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Yeon Bi Han
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P1.02 - Biology/Pathology (ID 614)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Biology/Pathology
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.02-027 - Minute Pulmonary Meningothelial-Like Nodules Presenting as Multiple Ground-Glass Density Nodules (GGNs): A Case Report (ID 8960)
09:30 - 09:30 | Presenting Author(s): Yeon Bi Han
- Abstract
Background:
Minute pulmonary meningothelial-like nodules (MPMNs) are generally detected incidentally in resected lung specimens. Recently, with increased use of high-resolution computer tomography (HRCT), MPMNs have occasionally been detected before surgery. They may appear as mild restrictive lung disease or randomly distributed micronodules of ground-glass attenuation on HRCT.
Method:
In this study, we retrospectively evaluated a case in which multiple ground glass density nodules (GGNs) were detected incidentally and operated for diagnosis in our hospital with the final diagnosis of MPMNs.
Result:
A 58-year-old non-smoking woman was referred to our hospital for multiple GGNs in bilateral lower lobes detected on a chest CT scan. HRCT was obtained for further evaluation. Numerous tiny GGNs were seen in the both lower lungs with centrilobular, subpleural and gravitational distribution. Many of them showed cystic or cavitary changes. Three differential diagnoses were presented by HRCT findings. The first was multifocal adenocarcinoma in situ or adenocarcinoma, the second was multifocal micronodular pneumocyte hyperplasia, and the third was atypical manifestation of langerhans cell histiocytosis or respiratory bronchiolitis interstitial lung disease. A follow up HRCT was reobtained after 2 months to determine diagnostic strategy and there was no significant change or mild prominence. For pathologic confirmation, video-assisted thoracoscopic surgery (VATS) right lower lobe wedge resection was performed. Microscopically, the surgical lung biopsy specimen showed multifocal ovoid cell proliferation along alveolar interstitium. The cells were bland, and no mitotic activity was identified. Immunohistochemical analysis was performed, and the sample was positive for epithelial membrane antigen (EMA), progesterone (PR) and CD56. Cytokerain, thyroid transcription factor-1, and S100 were negative. Finally the diagnosis of MPMNs was established, and there was no evidence of malignancy. On the second postoperative day, the patient was discharged without any complications.
Conclusion:
MPMNs are not uncommon incidental pathologic findings but the HRCT findings are nonspecific. They can occasionally manifest as multiple GGNs on HRCT, mimicking multifocal adenocarcinoma in situ or interstitial lung disease. Although most cases do not require special treatment, when there is no confident clinical diagnosis, such as in our case, a pathological correlation could be performed. An awareness of MPMNs presenting as GGNs is important because it may simulate neoplastic or other nonneoplastic diseases.
