Pulmoner Hidatid Kist ile Birlikte Bulunan Meningotelioid Nodüller: Nadir Bir Vaka Sunumu

Abstract

Meningotelioid nodüller nadir görülen ve genellikle benign pulmoner nodüllerdir. Bu olgu sunumunu, meningotelioid nodüller ile pulmoner hidatid kist ilişkisini rapor eden ilk olgu olması nedeniyle sunduk. 48 yaşında Türk kadın hasta, bir haftadır süren öksürük ve hemoptizi şikayetiyle başvurdu. Toraks bilgisayarlı tomografi görüntülerinde akciğerin sol alt lobunda hidatid kist için tipik “çift kontür bulgusu” gösteren iyi sınırlı, uniloküler kistik lezyon görüldü. Hastaya sol alt lobdaki hidatid kist nedeniyle torakoskopik wedge rezeksiyon yapılmasına karar verildi. Mikroskobik değerlendirmede hematoksilen-eozin kesitlerinde yuvarlak-oval nükleuslu, orta genişlikte eozinofilik sitoplazmalı ve açık granüler kromatinli epitelioid hücrelerden oluşan çok sayıda perivenüler nodül görüldü. Çoğu bölgede fokal olarak girdaplanmış tümör hücreleri mevcuttu. Hücrelerin bazılarında psödonükleer inklüzyonlar izlendi. Çevredeki akciğer parankiminde hidatid kist görüldü. Bu histopatolojik ve immünohistokimyal bulgulara dayanarak meningotelioid nodül ve hidatid kist tanısı konuldu. Meningotelioid nodüller ve pulmoner hidatid kistin bir arada bulunduğu nadir bir olguyla karşılaştık. Meningotelioid nodüllerin kesin tanısı için dikkatli bir patolojik, klinik ve radyolojik inceleme gereklidir ve cerrahi ile mükemmel bir prognoz sağlanabilir.

Keywords

• Meningotelioid nodül
• pulmoner kemodektoma
• pulmoner hidatid kist

MENINGOTHELIOID NODULES COEXISTING WITH PULMONARY HYDATID CYST:A RARE CASE REPORT

Abstract

Meningothelioid nodules are rare and usually benign pulmonary nodules. We present this case report because it represents the first reported case of an association between meningothelioid nodules and a pulmonary hydatid cyst. A 48-year-old Turkish female patient presented with a cough and hemoptysis lasting for a week. Chest computed tomography images revealed a well-circumscribed, unilocular cystic lesion in the left lower lobe of the lung, displaying the typical “double- wall sign” of a hydatid cyst. It was decided that the patient would undergo thoracoscopic wedge resection of the hydatid cyst in the left lower lobe. Microscopic examination revealed multiple perivenular nodules composed of epithelioid cells with round to oval nuclei, a moderate amount of eosinophilic cytoplasm, and finely granular chromatin in hematoxylin-eosin sections. Whorling of tumor cells was observed focally in most areas. Some cells exhibited pseudonuclear inclusions. The surrounding lung parenchyma contained hydatid cysts. Based on these histopathological and immunohistochemistry findings, a diagnosis of a meningothelioid nodule and a hydatid cyst was made. We encountered a rare case of coexisting meningothelioid nodules and a pulmonary hydatid cyst. Careful pathological, clinical, and radiological examination are required for the definitive diagnosis of meningothelioid nodules, and they can provide an excellent prognosis with surgery.

Keywords

• Meningothelioid nodule
• pulmonary chemodectoma
• pulmonary hydatid cyst

Ethical Statement

The study was conducted according to the guidelines of the Declaration of Helsinki. Ethics committee approval was not required due to the following considerations: all data related to patients’ identification were anonymized; only original slides stained with haematoxylin and eosin were reassessed and no new sections were produced; this study has a speculative aim and results will not modify in any way the diagnosis and prognosis or add new clinical information useful for patient management.

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