of the right lower lobe. We took pathological biopsy of the right upper lung and right lower lung nodules for the patient under thoracoscopy. The histomorphology of the right lower lobe nodule showed multiple lesions in the lung tissue, and the small foci in the alveolar septum were distributed in mild form of the aggregation of short spindle cells. The immunohistochemistry showed that the lesion was epithelial membrane antigen (EMA) (+), somatostatin receptor 2a (SSTR2a) (+), S-100 (-), chromogranin A (-), Syn (-), cytokeratin (-) and HMB-45 (-). The final diagnosis was minimally invasive adenocarcinoma, accompanied by MPMNs. We recommend that patients continue to receive treatment after surgery and to do regular follow-up observations.
CONCLUSION The imaging manifestations of MPMNs are atypical, histomorphology and immunohistochemistry can assist in its diagnosis. This article reviews the relevant literature of MPMNs immunohistochemistry and shows that MPMNs are positive for EMA, SSTR2a, and progesterone receptor.
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Affiliation(s)
- Xin Ruan
- Department of Thoracic Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
- School of Medicine, Shantou University, Shantou 515041, Guangdong Province, China
| | - Liu-Sheng Wu
- School of Medicine, Tsinghua University, Beijing 100084, China
| | - Zheng-Yang Fan
- Department of Graduate School, Xinjiang Medical University, Urumchi 830011, Xinjiang Uygur Autonomous Region, China
| | - Qi Liu
- Department of Thoracic Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
| | - Jun Yan
- School of Medicine, Tsinghua University, Beijing 100084, China
| | - Xiao-Qiang Li
- Department of Thoracic Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
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3
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Healy O, O'Callaghan M, Deegan A, McCarthy C. Diffuse pulmonary meningotheliomatosis: a rare cause of multiple pulmonary nodules. BMJ Case Rep 2023; 16:e254039. [PMID: 37788915 PMCID: PMC10551992 DOI: 10.1136/bcr-2022-254039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023] Open
Abstract
This case describes a woman in her 50s who presented with recurrent lower respiratory tract infections. She was an ex-smoker and had worked on a livestock farm for many years. Chest radiograph and CT of the chest revealed multiple bilateral pulmonary nodules. Bronchoalveolar lavage and transbronchial biopsy did not confirm a unifying diagnosis and thus, surgical biopsy was pursued. Video-assisted thoracoscopic surgical guided biopsy of the right upper, middle and lower lobes demonstrated intraparenchymal minute nodules, consisting of bland epithelioid cells without any evidence of malignancy. The nodules stained positive for neural cell adhesion molecule (CD56) and progesterone receptor with weakly positive epithelial membrane antigen and smooth muscle actin. The combination of this characteristic staining pattern, the diffuse subcentimetre nature of the nodules and this clinical presentation fit with a diagnosis of the ultra-rare pulmonary disease, diffuse pulmonary meningotheliomatosis (DPM). This case highlights a rare cause of bilateral diffuse pulmonary nodules and thus, the breadth of differential diagnoses that need to be considered when approaching such a finding. Careful history-taking and thorough workup is often needed, typically requiring input from multiple specialties. DPM, while rare, should not be overlooked when considering the underlying cause of this presentation, especially in female patients. This case reiterates how common clinical presentations can unveil rare conditions and the contributions of physicians, pathologists and radiologists in the diagnosis and management of these complex diseases.
