Zhang Yawen, Wu Jing, Zhao Youcai, Zhang Tao, Xu Hai, Chen Yu-Chen
Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
Department of Radiology, Nanjing Pukou District Central Hospital, Nanjing, China.
Quant Imaging Med Surg. 2023 Jan 1;13(1):462-470. doi: 10.21037/qims-21-1250. Epub 2022 Oct 8.
Increased use of multislice computed tomography (CT) scans has revealed that minute pulmonary meningothelial-like nodules (MPMNs) showed as ground-glass nodules (GGNs) are frequent in patients. However, little is known about the incidence and fate of nodules. By using a cross-sectional design, this study compared the multislice CT signs and pathological results of MPMNs, and further used pathological results to explain the formation mechanism of the CT signs of MPMNs to improve the clinical understanding of the disease.
The clinicopathological data of 93 cases diagnosed as MPMNs in the Jiangsu Province Hospital from January 2016 to September 2019 and the Nanjing First Hospital from January 2017 to December 2019 were examined. The related literature was reviewed, and each case's age, gender, medical history, and preoperative CT examinations were classified. Based on CT signs, this study analyzed the imaging features, including size, shape, boundary, distribution, opacity, and their relationship with pulmonary blood vessels.
A total of 13 cases had immunohistochemistry results among which the lesions showed consistent positive expression of vimentin (100%), followed by epithelial cell membrane antigen (92.3%) and progesterone (8%). The MPMNs mainly occurred in individuals aged 50-59 years (32.6%). Most patients (82.6%) had neoplastic disease. All nodules (100%) manifested with a round shape and well-demarcated borders on images. The size of the nodules on CT scans ranged from 2.5 to 5.0 mm, with an average size of 3.04±1.12 mm. Most nodules were subpleural (89.1%) and showed ground-glass opacity (97.8%). The follow-up results of postoperative clinical manifestations and chest CT examination were negative in 12 patients.
This study suggested that the pathological findings of MPMNs could explain the formation mechanism of the CT signs. The results can provide guidance for the diagnosis of the disease in the future.
多层螺旋计算机断层扫描（CT）的使用增加显示，表现为磨玻璃结节（GGN）的微小肺脑膜上皮样结节（MPMN）在患者中很常见。然而，关于这些结节的发生率和转归知之甚少。本研究采用横断面设计，比较了MPMN的多层螺旋CT征象和病理结果，并进一步用病理结果解释MPMN的CT征象形成机制，以提高临床对该疾病的认识。
检查了2016年1月至2019年9月在江苏省医院以及2017年1月至2019年12月在南京第一医院诊断为MPMN的93例患者的临床病理资料。回顾相关文献，并对每个病例的年龄、性别、病史和术前CT检查进行分类。基于CT征象，本研究分析了影像学特征，包括大小、形状、边界、分布、密度以及它们与肺血管的关系。
共有13例患者有免疫组化结果，其中病变波形蛋白呈一致阳性表达（100%），其次是上皮细胞膜抗原（92.3%）和孕激素（8%）。MPMN主要发生于50 - 59岁个体（32.6%）。大多数患者（82.6%）有肿瘤性疾病。所有结节（100%）在图像上均表现为圆形且边界清晰。CT扫描结节大小为2.5至5.0毫米，平均大小为3.04±1.12毫米。大多数结节位于胸膜下（89.1%）并表现为磨玻璃密度（97.8%）。12例患者术后临床表现及胸部CT检查的随访结果为阴性。
本研究表明，MPMN的病理表现可解释CT征象的形成机制。研究结果可为今后该病的诊断提供指导。
