Long-term radiographic stability of diffuse pulmonary meningotheliomatosis

Diffuse pulmonary meningotheliomatosis (DPM) is a rare lung disease characterised by numerous, bilateral, minute pulmonary meningothelial-like nodules that appear as small ground glass opacities which are often asymptomatic and of unclear clinical significance. This case involves a woman in her 80s presenting with progressive dyspnoea on exertion and a complicated medical history including anaemia and multi-valvular heart disease. Her investigations revealed stable radiographic findings of random, diffuse, bilateral ground glass nodules unchanged over 7 years and mild restrictive deficits on pulmonary function tests. Differential diagnoses included malignancy, infection and granulomatous diseases, but the findings favoured DPM due to the stable nature of the nodules. No biopsy was pursued, and the diagnosis was made radiographically after a multidisciplinary discussion. Her subacute symptoms were attributed to iron-deficiency anaemia and resolved with treatment. This case highlights the indolent nature of DPM with years of radiographic and functional stability.