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Affiliation(s)
- Orla Healy
- Department of Respiratory Medicine, St Vincent's University Hospital, Dublin, Ireland
| | - Marissa O'Callaghan
- Department of Respiratory Medicine, St Vincent's University Hospital, Dublin, Ireland
- School of Medicine, University College Dublin, Belfield Campus, Dublin 4, Ireland
| | - Alex Deegan
- Department of Respiratory Medicine, St Michael's Hospital, Dublin East Hospitals Group, Dun Laoghaire, Dublin, Ireland
| | - Cormac McCarthy
- Department of Respiratory Medicine, St Vincent's University Hospital, Dublin, Ireland
- School of Medicine, University College Dublin, Belfield Campus, Dublin 4, Ireland
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4
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Melocchi L, Rossi G, Valli M, Mengoli MC, Mondoni M, Lazzari-Agli L, Santandrea G, Davoli F, Baldovini C, Cavazza A, Colby TV. Diffuse Pulmonary Meningotheliomatosis: Clinic-Pathologic Entity or Indolent Metastasis from Meningioma (or Both)? Diagnostics (Basel) 2023; 13:diagnostics13040802. [PMID: 36832290 PMCID: PMC9955492 DOI: 10.3390/diagnostics13040802] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 02/23/2023] Open
Abstract
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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Affiliation(s)
- Laura Melocchi
- Pathology Unit, Department of Oncology, Fondazione Poliambulanza Hospital Institute, 25124 Brescia, Italy
- Correspondence: ; Tel.: +39-0303518661
| | - Giulio Rossi
- Pathology Unit, Department of Oncology, Fondazione Poliambulanza Hospital Institute, 25124 Brescia, Italy
| | - Mirca Valli
- Operative Unit of Pathologic Anatomy, Ospedale Infermi, Azienda USL Romagna, 47900 Rimini, Italy
| | | | - Michele Mondoni
- Respiratory Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, Università degli Studi di Milano, 20142 Milan, Italy
| | - Luigi Lazzari-Agli
- Pulmonology Unit, Ospedale Infermi, Azienda USL Romagna, 47900 Rimini, Italy
| | - Giacomo Santandrea
- Operative Unit of Pathology, Azienda USL/IRCCS, 42123 Reggio Emilia, Italy
| | - Fabio Davoli
- Department of Thoracic Surgery, Azienda USL Romagna, S. Maria delle Croci Teaching Hospital, 48121 Ravenna, Italy
| | - Chiara Baldovini
- Cardiovascular Pathology Unit, Department of Pathology, IRCCS, St. Orsola Hospital, University of Bologna, 40138 Bologna, Italy
| | - Alberto Cavazza
- Operative Unit of Pathology, Azienda USL/IRCCS, 42123 Reggio Emilia, Italy
| | - Thomas V. Colby
- Department of Laboratory Medicine and Pathology (Emeritus), Mayo Clinic Arizona, Scottsdale, AZ 13400, USA
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Diffuse pulmonary meningotheliomatosis with pan-TRK expression by immunohistochemistry: a novel finding and potential pitfall. Diagn Pathol 2023; 18:22. [PMID: 36782261 PMCID: PMC9926707 DOI: 10.1186/s13000-023-01292-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 01/13/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Pulmonary meningothelial-like nodules (PMNs) are benign proliferations of unclear clinical significance. They are mainly asymptomatic lesions that are usually discovered during the pathologic evaluation of resected pulmonary specimens or following post-mortem examination. Diffuse pulmonary meningotheliomatosis (DPM), which presents as bilateral multiple PMNs throughout the lungs, has been described less frequently. DPMs are benign lesions associated with both neoplastic and non-neoplastic pulmonary conditions. CASE PRESENTATION We report the case of a 59-year-old female patient who presented with a history of cough. Computerized tomography (CT) imaging revealed multiple subcentimeter bilateral pulmonary nodules. transbronchial biopsies were obtained which revealed foci of nodular interstitial proliferations composed of epithelioid to spindled cells in a vague whorled pattern. Immunohistochemical stains were diffusely positive for EMA and progesterone receptor. Furthermore, pan-TRK exhibited strong and diffuse membranous expression in the lesional cells. INSM1 was negative for expression. RNA-based next-generation sequencing for the detection of NTRK fusions was performed and was negative for gene rearrangements involving NTRK1, NTRK2, and NTRK3. CONCLUSION Here, we report a rare case of DPM and report pan-TRK expression in PMNs which has not been described. We provide a brief review of the literature and provide insight into the potential physiologic nature of PMNs. Lastly, we emphasize the recognition of pan-TRK immunoexpression in PMNs to avoid potential diagnostic errors.
