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Habib DS, Jani P, Zhao B, Jayaraman EA, Kesavan R. Pulmonary Endobronchial Hamartoma Presenting With Post-obstructive Pneumonia. Cureus 2024; 16:e60916. [PMID: 38910726 PMCID: PMC11193388 DOI: 10.7759/cureus.60916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2024] [Indexed: 06/25/2024] Open
Abstract
Pulmonary hamartomas (PH) are rare but are the most common benign tumors found in the lungs. They are slow-growing and are usually found incidentally on chest imaging during the sixth decade of life. Approximately 10% of pulmonary hamartomas are endobronchial. Rarely, pulmonary hamartomas can cause a spectrum of pulmonary symptoms depending on their size and location. We present a case of endobronchial hamartoma causing airway obstruction and recurrent post-obstructive pneumonia.
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Affiliation(s)
- Diane S Habib
- Internal Medicine, Hospital Corporation of America (HCA) Houston Healthcare Kingwood/University of Houston, Kingwood, USA
| | - Pushan Jani
- Internal Medicine, University of Texas Health Science Center at Houston-McGovern Medical School, Houston, USA
| | - Bihong Zhao
- Combined Anatomic and Clinical Pathology, University of Texas Health Science Center at Houston-McGovern Medical School, Houston, USA
| | | | - Ramesh Kesavan
- Pulmonary and Critical Care, Hospital Corporation of America (HCA) Houston Healthcare Kingwood/University of Houston College of Medicine, Kingwood, USA
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2
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Takigawa Y, Sato K, Inoue T, Takada M, Fujiwara K. Image of a thawed frozen specimen obtained using a cryoprobe floated with oil droplets in normal saline: An endobronchial lipomatous hamartoma image. Respirol Case Rep 2024; 12:e01318. [PMID: 38445221 PMCID: PMC10914470 DOI: 10.1002/rcr2.1318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 02/24/2024] [Indexed: 03/07/2024] Open
Abstract
Hereby, we present a rare case of a resected endobronchial tumour that floated or showed oil droplets in saline. In this study, we report an interesting image related to endobronchial lipomatous hamartoma cryotherapy.
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Affiliation(s)
- Yuki Takigawa
- Department of Respiratory MedicineNHO Okayama Medical CenterOkayamaJapan
| | - Ken Sato
- Department of Respiratory MedicineNHO Okayama Medical CenterOkayamaJapan
| | - Tomoyoshi Inoue
- Department of Respiratory MedicineNHO Okayama Medical CenterOkayamaJapan
| | - Masahiro Takada
- Department of Respiratory MedicineNHO Okayama Medical CenterOkayamaJapan
| | - Keiichi Fujiwara
- Department of Respiratory MedicineNHO Okayama Medical CenterOkayamaJapan
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Suzuki M, Watanabe H, Hashimoto M, Ishii S, Naka G, Iikura M, Izumi S, Takeda Y, Hojo M, Sugiyama H. Endobronchial hamartoma resected via bronchoscopy using high-frequency electrosurgical snare–Preoperative strategies using virtual bronchoscopy. Radiol Case Rep 2022; 17:4232-4238. [PMID: 36120524 PMCID: PMC9471341 DOI: 10.1016/j.radcr.2022.08.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/04/2022] [Accepted: 08/08/2022] [Indexed: 10/28/2022] Open
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Li S, Wu L, Zhou J, Wang Y, Jin F, Chen X, Liu J, Chen Z. Interventional therapy via flexible bronchoscopy in the management of foreign body-related occlusive endobronchial granulation tissue formation in children. Pediatr Pulmonol 2021; 56:282-290. [PMID: 33104291 DOI: 10.1002/ppul.25134] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 10/16/2020] [Accepted: 10/19/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Occlusive granulation tissue formation, as one of the most common sequelae of chronic foreign body aspiration, can cause tracheobronchial obstruction and delayed fixed airway stenosis necessitating interventions. The aim of this study was to explore the clinical efficacy and safety of interventional therapy via flexible bronchoscopy for treatment of granulation tissue related airway obstruction secondary to foreign body aspiration in children. METHOD Patients with long-term foreign body related granulation tissue were treated with flexible bronchoscopy therapeutic modalities, including forceps, cryotherapy, holmium laser, and balloon dilatation. Clinical efficacy was evaluated by clinical symptoms and endoscopic manifestations. RESULTS A total of eight patients with granulation tissue hyperplasia caused by foreign body in bronchus, with a median age of 29.5 (range, 18-54) months, underwent