Zhang Dan-Bin, Chen Tao
Department of Radiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
World J Clin Cases. 2022 May 6;10(13):4196-4206. doi: 10.12998/wjcc.v10.i13.4196.
Primary pulmonary meningioma (PPM) is a rare disease that is usually benign. The most common presentation of PPM is isolated pulmonary nodules or masses, so the disease can mimic any other lung tumor on imaging, especially lung cancer or metastasis.
A 47-year-old asymptomatic woman presented with a well-defined, lobulated pulmonary mass with calcification in the left lower lobe. The mass measured 69 mm × 57 mm × 61 mm and was found during a chest computed tomography (CT) performed for physical examination. Contrast-enhanced CT and positron emission tomography (PET)/CT revealed mild enhancement of the mass, with accumulation of 18-fluoro-2-deoxy-D-glucose (F-FDG). Transbronchial biopsy suggested a provisional diagnosis of low-grade neuroendocrine tumor. Subsequent enhanced head magnetic resonance imaging revealed no positive lesions. An open cuff resection of the left lower lobe and wedge resection of the lingual segment were performed. Histopathological and immunohistochemical examination revealed that the mass was a PPM.
PPM should be considered in the differential diagnosis of isolated pulmonary masses found incidentally on CT and should be diagnosed based on a combination of radiological and histological features. Surgical resection is currently the main treatment strategy. No recurrence of benign PPMs has been reported after complete resection.
原发性肺脑膜瘤（PPM）是一种罕见疾病，通常为良性。PPM最常见的表现是孤立性肺结节或肿块，因此在影像学上该疾病可类似于任何其他肺部肿瘤，尤其是肺癌或转移瘤。
一名47岁无症状女性，胸部计算机断层扫描（CT）体检时发现左肺下叶有一个边界清晰、分叶状且伴有钙化的肺部肿块。肿块大小为69 mm×57 mm×61 mm。对比增强CT和正电子发射断层扫描（PET）/CT显示肿块轻度强化，有18-氟-2-脱氧-D-葡萄糖（F-FDG）摄取。经支气管活检初步诊断为低级别神经内分泌肿瘤。随后增强头颅磁共振成像未发现阳性病变。对左肺下叶进行了袖状切除术，并对舌段进行了楔形切除术。组织病理学和免疫组织化学检查显示该肿块为PPM。
在鉴别诊断CT偶然发现的孤立性肺肿块时应考虑PPM，并应根据影像学和组织学特征进行诊断。手术切除是目前的主要治疗策略。完全切除后尚未报道良性PPM复发。