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6
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Tzilas V, Bouros D. A 58-Year-Old Woman With Lung Nodules and Chronic Cough. Chest 2021; 160:e285-e288. [PMID: 34488969 DOI: 10.1016/j.chest.2021.04.051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 04/17/2021] [Accepted: 04/26/2021] [Indexed: 11/19/2022] Open
Abstract
CASE PRESENTATION A 58-year-old woman was referred to our department with a cough of 1 year duration; her condition was unresponsive to the administration of inhaled steroid and beta-2 agonists. She denied the presence of dyspnea, chest pain, or other extrapulmonary symptoms. She was a never-smoker with a negative medical history and no occupational or domestic exposures. There was no history of cancer, gastroesophageal reflux disease, asthma, allergic rhinitis, or other allergies.
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Affiliation(s)
| | - Demosthenes Bouros
- Athens Medical Center, Athens, Greece; First Academic Department of Pneumonology, Interstitial Lung Diseases Unit, Hospital for Diseases of the Chest, "Sotiria," Medical School, National and Kapodistrian University of Athens, Athens, Greece.
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7
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Alkurashi AK, Almodallal Y, Albitar HAH, Cheville JC, Iyer VN. Diffuse Pulmonary Meningotheliomatosis: A Rare Lung Disease Presenting with Diffuse Ground-Glass Opacities and Cavitation. AMERICAN JOURNAL OF CASE REPORTS 2020; 21:e926172. [PMID: 33166273 PMCID: PMC7666436 DOI: 10.12659/ajcr.926172] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Diffuse pulmonary meningotheliomatosis (DPM) is an exceedingly rare diffuse pulmonary disease with a female predominance. It is characterized by the presence of widespread bilateral minute pulmonary meningothelial-like nodules (MPMNs) on chest imaging. Patients are generally asymptomatic or may present with nonspecific symptoms such as dyspnea. The nodules are typically detected incidentally on imaging for other indications. Here, we present a rare case of DPM in a 55-year-old woman. CASE REPORT A 55-year-old woman presented to the clinic with non-exertional chest pressure and dry cough of 4-month duration. She had a history of hypertension, hypercholesterolemia, hypothyroidism, gastroesophageal reflux disease, and impaired fasting blood glucose and was a lifelong nonsmoker. Physical examination was unremarkable. High-resolution chest computed tomography (CT) showed innumerable diffuse small ground-glass nodules. An extensive laboratory workup was negative for autoimmune and infectious etiologies. The patient underwent uncomplicated right video-assisted thoracoscopic surgery, and lung biopsy showed multiple well-circumscribed interstitial meningothelial-like nodules in perivenular distribution with occasional whorling of cells. The diagnosis of diffuse pulmonary meningotheliomatosis (DPM) was confirmed. The patient continued to complain of non-exertional chest pressure without pulmonary complaints, and a repeat chest CT showed stable findings 1 year after the diagnosis. CONCLUSIONS DPM should be considered in the differential diagnosis for patients presenting with diffuse bilateral pulmonary nodules. Patients are typically asymptomatic and it is most commonly detected incidentally. Further research is needed to better understand this disease and its clinical significance.
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Affiliation(s)
- Adham K Alkurashi
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | | | | | - John C Cheville
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Vivek N Iyer
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA
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8
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Yun G, Huang T, O'Dwyer D, Chugtai A, Agarwal P. Diffuse pulmonary meningotheliomatosis. Clin Imaging 2020; 70:111-113. [PMID: 33157366 DOI: 10.1016/j.clinimag.2020.10.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 09/19/2020] [Accepted: 10/01/2020] [Indexed: 11/16/2022]
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.
