Abstract
A 66-year-old woman presented with multiple tiny nodules in the bilateral lungs on a chest CT scan. These nodules were suspected of miliary tuberculosis or pulmonary metastases. A transbronchial lung biopsy provided no definitive diagnosis. No tubercle bacillus was isolated. FDG-PET to search for primary lesion showed abnormal uptake in the right lobe of the thyroid gland, where needle aspiration biopsy cytology revealed class III. To obtain the definitive diagnosis of the diffuse pulmonary nodules, we performed a biopsy by video-assisted thoracic surgery. The histology demonstrated the pulmonary nodules to be meningothelial-like nodules. Since they diffusely distributed in the bilateral lungs, diffuse pulmonary meningotheliomatosis (DPM) was diagnosed. Although minute pulmonary meningothelial-like nodules (MPMNs) are incidentally detected in the resected pulmonary specimens, DPM is rarely reported. It should be included in the differential diagnosis of diffuse bilateral lung nodules.
