Scientific letter
Pulmonary Meningotheliomatosis
Meningoteliomatosis pulmonar
a Division of Pulmonary & Critical Care Medicine, Michigan State University-Spectrum Health, Lake Dr SE, Grand Rapids, United States
b Division of Pulmonary, Critical Care and Sleep Medicine, University of Texas Health Science Center at Houston, Houston, United States
c Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, United States
d Respiratory Institute, Cleveland Clinic, Cleveland, United States
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Note also in (D) multiple cutaneous neurofibromas in the anterior thoracic wall.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Guilherme Felix Louza, Gláucia Zanetti, Edson Marchiori" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Guilherme Felix" "apellidos" => "Louza" ] 1 => array:2 [ "nombre" => "Gláucia" "apellidos" => "Zanetti" ] 2 => array:2 [ "nombre" => "Edson" "apellidos" => "Marchiori" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0300289617302648" "doi" => "10.1016/j.arbres.2017.07.011" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289617302648?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212918300223?idApp=UINPBA00003Z" "url" => "/15792129/0000005400000002/v2_201802071702/S1579212918300223/v2_201802071702/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1579212917303993" "issn" => "15792129" "doi" => "10.1016/j.arbr.2017.12.002" "estado" => "S300" "fechaPublicacion" => "2018-02-01" "aid" => "1658" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2018;54:103-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1396 "formatos" => array:3 [ "EPUB" => 168 "HTML" => 853 "PDF" => 375 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific letter</span>" "titulo" => "Unilateral Lung Infiltrate: A Rare Form of Presentation of Primary Pulmonary Lymphoma" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "103" "paginaFinal" => "104" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Infiltrado pulmonar unilateral: una forma rara de presentación de un linfoma pulmonar primario" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1133 "Ancho" => 1625 "Tamanyo" => 105520 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest CT slice showing the lesion. An adjacent area of para-aortic pulmonary consolidation and left posterior pleural calcification can be observed.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "José Antonio Delgado Torralbo, Luis Carlos García Gómez, Juan Manuel Sánchez Varilla" "autores" => array:3 [ 0 => array:2 [ "nombre" => "José Antonio" "apellidos" => "Delgado Torralbo" ] 1 => array:2 [ "nombre" => "Luis Carlos" "apellidos" => "García Gómez" ] 2 => array:2 [ "nombre" => "Juan Manuel" "apellidos" => "Sánchez Varilla" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289617302107" "doi" => "10.1016/j.arbres.2017.06.004" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289617302107?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212917303993?idApp=UINPBA00003Z" "url" => "/15792129/0000005400000002/v2_201802071702/S1579212917303993/v2_201802071702/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific letter</span>" "titulo" => "Pulmonary Meningotheliomatosis" "tieneTextoCompleto" => true "saludo" => "Dear Editor:" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "104" "paginaFinal" => "105" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Anupam Kumar, Sujith V. Cherian, Carol Farver, Atul C. Mehta" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Anupam" "apellidos" => "Kumar" "email" => array:1 [ 0 => "anupamkumarmd@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Sujith V." "apellidos" => "Cherian" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Carol" "apellidos" => "Farver" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "Atul C." "apellidos" => "Mehta" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Division of Pulmonary & Critical Care Medicine, Michigan State University-Spectrum Health, Lake Dr SE, Grand Rapids, United States" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Division of Pulmonary, Critical Care and Sleep Medicine, University of Texas Health Science Center at Houston, Houston, United States" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, United States" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Respiratory Institute, Cleveland Clinic, Cleveland, United States" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Meningoteliomatosis pulmonar" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 751 "Ancho" => 1700 "Tamanyo" => 534790 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) CT chest demonstrates multiple ground glass nodules along the subpleural area and lung periphery in the lower lobes bilaterally (marked with open arrows). (B) Histology on wedge biopsy demonstrates multiple minute pulmonary meningothelial-like nodules with intervening collagen (open arrow) (hematoxylin and eosin; 200×).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The differential diagnosis for diffuse bilateral pulmonary micro nodules is extensive and typically includes infections, inflammatory disorders and malignancy. Meningothelial-like nodules of the lung, which are the result of proliferation of epithelioid cells within the interstitium, can also present as solitary pulmonary nodule, or as diffuse micro nodules, as in our patient. Although initially characterized as “minute pulmonary chemodectomas”, these nodules were subsequently found to lack neuroendocrine properties.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1–4</span></a> The case adds to the growing literature on the natural history of pulmonary meningotheliomatosis (PM), as it remains an elusive clinical entity.