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Affiliation(s)
- Gabin Yun
- Department of Radiology, Division of Cardiothoracic Radiology, University of Pittsburgh Medical Center, Pittsburgh, USA.
| | - Tao Huang
- Department of Pathology, University of Michigan, Ann Arbor, USA
| | - David O'Dwyer
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Michigan Medical School, Ann Arbor, USA
| | - Aamer Chugtai
- Department of Radiology, Division of Cardiothoracic Radiology, Cleveland clinic, Cleveland, USA
| | - Prachi Agarwal
- Department of Radiology, Division of Cardiothoracic Radiology, University of Michigan, Ann Arbor, USA
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9
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Diffuse pulmonary meningotheliomatosis - a case report. Afr J Thorac Crit Care Med 2020; 26. [PMID: 34240017 PMCID: PMC8203085 DOI: 10.7196/ajtccm.2020.v26i1.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Diffuse pulmonary meningotheliomatosis is a rare condition of the lung that presents with nonspecific respiratory symptoms, and usually
follows a benign course. It should, however, be considered in the differential diagnosis of a miliary pattern on chest-imaging studies, as
illustrated in the case reported
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10
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Harada M, Aono Y, Yasui H, Uto T, Sato J, Imokawa S, Suzuki S, Tanioka F, Suda T. Minute Pulmonary Meningothelial-like Nodules Showing Multiple Ring-shaped Opacities. Intern Med 2019; 58:3149-3152. [PMID: 31327818 PMCID: PMC6875465 DOI: 10.2169/internalmedicine.2108-18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Chest computed tomography (CT) findings of minute pulmonary meningothelial-like nodules (MPMNs) usually show tiny nodules (2-5 mm in diameter) of ground-glass attenuation. However, diffuse, thin-walled cavities have rarely been reported. We herein report a 56-year-old woman with MPMNs showing diffuse, thin-walled cystic lesions on a thin-section chest CT scan. Clinicians need to be aware of the imaging characteristics of this conditions to guide appropriate management of lung diseases, as these CT findings may resemble certain metastatic lung neoplasias and primary adenocarcinoma of the lung.
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Affiliation(s)
- Masanori Harada
- Division of Respiratory Medicine, Iwata City Hospital, Japan
| | - Yuya Aono
- Division of Respiratory Medicine, Iwata City Hospital, Japan
| | - Hideki Yasui
- Division of Respiratory Medicine, Iwata City Hospital, Japan
| | - Tomohiro Uto
- Division of Respiratory Medicine, Iwata City Hospital, Japan
| | - Jun Sato
- Division of Respiratory Medicine, Iwata City Hospital, Japan
| | - Shiro Imokawa
- Division of Respiratory Medicine, Iwata City Hospital, Japan
| | | | | | - Takafumi Suda
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Japan
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11
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Michishita M, Fujiwara-Igarashi A, Suzuki S, Hatakeyama H, Machida Y, Yoshimura H, Yamamoto M, Azakami D, Ochiai K, Ishiwata T, Fujita M. Diffuse Pulmonary Meningotheliomatosis with Sarcomatous Transformation in a Shiba Dog. J Comp Pathol 2019; 171:1-5. [PMID: 31540619 PMCID: PMC7094254 DOI: 10.1016/j.jcpa.2019.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Revised: 06/18/2019] [Accepted: 06/24/2019] [Indexed: 11/17/2022]
Abstract
A 2-year-old neutered female Shiba dog exhibited laboured breathing for 1 month. Computed tomography of the thoracic cavity revealed multiple nodules (2-5 mm diameter) in the lungs. Grossly, the lungs were firm and normal in shape. The nodules were grey-white in colour. Microscopically, the nodules were non-encapsulated and exhibited an irregular shape. They were composed of polygonal or spindle cells with indistinct cell borders arranged in sheets. The cells had large, round, hyperchromatic nuclei and abundant pale eosinophilic cytoplasm with no atypia. Intrapulmonary arterial emboli and infiltration into the bronchioles were observed. Immunohistochemically, the cells were positive for vimentin and negative for cytokeratin, glial fibrillary acidic protein and α-smooth muscle actin. Ultrastructurally, the cells displayed cytoplasmic processes, desmosomes and intermediate filaments. These findings led to a diagnosis of diffuse pulmonary meningotheliomatosis with sarcomatous transformation. To the best of our knowledge, this is the first report of diffuse pulmonary meningotheliomatosis in a dog.
