An uncommon cause of miliary pattern of pulmonary nodules—diffuse pulmonary meningotheliomatosis

Pulmonary meningothelial-like nodules are benign lesions that are often incidentally detected in surgically resected lung tissue. These nodules are usually asymptomatic and single. Rarely, they present as diffuse micronodules similar to the miliary pattern seen in tuberculosis or metastatic cancer. While diffuse meningothelial-like micronodules are usually benign, it is important to include this condition in the differential diagnosis of patients presenting with diffuse micronodules. We present the case of a 74-year-old asymptomatic female referred to the pulmonary clinic for evaluation of incidentally detected diffuse bilateral pulmonary nodules. A transbronchial biopsy established a diagnosis of diffuse pulmonary meningotheliomatosis, obviating the need for further invasive workup. She remains stable after more than 2 years of follow-up.