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Minute pulmonary meningothelial-like nodules: associations between computed tomography and pathology features
Yawen Zhang1,2, Jing Wu1, Youcai Zhao3
1Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
Background:
Increased use of multislice computed tomography (CT) scans has revealed that minute pulmonary meningothelial-like nodules (MPMNs) showed as ground-glass nodules (GGNs) are frequent in patients. However, little is known about the incidence and fate of nodules. By using a cross-sectional design, this study compared the multislice CT signs and pathological results of MPMNs, and further used pathological results to explain the formation mechanism of the CT signs of MPMNs to improve the clinical understanding of the disease.
Methods:
The clinicopathological data of 93 cases diagnosed as MPMNs in the Jiangsu Province Hospital from January 2016 to September 2019 and the Nanjing First Hospital from January 2017 to December 2019 were examined. The related literature was reviewed, and each case's age, gender, medical history, and preoperative CT examinations were classified. Based on CT signs, this study analyzed the imaging features, including size, shape, boundary, distribution, opacity, and their relationship with pulmonary blood vessels.
Results:
A total of 13 cases had immunohistochemistry results among which the lesions showed consistent positive expression of vimentin (100%), followed by epithelial cell membrane antigen (92.3%) and progesterone (8%). The MPMNs mainly occurred in individuals aged 50-59 years (32.6%). Most patients (82.6%) had neoplastic disease. All nodules (100%) manifested with a round shape and well-demarcated borders on images. The size of the nodules on CT scans ranged from 2.5 to 5.0 mm, with an average size of 3.04±1.12 mm. Most nodules were subpleural (89.1%) and showed ground-glass opacity (97.8%). The follow-up results of postoperative clinical manifestations and chest CT examination were negative in 12 patients.
Conclusions:
This study suggested that the pathological findings of MPMNs could explain the formation mechanism of the CT signs. The results can provide guidance for the diagnosis of the disease in the future.
Insights
Minute pulmonary meningothelial-like nodules (MPMNs) are common findings on CT scans. This study correlates CT signs with pathology, offering insights into MPMN formation and improving future diagnosis.
Area of Science:
- Pulmonology
- Radiology
- Pathology
Background:
- Minute pulmonary meningothelial-like nodules (MPMNs) are frequently detected as ground-glass nodules (GGNs) on multislice computed tomography (CT) scans.
- Limited information exists regarding the incidence and clinical course of these MPMNs.
- Understanding MPMNs is crucial for accurate clinical interpretation of CT findings.
Purpose of the Study:
- To compare the multislice CT characteristics of MPMNs with their pathological results.
- To elucidate the formation mechanisms behind the CT signs of MPMNs.
- To enhance the clinical understanding and diagnostic accuracy of MPMNs.
Main Methods:
- Retrospective analysis of clinicopathological data from 93 MPMN cases across two hospitals.
- Review of related literature and classification of patient demographics, medical history, and CT findings.
- Detailed analysis of CT imaging features including size, shape, boundary, distribution, and opacity of MPMNs.
Main Results:
- MPMNs predominantly affect individuals aged 50-59, with 82.6% of patients having neoplastic disease.
- All nodules appeared round with well-defined borders, measuring 2.5-5.0 mm (average 3.04 mm), mostly subpleural (89.1%) and showing ground-glass opacity (97.8%).
- Immunohistochemistry showed consistent vimentin expression (100%) and high epithelial cell membrane antigen (92.3%) positivity.
Conclusions:
- Pathological findings of MPMNs provide a basis for understanding their CT imaging characteristics.
- The study's results can guide future diagnostic approaches for MPMNs.
- Further research can improve the clinical management of patients with MPMNs.
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