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Affiliation(s)
- M Michishita
- Department of Veterinary Pathology, School of Veterinary Nursing and Technology, Nippon Veterinary and Life Science University, Tokyo.
| | - A Fujiwara-Igarashi
- Division of Veterinary Radiology, School of Veterinary Nursing and Technology, Nippon Veterinary and Life Science University, Tokyo
| | - S Suzuki
- Division of Veterinary Surgery, School of Veterinary Nursing and Technology, Nippon Veterinary and Life Science University, Tokyo
| | - H Hatakeyama
- Laboratory of Comparative Cellular Biology, School of Veterinary Medicine, School of Veterinary Nursing and Technology, Nippon Veterinary and Life Science University, Tokyo
| | - Y Machida
- Department of Veterinary Pathology, School of Veterinary Nursing and Technology, Nippon Veterinary and Life Science University, Tokyo
| | - H Yoshimura
- Department of Applied Science, School of Veterinary Nursing and Technology, Nippon Veterinary and Life Science University, Tokyo
| | - M Yamamoto
- Department of Applied Science, School of Veterinary Nursing and Technology, Nippon Veterinary and Life Science University, Tokyo
| | - D Azakami
- Department of Veterinary Nursing, School of Veterinary Nursing and Technology, Nippon Veterinary and Life Science University, Tokyo
| | - K Ochiai
- Department of Basic Science, School of Veterinary Nursing and Technology, Nippon Veterinary and Life Science University, Japan
| | - T Ishiwata
- Division of Aging and Carcinogenesis, Research Team for Geriatric Pathology, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - M Fujita
- Division of Veterinary Radiology, School of Veterinary Nursing and Technology, Nippon Veterinary and Life Science University, Tokyo
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12
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Tamburini N, Morandi L, Rinaldi R, Maniscalco P, Quarantotto F, Montinari E, Papi A, Anania G, Cavallesco G. Diffuse pulmonary meningothelial like nodules simulating metastatic thymoma. J Thorac Dis 2018; 10:E442-E446. [PMID: 30069401 DOI: 10.21037/jtd.2018.05.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Nicola Tamburini
- Department of Morphology, Experimental Medicine and Surgery, Section of Chirurgia 1, Section of Anatomic Pathology, University of Ferrara, Ferrara, Italy
| | - Luca Morandi
- Department of Respiratory Diseases, Section of Anatomic Pathology, University of Ferrara, Ferrara, Italy
| | - Rosa Rinaldi
- Department of Experimental and Diagnostic Medicine, Section of Anatomic Pathology, University of Ferrara, Ferrara, Italy
| | - Pio Maniscalco
- Department of Morphology, Experimental Medicine and Surgery, Section of Chirurgia 1, Section of Anatomic Pathology, University of Ferrara, Ferrara, Italy
| | - Francesco Quarantotto
- Department of Morphology, Experimental Medicine and Surgery, Section of Chirurgia 1, Section of Anatomic Pathology, University of Ferrara, Ferrara, Italy
| | - Elena Montinari
- Department of Experimental and Diagnostic Medicine, Section of Anatomic Pathology, University of Ferrara, Ferrara, Italy
| | - Alberto Papi
- Department of Respiratory Diseases, Section of Anatomic Pathology, University of Ferrara, Ferrara, Italy
| | - Gabriele Anania
- Department of Morphology, Experimental Medicine and Surgery, Section of Chirurgia 1, Section of Anatomic Pathology, University of Ferrara, Ferrara, Italy
| | - Giorgio Cavallesco
- Department of Morphology, Experimental Medicine and Surgery, Section of Chirurgia 1, Section of Anatomic Pathology, University of Ferrara, Ferrara, Italy
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13
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Kumar A, Cherian SV, Farver C, Mehta AC. Pulmonary Meningotheliomatosis. Arch Bronconeumol 2017; 54:104-105. [PMID: 28760571 DOI: 10.1016/j.arbres.2017.06.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 06/21/2017] [Accepted: 06/23/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Anupam Kumar
- Division of Pulmonary & Critical Care Medicine, Michigan State University-Spectrum Health, Lake Dr SE, Grand Rapids, United States.
