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Published on: May 19, 2023
Clinicopathologic features of minute pulmonary meningothelial-like nodules
Ayaka Asakawa1, Hirotoshi Horio1, Tsunekazu Hishima2
11 Department of Thoracic Surgery, 118084 Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital , Tokyo, Japan.
Abstract:
Purpose Minute pulmonary meningothelial-like nodules are incidentally discovered in lung specimens. We analyzed the clinicopathologic features of 14 cases identified in surgically resected lungs. Methods Among patients who underwent lung resection in our hospital from October 2007 to March 2016, 14 were found to have minute pulmonary meningothelial-like nodules. The clinical parameters, radiologic findings, and pathologic features of these patients were retrospectively reviewed using the medical records. Results The patients included 4 men and 10 women, with a mean age of 69 years (range 53-82 years). The coexisting main disease was adenocarcinoma in 8 patients, squamous cell carcinoma in 1, atypical adenomatous hyperplasia in 1, and metastatic pulmonary tumor in 3. In one patient, the minute pulmonary meningothelial-like nodules presented as multiple lung nodules on chest computed tomography. The median size of the nodules was 1.4 mm (range 0.3-6.0 mm). Similar to meningioma, one case had immunoreactivity to progesterone receptor and epithelial membrane antigen, although the minute pulmonary meningothelial-like nodules were not associated with a meningioma. Conclusions The relationship between minute pulmonary meningothelial-like nodules and meningioma should be investigated. If minute pulmonary meningothelial-like nodules are found on preoperative computed tomography, thoracoscopic lung biopsy is helpful for differential diagnosis.
Insights
Minute pulmonary meningothelial-like nodules are rare lung findings. Further research is needed to understand their connection to meningioma, especially when detected on preoperative computed tomography.
Area of Science:
- Pulmonary Pathology
- Surgical Pathology
- Oncology
Background:
- Minute pulmonary meningothelial-like nodules are incidental findings in lung specimens.
- These nodules share similarities with meningioma, including specific receptor expression.
Purpose of the Study:
- To analyze the clinicopathologic features of minute pulmonary meningothelial-like nodules.
- To investigate the potential relationship between these nodules and meningioma.
Main Methods:
- Retrospective review of 14 cases of minute pulmonary meningothelial-like nodules identified in surgically resected lungs.
- Analysis of clinical, radiologic, and pathologic data, including immunohistochemistry for progesterone receptor and epithelial membrane antigen.
Main Results:
- The study included 14 patients (4 men, 10 women; mean age 69 years).
- Coexisting lung diseases included adenocarcinoma (8 patients), squamous cell carcinoma (1), atypical adenomatous hyperplasia (1), and metastatic tumors (3).
- Nodule sizes ranged from 0.3 to 6.0 mm (median 1.4 mm); one case showed multiple nodules on CT. One case exhibited progesterone receptor and epithelial membrane antigen immunoreactivity, similar to meningioma, but was not associated with meningioma.
Conclusions:
- The relationship between minute pulmonary meningothelial-like nodules and meningioma requires further investigation.
- Thoracoscopic lung biopsy is recommended for differential diagnosis when these nodules are detected preoperatively via computed tomography.
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