転移性肺腫瘍との鑑別を要したdiffuse pulmonary meningotheliomatosisの1例

Diffuse Pulmonary Meningotheliomatosis Needed to be Differentiate from Metastatic Lung Tumor：Report of a Case

はじめに　微小髄膜細胞様結節（minute pulmonary meningothelial-like nodules：MPMN）は生検や切除検体内で偶発的に発見される肺結節であり1），両肺にびまん性に多発した症例はdiffuse pulmonary meningotheliomatosis（DPM）と称されるまれな疾患である．われわれは，大腸癌と乳癌を合併しCTで両肺に多発粒状影を認め，転移性肺腫瘍との鑑別を要したDPMの1例を経験したので報告する．

A 77-year-old woman was found to have multiple granular shadows in the bilateral lungs and a right mammary mass on chest computed tomography （CT） scan for preoperative check of colorectal cancer. The right mammary mass was diagnosed as breast cancer as a result of vacuum-assisted breast biopsy. Fluorodeoxyglucose-positron emission tomography （FDG-PET） showed no abnormal uptake in the lung fields. Since a transbronchial lung biopsy did not establish a diagnosis, an incisional biopsy was performed via a thoracoscopic approach. The histology of the pulmonary nodules revealed minute pulmonary meningothelial-like nodules （MPMNs） and the patient was diagnosed with diffuse pulmonary meningotheliomatosis （DPM）. When multiple pulmonary nodules are found in patients with coexisting malignancy, DPM should be considered in addition to metastatic lung tumors.