</p><p id="par0010" class="elsevierStylePara elsevierViewall">We report the case of a 58-year-old female, non-smoker, who presented to our clinic with an “abnormal” CT scan of the chest. The patient had presented to the emergency department a week previously for abdominal pain for which a CT abdomen/pelvis was obtained. The abdominal imaging was unremarkable except for lung nodules visualized at the bases. This prompted a dedicated chest CT scan and referral to our clinic. Her only symptom was intermittent dry cough for 3 months before presentation. Her physical examination, pulmonary function tests, routine blood work and rheumatology studies were unremarkable.</p><p id="par0015" class="elsevierStylePara elsevierViewall">CT (computed tomography) scan chest showed multiple bilateral micronodules, some of which had ground glass appearance while others were more well-defined (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A). Both upper and lower zones were involved although there was a basal predominance. Bronchoscopy with bronchoalveolar lavage (BAL) was unremarkable and showed normal macrophage predominance. Transbronchial biopsy was non-diagnostic. A video assisted thoracoscopic (VATS) biopsy was performed, the histopathology of which revealed multiple pulmonary meningothelial lesions (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B). A final diagnosis of pulmonary meningotheliomatosis (PM) was made based on radiology and histopathological features.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Meningothelial lesions of the lung were first described by Korn et al. in 1960, and were initially characterized as “minute pulmonary chemodectomas”.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> Since immunohistochemical studies showed it lacked neuroendocrine properties, the condition was renamed “minute pulmonary meningothelial-like nodules”.<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3,4</span></a> Other term that surfaced in our review of literature includes “diffuse pulmonary meningotheliomatosis”, particularly when there are numerous pulmonary micronodules causing symptoms.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2,5</span></a> For purpose of uniformity, we will refer to this entity as “pulmonary meningotheliomatosis” (PM) henceforth.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Data from large retrospective studies so far show that it most commonly presents in the sixth decade of life.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2,6,7</span></a> The age range can be between 20 and 80 years of age.<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">6,7</span></a> The condition seems to have a strong female predilection.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2,6,7</span></a> Although mostly diagnosed incidentally on pathology specimens, in patients with diffuse micronodules, non-specific symptoms (e.g.: cough, shortness of breath, fatigue) and pulmonary function abnormalities have been reported.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">PM can present as a solitary nodule, or more commonly as multiple, sub-centimeter, ground glass nodules on the CT scan.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2,7,8</span></a> While majority of the cases have reported basal predominance, this does not seem to be universal.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> Although surgical lung biopsy seems to have a higher yield for diagnosis, transbronchial biopsy has also been utilized successfully.<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">5,9</span></a> When it presents as diffuse micronodules, such as in our patient, it closely resembles more common etiologies such as granulomatous infections or metastatic malignancy, from which it needs to be distinguished. Therefore, given its rarity and lack of a characteristic radiological pattern, diagnosis of PM requires histopathology.</p><p id="par0035" class="elsevierStylePara elsevierViewall">The etiology and risk factors for proliferation of meningothelial-like nodules remain unclear. It is more commonly associated with chronic lung insults than with acute lung injury.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> One of the most commonly reported association for meningothelial lesions has been with pulmonary thromboembolic disease.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> This was highlighted again in the retrospective study by Mukhopadhyay et al. where the highest incidence of meningothelial lesions was in patients with thromboembolic disease/infarcts (5/12; 42%).<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> Interestingly, 26% of patients were also found to have smoking related interstitial lung disease such as respiratory bronchiolitis-associated interstitial lung disease/desquamative interstitial pneumonia.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> However, relationship with smoking remains unclear and causality cannot be inferred based on available data. Pulmonary meningothelial nodules have also been found in higher incidence in patients with malignant pulmonary tumors than in those with benign disease (7.3% versus 2.5%; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.044).<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> In the analysis of 121 patients by Mizutani et al., meningothelial lesions were found more often in patients with lung adenocarcinoma than with other primary pulmonary malignant tumors.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> A similar trend was noted in the study by Mukhopadhyay et al. but was not statistically significant.