interventional therapy between January 2016 and December 2019. Four patients received forceps and CO2 cryotherapy and one patient required forceps only. The remaining three patients received holmium laser combined with CO2 cryotherapy, and one of them required additional balloon dilatation. Four cases required a second cryotherapy procedure, and one case received three cryotherapy procedures for extensive granulation tissue. The treatment efficacy was 100% without complications. CONCLUSION Interventional procedure via flexible bronchoscopy is a safe, reliable, and effective method in the management of tracheobronchial obstruction and stenosis caused by foreign body-related granulation tissue hyperplasia. It is worthy of clinical application.
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Affiliation(s)
- Shuxian Li
- Department of Pulmonology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China.,Department of Endoscopy Center, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Lei Wu
- Department of Pulmonology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China.,Department of Endoscopy Center, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Junfen Zhou
- Department of Pulmonology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China.,Department of Pediatrics, Wenling Maternal and Child Health Care Hospital, Wenling, Zhejiang, China
| | - Yingshuo Wang
- Department of Pulmonology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China.,Department of Endoscopy Center, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Fang Jin
- Department of Pulmonology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Xiaoyang Chen
- Department of Developmental and Behavioral, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Jinling Liu
- Department of Pulmonology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Zhimin Chen
- Department of Pulmonology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
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Ng BH, Ban Yu-Lin A, Low HJ, Faisal M. Cryodebulking of endobronchial hamartoma via fibreoptic bronchoscopy and literature review. BMJ Case Rep 2020; 13:13/8/e235316. [PMID: 32843453 DOI: 10.1136/bcr-2020-235316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Endobronchial hamartoma is a rare tumour. We report a 65-year-old woman with a history of recurrent pneumonia. Bronchoscopy revealed a 1 cm endobronchial mass obstructing the left upper lobe bronchus. Histopathological examination was consistent with a pulmonary hamartoma. This lesion was successfully debulked endoscopically with the use of a flexible cryoprobe without any complications. This case highlights both the importance of investigating recurrent pneumonia and the usefulness of endoscopic recanalisation in an obstructed segmental bronchus.
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Affiliation(s)
- Boon Hau Ng
- Respiratory Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Andrea Ban Yu-Lin
- Respiratory Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Hsueh Jing Low
- Anaesthesiology and Intensive Care, Pusat Perubatan Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Mohamed Faisal
- Respiratory Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
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Song W, Zha W, Qi X, Jiwang W. Efficacy and safety of flexible endoscopic intervention via laryngeal mask airway for endobronchial hamartoma removal. MINIM INVASIV THER 2020; 30:139-146. [PMID: 32011200 DOI: 10.1080/13645706.2020.1720250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To evaluate the clinical characteristics, efficacy and safety of flexible endoscopic intervention for endobronchial hamartoma. MATERIAL AND METHODS Thirteen patients with endobronchial hamartoma who underwent flexible endoscopic intervention at a single center were analyzed retrospectively. The clinical characteristics and efficacy of flexible endoscopic intervention were described. RESULTS Nine patients were cured after one single flexible endoscopic intervention, three patients underwent second flexible endoscopic interventions due to late tumor recurrence, while one patient who eventually became stable with a 40% stenosis of the airway lumen, received a third intervention because of two relapses. Pneumothorax occurred in one patient who was cured after oxygen therapy. There were no serious complications such as massive hemorrhage, airway perforation, airway ignition and suffocation associated with the therapy. CONCLUSIONS Flexible endoscopic intervention appeared to be safe and effective for the treatment of patients with endobronchial hamartoma.
