Liu Xibo, Xu Xia, Zou Yi
Department of Pathology, Shaoxing People's Hospital, No. 568, Zhongxing North Road, Shaoxing, Zhejiang, 312000, China.
Department of Pathology, The Second Affiliated Hospital of Zhejiang University School of Medicine, No. 88, Jiefang Road, Hangzhou, Zhejiang, 310009, China.
Heliyon. 2023 May 25;9(6):e16705. doi: 10.1016/j.heliyon.2023.e16705. eCollection 2023 Jun.
Primary pulmonary meningioma (PPM) is rare, mostly asymptomatic, and difficult to recognize preoperatively. In this report, we describe two new cases of PPM and provide an updated review of the literature to enhance our understanding of PPM.
The first patient was a 53-year-old woman with an asymptomatic solitary pulmonary nodule in the right lower lobe on chest computed tomography (CT). Wedge resection of the right lung was performed and histological features of benign PPM were pathologically confirmed, which was further supported by immunohistochemistry. The second patient was a 63-year-old man who had a left pulmonary nodule during routine physical examination. CT revealed a solid nodule in the outer basal segment of the left lower lobe. The patient underwent a wedge resection of the left lower lobe and mediastinal lymph node dissection. Postoperative pathology confirmed the presence of two tumors: one adenocarcinoma and one PPM. Both cases were confirmed to be benign PPM (grade I) by pathological examination, with histological subtypes of fibrous and psammomatous.
Radiological imaging is crucial for the early detection of PPM, while pathological examination is necessary to confirm the diagnosis. Surgical treatment is recommended, and intraoperative frozen sections are essential for determining the extent of the operation.
原发性肺脑膜瘤(PPM)较为罕见,大多无症状,术前难以识别。在本报告中,我们描述了两例PPM新病例,并对文献进行了更新回顾,以加深我们对PPM的理解。
首例患者为一名53岁女性,胸部计算机断层扫描(CT)显示右下叶有一个无症状的孤立性肺结节。进行了右肺楔形切除术,病理证实为良性PPM的组织学特征,免疫组化进一步支持这一诊断。第二例患者为一名63岁男性,在常规体检时发现左肺结节。CT显示左下叶外基底段有一个实性结节。患者接受了左下叶楔形切除术和纵隔淋巴结清扫术。术后病理证实存在两种肿瘤:一种腺癌和一种PPM。两例经病理检查均确诊为良性PPM(I级),组织学亚型为纤维型和砂粒型。
放射影像学检查对PPM的早期发现至关重要,而病理检查是确诊的必要手段。建议采用手术治疗,术中冰冻切片对于确定手术范围至关重要。