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Duan X, Yu Y, Tian J, Xi D. A case report of intrapulmonary hamartoma with cough as the first symptom. Asian J Surg 2023; 46:5248-5249. [PMID: 37537042 DOI: 10.1016/j.asjsur.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 07/09/2023] [Indexed: 08/05/2023] Open
Affiliation(s)
- Xiaokai Duan
- Department of General Practice, Zhengzhou First People's Hospital, Zhengzhou, China.
| | - Yong Yu
- Department of General Practice, Zhengzhou First People's Hospital, Zhengzhou, China
| | - Jinya Tian
- Department of General Practice, Zhengzhou First People's Hospital, Zhengzhou, China
| | - Daojin Xi
- Department of Medical Imaging, Zhengzhou First People's Hospital, Zhengzhou, China
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Volterrani L, Perrella A, Bagnacci G, Di Meglio N, Di Martino V, Bertelli P, Bellan C, Mazzei MA, Luzzi L. Washout-Computed Tomography Discriminates Pulmonary "Fat-poor" Hamartomas From Neuroendocrine Neoplasms: A Simple Method in the Radiomics Era. J Thorac Imaging 2023; 38:278-285. [PMID: 37115915 DOI: 10.1097/rti.0000000000000712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
PURPOSE Pulmonary hamartomas (HAs) and neuroendocrine neoplasms (NENs) are often impossible to discriminate using high-resolution computed tomography (CT) as they share morphologic features. This challenge makes differential diagnosis crucial as HAs are invariably benign, whereas NENs must be considered malignant, thus requiring them to be evaluated for surgical excision.Our aim was, therefore, to develop a simple method to discriminate between pulmonary "fat-poor" HAs and NENs using contrast-enhanced CT (CECT). MATERIALS AND METHODS Between September 2015 and December 2021, 95 patients with a histologically proven diagnosis of lung NENs (74) and HAs (21) and who underwent a preoperative CECT scan were initially identified through a review of our pathologic and radiologic databases. Among these, 55 cases (18 HAs and 37 NENs), which have been studied with biphasic CECT, were ultimately selected and reviewed by 3 radiologists with different levels of experience, analyzing their morphologic and enhancement features.The enhancement analysis was performed by placing a region of interest within the lesion in noncontrast (NCp), postcontrast (PCp, 55 to 65 s after intravenous contrast injection), and delayed phases (Dp, 180 to 300 s). A subgroup of 35 patients who underwent 18FDG-PET/CT was evaluated in a secondary analysis. RESULTS HU values were significantly different between NENs and HAs in the PCp ( P <0.001). NCp and Dp attenuation values did not show significant differences in the 2 groups. Differences in values of HUs in PCp and Dp allowed to discriminate between NENs and HAs. CONCLUSION Wash-out analysis, ΔHU (PCp-Dp), can perfectly discriminate pulmonary "fat-poor" HAs from NENs.
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Affiliation(s)
- Luca Volterrani
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences
| | - Armando Perrella
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences
| | - Giulio Bagnacci
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences
| | - Nunzia Di Meglio
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences
| | - Vito Di Martino
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences
| | | | - Cristiana Bellan
- Unit of Pathological Anatomy and Histology, Department of Medical Biotechnologies
| | - Maria A Mazzei
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences
| | - Luca Luzzi
- Thoracic Surgery Unit, Department of Medical, Surgical and Neuro Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, Siena, Italy
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Erdogu V, Emetli EY, Kutluk AC, Onay S, Ciftci A, Bilen S, Erduhan S, Yildiz N, Akin H, Metin M. Does Pulmonary Hamartoma Increase the Risk of Lung Cancer? Outcomes of 38 Pulmonary Hamartoma Cases. SISLI ETFAL HASTANESI TIP BULTENI 2021; 55:344-348. [PMID: 34712076 PMCID: PMC8526217 DOI: 10.14744/semb.2020.06936] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 10/15/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Hamartomas are common benign tumors of the lung. Rarely, lung cancer coincidence may occur at the time of diagnosis or in the follow-up period. METHODS Between 2016 and 2019, 38 patients who underwent a surgical procedure and diagnosed with lung hamartoma were retrospectively evaluated regarding clinicopathological features. Cases were analyzed according to age, sex, radiological