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Affiliation(s)
- Wei Song
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Wangjian Zha
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Xu Qi
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Wang Jiwang
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
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Ma K, Sun F, Yang X, Wang S, Wang L, Jin Y, Shi Y, Jiang W, Zhan C, Wang Q. Prognosis of patients with primary malignant main stem bronchial tumors: 7,418 cases based on the SEER database. Onco Targets Ther 2017; 11:83-95. [PMID: 29317836 PMCID: PMC5744741 DOI: 10.2147/ott.s142847] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Background The aim of this study was to identify risk factors for patients with malignant main stem bronchial tumors (MBTs) and to develop a nomogram for predicting prognosis in those patients using data from the Surveillance, Epidemiology, and End Results (SEER) database. Method A process was used for case screening from the SEER database. The effect of prognostic factors on survival was evaluated using the Kaplan–Meier method and log-rank test, a competing risk model, and the Cox proportional hazards regression model. A nomogram was established for predicting 1-, 3-, and 5-year overall survival (OS) in patients with MBTs. Results A total of 7,418 cases were included in this study. Age, gender, pathologic grade, histologic type, tumor size, involvement of lymph nodes, tumor extension, chemotherapy, and surgery were identified as independent risk factors by univariate and multivariate analyses. A nomogram was established based on the results of the Cox model, which was validated by a C-index of 0.672 (95% CI, 0.664–0.680), and a group of calibration plots. Conclusion Age, gender, pathologic grade, histologic type, tumor size, involvement of lymph nodes, tumor extension, chemotherapy, and surgery were independent risk factors for OS of patients with MBTs. A nomogram was formulated to predict 1-, 3-, and 5-year OS in patients with MBTs based on individual clinical characteristics.
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Affiliation(s)
- Ke Ma
- Department of Thoracic Surgery, Zhongshan Hospital of Fudan University, Shanghai, People's Republic of China
| | - Fenghao Sun
- Department of Thoracic Surgery, Zhongshan Hospital of Fudan University, Shanghai, People's Republic of China
| | - Xiaodong Yang
- Department of Thoracic Surgery, Zhongshan Hospital of Fudan University, Shanghai, People's Republic of China
| | - Shuai Wang
- Department of Thoracic Surgery, Zhongshan Hospital of Fudan University, Shanghai, People's Republic of China
| | - Lin Wang
- Department of Thoracic Surgery, Zhongshan Hospital of Fudan University, Shanghai, People's Republic of China
| | - Yulin Jin
- Department of Thoracic Surgery, Zhongshan Hospital of Fudan University, Shanghai, People's Republic of China
| | - Yu Shi
- Department of Thoracic Surgery, Zhongshan Hospital of Fudan University, Shanghai, People's Republic of China
| | - Wei Jiang
- Department of Thoracic Surgery, Zhongshan Hospital of Fudan University, Shanghai, People's Republic of China
| | - Cheng Zhan
- Department of Thoracic Surgery, Zhongshan Hospital of Fudan University, Shanghai, People's Republic of China
| | - Qun Wang
- Department of Thoracic Surgery, Zhongshan Hospital of Fudan University, Shanghai, People's Republic of China
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Saoud M, Patil M, Dhillon SS, Pokharel S, Picone A, Hennon M, Yendamuri S, Harris K. Rare airway tumors: an update on current diagnostic and management strategies. J Thorac Dis 2016; 8:1922-34. [PMID: 27621844 DOI: 10.21037/jtd.2016.07.40] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Marwan Saoud
- Department of Medicine, Critical Care and Sleep Medicine, Department of Medicine, State University of New York, Buffalo, New York, USA
| | - Monali Patil
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, State University of New York, Buffalo, New York, USA
| | - Samjot Singh Dhillon
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, State University of New York, Buffalo, New York, USA;; Department of Medicine, Interventional Pulmonary Section, Roswell Park Cancer Institute, Buffalo, New York, USA
| | - Saraswati Pokharel
- Department of Pathology, Roswell Park Cancer Institute, Buffalo, New York, USA
