Giant cystic chondroid hamartoma

Large cystic-solid pulmonary hamartoma: A case report

BACKGROUND

It now seems that all pulmonary hamartomas (PHs) are large cystic-solid lesions that are difficult to diagnose. However, few cases of large cystic-solid PHs have been reported. The present case report presents a large cystic-solid PH and provides a literature review of the imaging features, formation mechanism and histopathological basis of PHs.

CASE SUMMARY

A 53-year-old woman with no clinical symptoms underwent a chest computed tomography (CT) examination at our hospital. Nonenhanced CT images revealed a large, flat tumor with multiple air-containing cysts in the left thoracic cavity and a cystic part confined to the medial side of the tumor; the solid part of the tumor showed abundant fat and lamellar soft tissue components. Multiple small blood vessels were detected in the solid part of the tumor on contrast-enhanced CT images. Given the large size of the lesion, the patient elected to undergo surgery. Histological examination revealed PH. A detailed review of the patient’s CT imaging showed that the lesion had a small vascular pedicle to the left lower lobe, which was a clue to its lung tissue histological origin. According to immunohistochemical staining, the confined multiple air-containing cysts were caused by the entrapment of respiratory/alveolar epithelium.

CONCLUSION

This case shows the imaging manifestations of a large PH. Heightened awareness of its formation mechanism and histopathological basis may alert radiologists to consider this diagnosis in their daily workflow.

Giant cystic pulmonary hamartoma-images

Hamartoma is the commonest benign tumor of the lung. They usually present as an asymptomatic solitary solid nodule of varying size, located peripherally in the lung parenchyma and picked up incidentally in a chest X-ray. Rarely, they may be intra-bronchial in location. A giant cystic variant of hamartoma is very rare, with only a few cases reported in literature so far. It may be misdiagnosed as any other cystic disease of the lung and thus get mismanaged. We herewith present the images of a patient with a giant cystic pulmonary hamartoma who presented with respiratory distress.

Mesenchymal cystic hamartoma presenting with pneumothorax: case report and review of the literature

Mesenchymal cystic hamartoma (MCH) of the lung is a rare disease, with an indolent course in the majority of cases. It can be single or multifocal and it is composed of primitive mesenchymal cells admixed with cystic spaces. Only few cases have been reported in the literature, with variable clinical presentation. We describe the case of a huge MCH, presenting with spontaneous pneumothorax in a 65-year-old man. Further, we provide a brief overview of the literature and discuss the differential diagnosis with other entities, and the possible diagnostic pitfalls.

Pulmonary giant chondromatous hamartoma with multifocal evolution in an infant

Hamartoma is the most common benign pulmonary tumor in adults, but is rarely described in the pediatric population. Giant chondromatous and progressive forms are even rarer. We report the novel case of a 13-month-old infant hospitalized for giant pulmonary chondromatous hamartoma discovered during a septic episode, rapidly progressive, with severe multifocal lesions, without clear response to several cytotoxic therapies. No predisposition syndrome was identified.

Giant hamartoma of lung presented with massive hemoptysis: A rare case report and review of the literature

Hamartoma of lung is a common tumor, majority of which are small and incidentally discovered during plain chest radiography. Our case is a 30-year-old gentleman with an extremely uncommon presentation of a common tumor, that is, a giant hamartoma of lung presenting as massive hemoptysis and intractable cough. To the best of our knowledge, such occurrence of giant pulmonary hamartoma is very uncommon and its presentation with massive hemoptysis is even more uncommon. Less than 20 cases of giant hamartoma of lung have been reported in the English literature so far.

