Multifocal micronodular pneumocyte hyperplasia
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Multifocal micronodular pneumocyte hyperplasia (MMPH) is a rare benign hamartomatous proliferation of type II pneumocytes and is mostly seen in association with tuberous sclerosis (TS). It can occur with or without concurrent lymphangiomyomatosis.
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Radiographic features
CT
Seen as random 1 relatively well defined small (1-10 mm 1,4) nodular lung opacities in patients with tuberous sclerosis.
Treatment and prognosis
Unlike lymphangiomyomatosis, multifocal micronodular pneumocyte hyperplasia is not progressive and therefore treatment is not required 3 however they have been observed to regress on mTOR inhibitors.
History and etymology
It was first described by Popper et al. in 1991 7.
Differential diagnosis
General imaging differential considerations include
multiple atypical adenomatous hyperplasia (MAAH)
early pulmonary Langerhans cell histiocytosis: nodular stage, although these are centrilobular and upper zone predominant
minute hematogenous lung metastases, random nodules usually vary in size
miliary tuberculosis, random nodules usually similar in size
diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) which often typically is associated with lobular air-trapping
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