CTICasesMultiple Coexisting Pulmonary Pathologies (Adenocarcinoma, Meningothelial-Like Nodules, Carcinoid Tumorlets, and Lymphoma)
Imaging findings
CT demonstrates multiple bilateral ground-glass and mixed sub-solid nodules of varying sizes, many with a ring or cheerio appearance (lucent center), some slowly growing over years. Lobectomy specimen revealed four simultaneous pathologies: invasive adenocarcinoma, multiple meningothelial-like nodules (MELN), carcinoid tumorlets, and axillary lymphoma.
Key takeaways
Meningothelial-like nodules (MELN), formerly minute pulmonary meningothelial-like nodules (MPMN), are benign incidental microscopic findings that appear as tiny solid nodules or cheerio-sign nodules (ring-like) on CT. They can coexist with adenocarcinoma spectrum lesions and carcinoid tumorlets in the same patient, making interpretation of indeterminate lung nodules challenging.
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