Diffuse pulmonary meningotheliomatosis

Case contributed by Dr Luke Danaher

Presentation

Patient well. Incidental finding.

Patient Data

Gender: Female
CT

CT Chest

Random distribution of miliary pulmonary nodules. No cavitation. No consolidation. No pleural effusion. No lymph node enlargement / calcification. 

Pathology (wedge resection)

Multiple parenchymal and subpleural small foci, each up to 2-3mm in size.

Corresponding to minimal cystic change and collections of uniform fusiform to plump cells

EMA+, PR+, vimentin pending, HMB45-, SMA-/+, AE1/3-, synaptophysin-, chromogranin-, melanA- and pigments.

Intervening lung parenchyma, small airways and blood vessels are unremarkable.

Interstitial fibrosis or inflammation, granulomas, alveolar exudates, Langerhans cell infiltrate, organising pneumonia, and neoplasia not present.

CT

CT Chest (Follow-up)

Miliary ground-glass nodules.

Random distribution.

No significant change.

Case Discussion

Miliary pulmonary nodules in a well patient with no known history of malignancy. 

The patient went on to have a non-diagnostic endobronchial biopsy.

Diagnosis made on wedge resection.

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Case information

rID: 67624
Published: 16th Apr 2019
Last edited: 17th Apr 2019
System: Chest
Inclusion in quiz mode: Excluded

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