findings, localization of nodules, surgical methods, and the coincidence of lung cancer. RESULTS The mean age was 50.2±11.1 (range 28-76 years). There were 23 male (60.5%) and 15 female (39.5%) patients. Mean size was 2.7±1.8 (range 0.8-10 cm). In 28 patients, hamartoma was <3 cm in diameter (73.6%). Eighteen hamartomas were localized in the upper lobe (47.4%). Only 6 cases (15.8%) were localized at the central part of the lung. Multiple nodules were reported in 10 cases (26.3%). In 4 cases (10.5%), lung carcinoma and hamartoma were seen together at the time of diagnosis. Video-assisted thoracoscopic surgery (VATS) has been performed in 29 cases (76.3%). As a surgical method, enucleation was performed in 4 cases (10.5%), wedge resection in 28 cases (73.7%), and lobectomy in 6 cases (15.8%). No post-operative mortality appeared in the early follow-up. CONCLUSION Pulmonary hamartomas are usually present as solitary pulmonary nodules with benign radiological findings. VATS wedge resection is a method that can be used safely in diagnosis and treatment. Hamartomas may be associated with lung cancer at the time of diagnosis or follow-up, so it should be kept in mind that a different nodule seen in patients diagnosed with hamartoma may be associated with lung cancer.
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Affiliation(s)
- Volkan Erdogu
- Department of Chest Surgery, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Ece Yasemin Emetli
- Department of Chest Surgery, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | | | - Selin Onay
- Department of Chest Surgery, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Aysegul Ciftci
- Department of Chest Surgery, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Salih Bilen
- Department of Chest Surgery, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Semih Erduhan
- Department of Chest Surgery, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Nisa Yildiz
- Department of Chest Surgery, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Hasan Akin
- Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
| | - Muzaffer Metin
- Department of Chest Surgery, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
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A pulmonary hamartoma in Covid-19 pneumonia: an interesting case studied with computed tomography. Radiol Case Rep 2021; 16:942-944. [PMID: 33552326 PMCID: PMC7847404 DOI: 10.1016/j.radcr.2021.01.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 01/22/2021] [Accepted: 01/28/2021] [Indexed: 12/05/2022] Open
Abstract
Since the widespread of acute respiratory syndrome infection caused by Coronavirus-19, chest computed tomography (CT) was considered a useful imaging tool commonly used in early diagnosis and monitoring of patients with complicated Covid-19 pneumonia. Many typical imaging features of this disease were carefully described with chest CT, as well as the collateral CT findings in the lungs and mediastinum. Here we describe the case of a patient with Covid-19 pneumonia, that collaterally had a pulmonary hamartoma in the left lung, documented at CT.
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Suut S, Al-Ani Z, Allen C, Rajiah P, Durr-E-Sabih, Al-Harbi A, Al-Jahdali H, Khan AN. Pictorial essay of radiological features of benign intrathoracic masses. Ann Thorac Med 2015; 10:231-42. [PMID: 26664560 PMCID: PMC4652288 DOI: 10.4103/1817-1737.160365] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
With increased exposure of patients to routine imaging, incidental benign intrathoracic masses are frequently recognized. Most have classical imaging features, which are pathognomonic for their benignity. The aim of this pictorial review is to educate the reader of radiological features of several types of intrathoracic masses. The masses are categorized based on their location/origin and are grouped into parenchymal, pleural, mediastinal, or bronchial. Thoracic wall masses that invade the thorax such as neurofibromas and lipomas are included as they may mimic intrathoracic masses. All examples are illustrated and include pulmonary hamartoma, pleural fibroma, sarcoidosis, bronchial carcinoid, and bronchoceles together with a variety of mediastinal cysts on plain radiographs, computed tomography (CT) and magnetic resonance imaging (MRI). Sometimes a multimodality approach would be needed to confirm the diagnosis in atypical cases. The study would include the incorporation of radionuclide studies and relevant discussion in a multidisciplinary setting.
