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Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
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Diffuse pulmonary meningotheliomatosis.

Saul Suster1, Cesar A Moran

  • 1Department of Pathology, Division of Anatomic Pathology, The Ohio State University, Columbus, OH 43210, USA. saul.suster@osumc.edu

The American Journal of Surgical Pathology
|April 7, 2007
PubMed
Summary

Minute pulmonary meningothelial nodules are rare lung lesions. This study documents 5 cases of diffuse bilateral pulmonary involvement causing restrictive lung disease, a previously undocumented presentation.

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Area of Science:

  • Pulmonary Pathology
  • Neoplastic Diseases
  • Rare Lung Lesions

Background:

  • Minute pulmonary meningothelial nodules are rare, typically asymptomatic lung lesions.
  • They are usually incidentally discovered and often solitary or unilaterally distributed.
  • Disseminated bilateral pulmonary involvement with clinical symptoms is not previously documented.

Purpose of the Study:

  • To describe a novel presentation of minute pulmonary meningothelial nodules.
  • To characterize the clinical, radiologic, and histologic features of diffuse bilateral pulmonary meningotheliomatosis.
  • To highlight the diagnostic challenges posed by this rare condition.

Main Methods:

  • Case series of 5 patients with diffuse bilateral pulmonary meningothelial nodules.
  • Clinical data, chest imaging (X-ray, CT), and open lung biopsy findings were analyzed.
  • Histologic examination, immunohistochemistry, and electron microscopy were performed.

Main Results:

  • Five patients (4 female, 1 male; aged 54-75) presented with dyspnea and diffuse bilateral interstitial lung infiltrates.
  • Radiologic findings mimicked metastatic disease in 3 patients with prior malignancy.
  • Histology confirmed minute pulmonary meningothelial nodules with characteristic immunohistochemical and ultrastructural features.

Conclusions:

  • Diffuse bilateral pulmonary meningotheliomatosis is a rare but distinct entity.
  • It can present with restrictive pulmonary disease and diffuse lung infiltrates, mimicking other interstitial lung diseases.
  • Consideration of diffuse pulmonary meningotheliomatosis in the differential diagnosis of diffuse interstitial lung infiltrates is crucial.