case_images: PMC11789907_01
case_images: (A-C) Chest CT images showing multiple nodules in both lungs, the largest one is located in the right lower lung; (D-F) Enhancement scans of the largest lesion showing mild to moderate enhancement, which is less homogeneous. CT = computerized tomography.
case_images: medi-104-e41294-g002.jpg
case_images: PMC11789907_01_medi-104-e41294-g002.jpg
case_images: F1
case_images: Contrast-enhanced chest computerized tomography (CT) revealed several isolated nodules on both lungs with well-defined lobes (Fig. 1A-C), the largest one where was located in the right lower lobe showed mild to moderate heterogeneous enhancement (Fig. 1D-F).
case_images: (A and B) The lesion in the cranial bone barrier shows a high signal in T2WI Flair images, and mild to moderate enhancement in T1-weighted MR image; (C) The MRS image no show NAA peak and Cr peak of the lesion, and show the broad Lip peak.
case_images: medi-104-e41294-g003.jpg
case_images: PMC11789907_01_medi-104-e41294-g003.jpg
case_images: F2
case_images: MR images; the MRS images no show NAA peak and Cr peak, and show the broad Lip peak (Fig. 2A-C). Multiple pulmonary nodules and the lesion in head had mild fluorodeoxyglucose (FDG) uptake (the largest nodule with a SUVmax of 2.5, other nodules with a SUVmax of 1.0 to 1.2, the lesion in head with a SUVmax of 2.1) on 18 F-FDG PET/CT (Fig. 3A and B).
case_images: (A) Mildly increased metabolism nodules on PET/CT in the right lower lung; (B) Mildly increased metabolism lesion on PET/CT in the cranial bone barrier. CT = computerized tomography.
case_images: medi-104-e41294-g004.jpg
case_images: PMC11789907_01_medi-104-e41294-g004.jpg
case_images: F3
case_images: MR images; the MRS images no show NAA peak and Cr peak, and show the broad Lip peak (Fig. 2A-C). Multiple pulmonary nodules and the lesion in head had mild fluorodeoxyglucose (FDG) uptake (the largest nodule with a SUVmax of 2.5, other nodules with a SUVmax of 1.0 to 1.2, the lesion in head with a SUVmax of 2.1) on 18 F-FDG PET/CT (Fig. 3A and B).
case_images: (A) The boundary of lesion in the cranial bone barrier is clear, the cytoplasm is eosinophilic, and the nucleus is ovoid; (B) The right lower lung nodule puncture microscopy observed that the meningioma cells in the lung tissue were arranged in the form of a whirlpool; the nucleus was large, the nuclear membrane was clear, and the nucleolus could be seen.
case_images: medi-104-e41294-g005.jpg
case_images: PMC11789907_01_medi-104-e41294-g005.jpg
case_images: F4
case_images: The lesion under the cranial bone barrier was described as a piece of grayish-white tissue of 1.5 x 1.5 x 0.5 cm in size, hard as a stone, and microscopically the spindle cell lesion within the cranial plate baffle was examined and detected as having a still-clear border, eosinophilic cytoplasm, and ovoid nuclei (Fig. 4A). Two linear samples of 0.8 to 1.0 cm in length and 0.1 cm in diameter were taken from the right lower lung nodule, and under the microscope, we saw meningioma cells were arranged in a swirling pattern in the lung tissue; the nucleus was large, the nuclear membrane was clear, and the nucleolus could be seen (Fig. 4b). The Immunohistochemistry results were: Vimentin (+), E-cad (+), EMA (+), CD56 (+), CD34 (+), PGP9.5 (+), S-100 (partly +), PR (partly weakly +), STAT-6 (partly plasma cell +), CK7 (-), TTF-1 (-), NapsinA (-), P40 (-), CK5/6 (-), GFAP (-), CgA (-), Syn (-), Pan-CK (-).