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> Thus, based on most of the studies, the meningothelial proliferation likely occurs in the setting of a chronic lung disease, as a reaction to hypoxia, ischemia or an underlying malignancy.</p><p id="par0040" class="elsevierStylePara elsevierViewall">On histopathology, PM is characterized by an interstitial proliferation of epithelioid cells with oval, bland nuclei with stippled chromatin. These cells are arranged in nests within the alveolar septa, usually expanding it, and they are usually found around pulmonary veins.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> As they expand, they may connect to each other with intervening collagen.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> However, proximity to pulmonary veins is not universal.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> Immunohistochemical characteristics usually include immunoreactivity with antibodies to vimentin, epithelial membrane antigen (EMA) and progesterone receptors (PR).<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2,6</span></a> Niho et al. initially reported that about half of the pulmonary meningothelial nodules exhibited immunoreactivity for the PR.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> In the series by Mukhopadhyay et al., all the patients with pulmonary meningothelial lesions stained positive for PR.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> Interestingly, progesterone receptor positivity has also been identified in approximately 50–60% of patients with non-small cell cancer, particularly adenocarcinoma.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> Even though progesterone receptors are so far not a major therapeutic target in lung cancer, the higher incidence of progesterone receptor in meningothelial-like nodules and its potential co-existence with adenocarcinoma is noteworthy. This could also, in part, explain the increased incidence of meningothelial-like nodules in female gender. Staining with CD 56 is yet another immunohistochemical marker that was reported by Mukhopadhay et al.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> Presence of CD 56, although can be seen in neuroendocrine cells, its presence in meningiomas also confirms the meningothelial origin of these pulmonary nodules. While immunohistochemistry can aid in confirmation in ambiguous situations, a confident diagnosis can be made based on the histology pattern.<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">7,9</span></a> Thus, PM which represents proliferation of epithelioid cells within interstitium, should be considered in the differential diagnosis of diffuse micronodules of the lung. However, its exact relationship with underlying lung diseases and natural history needs to be studied further.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 751 "Ancho" => 1700 "Tamanyo" => 534790 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) CT chest demonstrates multiple ground glass nodules along the subpleural area and lung periphery in the lower lobes bilaterally (marked with open arrows). (B) Histology on wedge biopsy demonstrates multiple minute pulmonary meningothelial-like nodules with intervening collagen (open arrow) (hematoxylin and eosin; 200×).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Multiple minute pulmonary tumors resembling chemodectomas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "D. Korn" 1 => "K. Bensch" 2 => "A.A. Liebow" 3 => "B. Castleman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Pathol" "fecha" => "1960" "volumen" => "37" "paginaInicial" => "641" "paginaFinal" => "672" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/13753180" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0060" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diffuse pulmonary meningotheliomatosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S. Suster" 1 => "C.A. Moran" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/01.pas.0000213385.25042.cf" "Revista" => array:6 [ "tituloSerie" => "Am J Surg Pathol" "fecha" => "2007" "volumen" => "31" "paginaInicial" => "624" "paginaFinal" => "631" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17414111" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0065" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Minute pulmonary meningothelial-like nodules. A clinicopathologic study of so-called minute pulmonary chemodectoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.J. Gaffey" 1 => "S.E. Mills" 2 => "F.B. Askin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Surg Pathol" "fecha" => "1988" "volumen" => "12" "paginaInicial" => "167" "paginaFinal" => "175" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2830799" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0070" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Immunohistochemical and clonal analysis of minute pulmonary meningothelial-like nodules" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Niho" 1 => "T. Yokose" 2 => "Y. Nishiwaki" 3 => "K. Mukai" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Hum Pathol" "fecha" => "1999" "volumen" => "4" "paginaInicial" => "425" "paginaFinal" => "429" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0075" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diffuse pulmonary meningotheliomatosis diagnosed by transbronchial lung biopsy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "R. Bernabeu Mora" 1 => "J.M. Sanchez Nieto" 2 => "C. Hu" 3 => "E. Alcaraz Mateos" 4 => "A. Gimenez Bascunana" 5 => "M. Rodriguez Rodriguez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000350430" "Revista" => array:6 [ "tituloSerie" => "Respiration" "fecha" => "2013" "volumen" => "86" "paginaInicial" => "145" "paginaFinal" => "148" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23796886" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0080" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary meningothelial-like nodules: new insights into a common but poorly understood entity" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S. Mukhopadhyay" 1 => "O.A. El-Zammar" 2 => "A.L. Katzenstein" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/PAS.0b013e31818b1de7" "Revista" => array:6 [ "tituloSerie" => "Am J Surg Pathol" "fecha" => "2009" "volumen" => "33" "paginaInicial" => "487" "paginaFinal" => "495" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19047895" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0085" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Minute pulmonary meningothelial-like nodules: clinicopathologic analysis of 121 patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "E. Mizutani" 1 => "K. Tsuta" 2 => "A.M. Maeshima" 3 => "H. Asamura" 4 => "Y. Matsuno" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.humpath.2008.08.018" "Revista" => array:6 [ "tituloSerie" => "Hum Pathol" "fecha" => "2009" "volumen" => "40" "paginaInicial" => "678" "paginaFinal" => "682" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19144385" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0090" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Minute pulmonary meningothelial-like nodules: a case of incidentally detected diffuse cystic micronodules on thin-section computed tomography" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "G. Kraushaar" 1 => "A.M. Ajlan" 2 => "J.C. English" 3 => "N.L. Muller" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "J Comput Assist Tomogr" "fecha" => "2010" "paginaInicial" => "780" "paginaFinal" => "782" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0095" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "An uncommon cause of miliary pattern of pulmonary nodules-diffuse pulmonary meningotheliomatosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "V. Jayaschandran" 1 => "S. Gjorgova-Gjeorgjievski" 2 => "H. Siddique" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Respirol Case Rep" "fecha" => "2017" "volumen" => "5" "paginaInicial" => "00238" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0100" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Progesterone receptor in non-small cell lung cancer – a potent prognostic factor and possible target for endocrine therapy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H. Ishibashi" 1 => "T. Suzuki" 2 => "S. Suzuki" 3 => "H. Niikawa" 4 => "L. Lu" 5 => "Y. Miki" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1158/0008-5472.CAN-04-3087" "Revista" => array:6 [ "tituloSerie" => "Cancer Res" "fecha" => "2005" "volumen" => "65" "paginaInicial" => "6450" "paginaFinal" => "6458" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16024650" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005400000002/v2_201802071702/S157921291830020X/v2_201802071702/en/main.assets" "Apartado" => array:4 [ "identificador" => "49861" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Scientific letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005400000002/v2_201802071702/S157921291830020X/v2_201802071702/en/main.pdf?idApp=UINPBA00003Z&text.app=https://www.archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S157921291830020X?idApp=UINPBA00003Z" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 October | 26 | 12 | 38 |
| 2024 September | 56 | 23 | 79 |
| 2024 August | 71 | 41 | 112 |
| 2024 July | 33 | 33 | 66 |
| 2024 June | 61 | 32 | 93 |
| 2024 May | 67 | 30 | 97 |
| 2024 April | 33 | 34 | 67 |
| 2024 March | 40 | 18 | 58 |
| 2024 February | 31 | 19 | 50 |
| 2023 March | 20 | 3 | 23 |
| 2023 February | 53 | 26 | 79 |
| 2023 January | 39 | 37 | 76 |
| 2022 December | 69 | 43 | 112 |
| 2022 November | 55 | 41 | 96 |
| 2022 October | 56 | 75 | 131 |
| 2022 September | 34 | 41 | 75 |
| 2022 August | 39 | 49 | 88 |
| 2022 July | 32 | 50 | 82 |
| 2022 June | 42 | 45 | 87 |
| 2022 May | 77 | 48 | 125 |
| 2022 April | 36 | 36 | 72 |
| 2022 March | 49 | 42 | 91 |
| 2022 February | 35 | 47 | 82 |
| 2022 January | 69 | 45 | 114 |
| 2021 December | 80 | 53 | 133 |
| 2021 November | 64 | 41 | 105 |
| 2021 October | 58 | 81 | 139 |
| 2021 September | 42 | 48 | 90 |
| 2021 August | 57 | 45 | 102 |
| 2021 July | 64 | 36 | 100 |
| 2021 June | 67 | 46 | 113 |
| 2021 May | 68 | 36 | 104 |
| 2021 April | 171 | 126 | 297 |
| 2021 March | 57 | 23 | 80 |
| 2021 February | 32 | 29 | 61 |
| 2021 January | 41 | 16 | 57 |
| 2020 December | 39 | 17 | 56 |
| 2020 November | 49 | 16 | 65 |
| 2020 October | 26 | 15 | 41 |
| 2020 September | 22 | 8 | 30 |
| 2020 August | 26 | 16 | 42 |
| 2020 July | 31 | 31 | 62 |
| 2020 June | 18 | 2 | 20 |
| 2020 May | 36 | 15 | 51 |
| 2020 April | 39 | 19 | 58 |
| 2020 March | 20 | 11 | 31 |
| 2020 February | 30 | 15 | 45 |
| 2020 January | 38 | 21 | 59 |
| 2019 December | 37 | 16 | 53 |
| 2019 November | 29 | 21 | 50 |
| 2019 October | 16 | 8 | 24 |
| 2019 September | 8 | 10 | 18 |
| 2019 August | 25 | 26 | 51 |
| 2019 July | 24 | 18 | 42 |
| 2019 June | 9 | 10 | 19 |
| 2019 May | 31 | 14 | 45 |
| 2019 April | 45 | 8 | 53 |
| 2019 March | 25 | 19 | 44 |
| 2019 February | 36 | 21 | 57 |
| 2019 January | 26 | 23 | 49 |
| 2018 December | 34 | 20 | 54 |
| 2018 November | 42 | 28 | 70 |
| 2018 October | 84 | 45 | 129 |
| 2018 September | 24 | 6 | 30 |
| 2018 May | 1 | 0 | 1 |
| 2018 February | 1 | 0 | 1 |
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