| | - Sujith V Cherian
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Texas Health Science Center at Houston, Houston, United States
| | - Carol Farver
- Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, United States
| | - Atul C Mehta
- Respiratory Institute, Cleveland Clinic, Cleveland, United States
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14
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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. [PMID: 28469917 PMCID: PMC5408716 DOI: 10.1002/rcr2.238] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 03/03/2017] [Accepted: 03/09/2017] [Indexed: 11/30/2022] Open
Abstract
Pulmonary meningothelial‐like nodules are benign lesions that are often incidentally detected in surgically resected lung tissue. These nodules are usually asymptomatic and single. Rarely, they present as diffuse micronodules similar to the miliary pattern seen in tuberculosis or metastatic cancer. While diffuse meningothelial‐like micronodules are usually benign, it is important to include this condition in the differential diagnosis of patients presenting with diffuse micronodules. We present the case of a 74‐year‐old asymptomatic female referred to the pulmonary clinic for evaluation of incidentally detected diffuse bilateral pulmonary nodules. A transbronchial biopsy established a diagnosis of diffuse pulmonary meningotheliomatosis, obviating the need for further invasive workup. She remains stable after more than 2 years of follow‐up.
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15
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Gleason JB, Schroeder JR, Ramirez J. Meningotheliomatosis: A Rare Cause of Diffuse Miliary Pattern Pulmonary Opacities. J Clin Diagn Res 2016; 10:OJ05. [PMID: 27656496 DOI: 10.7860/jcdr/2016/22345.8354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Accepted: 07/15/2016] [Indexed: 11/24/2022]
Affiliation(s)
- James Benjamin Gleason
- Chief Fellow, Department of Pulmonary and Critical Care Medicine, Cleveland Clinic Florida , Weston, Florida, USA
| | - Jonathan Ryan Schroeder
- Fellow, Department of Pulmonary and Critical Care Medicine, Cleveland Clinic Florida , Weston, Florida, USA
| | - Jose Ramirez
- Attending Physician, Department of Pulmonary and Critical Care Medicine, Cleveland Clinic Florida , Weston, Florida, USA
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Huang EC, Zhang Y, Bishop JW, Gandour-Edwards RF, Afify AM. Diffuse pulmonary meningotheliomatosis: A diagnostically challenging entity on fine-needle aspiration cytology. Diagn Cytopathol 2015; 43:727-30. [PMID: 25964107 DOI: 10.1002/dc.23276] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 02/03/2015] [Accepted: 03/30/2015] [Indexed: 12/14/2022]
Abstract
Diffuse pulmonary meningotheliomatosis (DPM) is an exceedingly rare entity consisting of multiple minute pulmonary meningothelial-like nodules profusely involving the lungs. To the best of our knowledge, we present the first cytologic description of this uncommon lesion from a 57-year-old nonsmoking woman. Computerized tomographic-guided fine-needle aspiration cytology from a left upper lobe nodule showed whorled/nested clusters of elongated cells with oval nuclei, clear pseudonuclear inclusions, nuclear grooves/indentations, smooth nuclear contours, fine granular chromatin, inconspicuous nucleoli, and abundant fibrillary cytoplasm with indistinct cell borders. The subsequent pulmonary wedge resections confirmed the diagnosis of DPM. As this condition is exceptionally rare, familiarity with these cytologic features is of the essence to accurately establish this challenging diagnosis.
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Affiliation(s)
- Eric C Huang
- Department of Pathology and Laboratory Medicine, University of California, Davis Medical Center, Sacramento, California
| | - Yanhong Zhang
- Department of Pathology and Laboratory Medicine, University of California, Davis Medical Center, Sacramento, California
| | - John W Bishop
- Department of Pathology and Laboratory Medicine, University of California, Davis Medical Center, Sacramento, California
| | - Regina F Gandour-Edwards
- Department of Pathology and Laboratory Medicine, University of California, Davis Medical Center, Sacramento, California
| | - Alaa M Afify
- Department of Pathology and Laboratory Medicine, University of California, Davis Medical Center, Sacramento, California
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