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Affiliation(s)
- Syahminan Suut
- Consultant Radiologist, Radiology Department, North Manchester General Hospital, Acute Pennine NHS Trust, Crumpsal, Manchester M8 6RB, United Kingdom
| | - Zeid Al-Ani
- Specialist Registrar in Radiology, North Manchester General Hospital, Delaunays Road M8 5RB, Manchester, United Kingdom
| | - Carolyn Allen
- Clinical Director, Acute Pennine NHS Trust, Crumpsal, Manchester M8 6RB, United Kingdom
| | - Prabhakar Rajiah
- Assistant Professor, Cardiothoracic Imaging, Radiology Department, Case Western Reserve University, University Hospitals of Cleveland, Cleveland, Ohio, United States
| | - Durr-E-Sabih
- Director, Multan Institute of Nuclear Medicine and Radiotherapy, Nishtar Hospital, Multan 60000, Pakistan
| | - Abdullah Al-Harbi
- Assistant Professor, Pulmonary Division, King Saud University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Hamdan Al-Jahdali
- Assistant Professor, Pulmonary Division, King Saud University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Ali Nawaz Khan
- Consultant Radiologist, Radiology Department, North Manchester General Hospital, Acute Pennine NHS Trust, Crumpsal, Manchester M8 6RB, United Kingdom
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Gleeson T, Thiessen R, Hannigan A, Murphy D, English JC, Mayo JR. Pulmonary hamartomas: CT pixel analysis for fat attenuation using radiologic-pathologic correlation. J Med Imaging Radiat Oncol 2013; 57:534-43. [DOI: 10.1111/1754-9485.12083] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Accepted: 04/19/2013] [Indexed: 11/27/2022]
Affiliation(s)
| | - Rennae Thiessen
- Department of Radiology; St. Pauls Hospital; University of British Columbia; Vancouver; BC; Canada
| | - Ailish Hannigan
- Graduate Entry Medical School; University of Limerick; Limerick; Ireland
| | - Darra Murphy
- Department of Radiology; Vancouver General Hospital; University of British Columbia; Vancouver; BC; Canada
| | - John C. English
- Department of Pathology; Vancouver General Hospital; Vancouver; BC; Canada
| | - John R. Mayo
- Department of Radiology; Vancouver General Hospital; University of British Columbia; Vancouver; BC; Canada
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Abstract
Pulmonary hamartoma is a benign lung neoplasm and it comprises 6% of solitary pulmonary nodules. Two clinical types have been defined according to its location: intraparenchymal (90%) and endobronchial (10%). We report on a case of endobronchial hamartoma resected with electrocautery by a flexible bronchoscope (FB). A 57-year-old male patient was admitted to our clinic because of worsening dyspnea. The patient had been smoking 1 pack per day for 37 years. A solid smooth lesion with calcification, located in the distal part of the left main bronchus and partially obstructing the lumen of bronchus, was detected at computerized tomography. A mass lesion that moved with coughing was observed during FB. The polypoid mass was arising from the anterior wall of the left main bronchus. Punch biopsies were taken from the polypoid lesion and a diagnosis of bronchial papilloma was made after histopathologic examination. The patient underwent endobronchial electrosurgery and the lesion was excised using FB. Pathologic evaluation revealed it to be a cartilagenous hamartoma. In conclusion, endobronchial hamartomas are benign neoplasms of the tracheobronchial tree. Endoscopic treatment with flexible bronchoscopic electrocautery is safe and less invasive in experienced hands. Therefore, it should be considered as the primary treatment approach in selected cases.
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Sodhi KS, Virmani V, Jindal SK, Khandelwal N. Pulmonary Hamartoma. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2009. [DOI: 10.47102/annals-acadmedsg.v38n12p1110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Affiliation(s)
- Kushaljit Singh Sodhi
- Department of Radiodiagnosis Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Vivek Virmani
- Department of Radiodiagnosis Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - SK Jindal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Niranjan Khandelwal
- Department of Radiodiagnosis Postgraduate Institute of Medical Education and Research, Chandigarh, India
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O'Connor-Harris L, Nasrallah D, Heitmiller R. Extralobar pulmonary hamartoma. J Am Coll Surg 2006; 202:378-9. [PMID: 16427566 DOI: 10.1016/j.jamcollsurg.2005.07.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2005] [Revised: 07/13/2005] [Accepted: 07/28/2005] [Indexed: 11/28/2022]
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Affiliation(s)
- R J Klecker
- Department of Radiology, The Ohio State University Medical Center, Columbus 43210, USA
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