Pulmonary chondroid hamartoma with nontuberculous mycobacterial infection: two case reports

Solitary pulmonary nodules (SPNs) can be manifested in a variety of disorders including neoplasms, infection, inflammation, and vascular or congenital abnormalities. In addition, they are often accompanied with other pulmonary pathologic lesions such as consolidations and several pulmonary disorders present as similar pulmonary nodular lesions simultaneously. Diagnostic workup is important for these SPNs; however, many physicians often miss the second diagnosis for multiple pulmonary lesions with SPNs due to lack of clinical suspicion that each pulmonary nodule or pathologic lesion can have each other's diagnosis. Herein, we report 2 cases of coexistence of pulmonary chondroid hamartoma with nontuberculous mycobacterial (NTM) infection presenting as pulmonary nodules and multiple consolidative lesions. A 60-year-old man was admitted for the evaluation of multifocal pulmonary lesions including SPN with chronic exertional dyspnea. Multiple lung tissues were obtained from each lesion through percutaneous transthoracic needle biopsy (PTNB). At the same time, bacteriologic examination was performed using respiratory samples obtained by bronchoscopy. Based on pathologic and microbiologic results, the patient diagnosed as pulmonary chondroid hamartoma with pulmonary NTM infectious disease. In addition, a 56-year-old woman visited for the evaluation of a small SPN. The SPN was resected surgically for the pathologic examination and turned out to be pulmonary chondroid hamartoma. Interestingly, the diagnostic workup revealed that the patient had Lady Windermere syndrome which is one of features for Mycobacterium avium complex (MAC) pulmonary disease. Both patients were treated with the standard antibiotics against MAC as recommended by the ATS/IDSA guideline. This is the first report of 2 patients, as far as we know, that chondroid hamartoma and NTM disease develop simultaneously in the lung. This report emphasizes that physicians should endeavor to confirm the individual diagnosis for the various pulmonary abnormal lesions detected at the same time, if necessary through multifocal biopsies for each lesion.

Giant pulmonary chondroid hamartoma: imaging and pathology correlation of a rare tumor demonstrated with bone scintigraphy and 18F-FDG PET/CT

A 35-year-old man presented to the emergency department with a worsening cough and a history of unintended weight loss. Chest radiograph revealed a giant mass occupying the left hemithorax. On CT scan, the mass measured over 20 cm and shifted the heart into the right hemithorax. Bone scan demonstrated multifocal radiotracer uptake within coarse intratumoral calcifications. Biopsy revealed no malignant cells. However, malignancy was clinically suspected due to size, and FDG PET/CT was performed. Mild FDG uptake was present in the mass. The mass was excised, and pathologic examination revealed the rare diagnosis of a giant pulmonary chondroid hamartoma.

Diffuse chondroid malformation of the lung: cases series of a hitherto undescribed congenital lung disease

Congenital chondroid lesions of the lung are rare pathological findings. They are a constant feature of lung malformations such as giant cystic pulmonary chondroid hamartoma, chondroid cystic malformation, and in the "cartilaginous variant" of congenital adenomatoid malformation. All of these present as a large single thoracic mass.We present the cases of three males and two females with hitherto undescribed diffuse chondroid lung disease, all but one of whom had neonatal respiratory distress syndrome with interstitial syndrome on chest radiograph. The pathological findings were similar in all patients, showing large areas of disorganized lung parenchyma containing diffusely distributed mature cartilage islands. With a mean follow-up of 6 years, all patients had a favorable outcome. This diffuse chondroid lung disease appears to be a new entity whose initial presentation mimicked interstitial lung disease without the usual clinical, radiological, and histological features. We speculate that it could be part of a clinical spectrum between malformative chondroid lung cyst and congenital pulmonary airway malformation.

Giant pulmonary hamartoma

A 61-year-old woman presented with dyspnea and intense cough. Chest radiography showed opacity of the entire left hemithorax and computed tomography of the chest confirmed a solid heterogeneous mass extending from apex to base, with foci of calcification and areas of low attenuation. Left upper lobe resection was performed, removing the tumor in large pieces. Histologic characteristics of the lesion were compatible with typical hamartoma. No signs of recurrence were detected 2.5 years after the operation.

Giant Pulmonary Hamartoma—A Rare Presentation of a Common Tumor

Hamartomata, the most common benign tumors of the lung, are rarely symptomatic and usually come to clinical attention as coin-shaped lesions on a routine plain chest roentgenogram. We report a case of a 63-year-old woman presenting with reduced endurance on exercise. The plain chest roentgenogram showed a tumor in the left chest. After clinical work-up, the patient underwent radical tumor resection through a lateral thoracotomy. The resected tumor, with two separate nodules, measured 26 x 25 cm and weighed 3.2 kg. The histopathology work-up showed pulmonary hamartoma.