| | - Anthony Picone
- Department of Thoracic Surgery, Roswell Park Cancer Institute, Buffalo, New York, USA
| | - Mark Hennon
- Department of Thoracic Surgery, Roswell Park Cancer Institute, Buffalo, New York, USA;; Department of Surgery, Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
| | - Sai Yendamuri
- Department of Thoracic Surgery, Roswell Park Cancer Institute, Buffalo, New York, USA;; Department of Surgery, Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
| | - Kassem Harris
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, State University of New York, Buffalo, New York, USA;; Department of Medicine, Interventional Pulmonary Section, Roswell Park Cancer Institute, Buffalo, New York, USA
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Endoscopic treatment of primary benign central airway tumors: Results from a large consecutive case series and decision making flow chart to address bronchoscopic excision. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2015; 41:1437-42. [PMID: 26329785 DOI: 10.1016/j.ejso.2015.08.157] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 07/15/2015] [Accepted: 08/13/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Benign tracheo-bronchial neoplasms are rare, but potentially dangerous conditions with life threatening consequences. Tumor removal should be pursued by methods minimizing the procedural stress. The role of endoscopic treatment, as an alternative to open surgery, remains controversial. OBJECTIVES report the twelve-years endoscopic experience in Rome, Italy. Fifty-seven benign tracheo-bronchial tumors were diagnosed and 130 tracheo-bronchial resections by rigid bronchoscopy performed. METHODS we identified histotypes associated with higher recurrence rate and assessed their relationship with gender, age and tracheo-bronchial location. We provided data on safety and complications and suggested a decision making flow chart to address the patients to endoscopic resection. RESULTS complete eradication after a single procedure without recurrence at 2 years was obtained in 63.1% of cases (36/57). Need of a second intervention within few months but no further recurrence at follow up was seen in a further 8.8% (5/57). Histotypes associated with recurrence were papillomas and inflammatory polyp. Seven patients (12.3%) were addressed to surgery because of multiple recurrence. Ten patients (17.5%) were lost at follow up. In case of recurrence, the bronchial biopsy was always repeated and no malignant transformation was observed. No major complications, pneumothorax or pneumomediastinum occurred. CONCLUSIONS endoscopic treatment of benign tracheo bronchial tumors is safe and effective, provided that the procedure is carefully and systematically planned. The rate of eradication is satisfactory and the incidence of complications negligible. This will encourage this approach as first line treatment especially in patients, frequently elderly people, having increased surgical risk due to concomitant respiratory failure or major comorbidities.
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Oguma T, Takiguchi H, Niimi K, Tomomatsu H, Tomomatsu K, Hayama N, Aoki T, Urano T, Nakano N, Ogura G, Nakagawa T, Masuda R, Iwazaki M, Abe T, Asano K. Endobronchial hamartoma as a cause of pneumonia. AMERICAN JOURNAL OF CASE REPORTS 2014; 15:388-92. [PMID: 25208559 PMCID: PMC4165510 DOI: 10.12659/ajcr.890869] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Patient: Male, 66 Final Diagnosis: Endobronchial hamartoma Symptoms: Fever Medication: — Clinical Procedure: Flexible bronchoscopy • surgical resection Specialty: Pulmonology
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Affiliation(s)
- Tsuyoshi Oguma
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Hiroto Takiguchi
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Kyoko Niimi
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Hiromi Tomomatsu
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Katsuyoshi Tomomatsu
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Naoki Hayama
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Takuya Aoki
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Tetsuya Urano
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Natsuko Nakano
- Department of Pathology, Tokai University School of Medicine, Kanagawa, Japan
| | - Go Ogura
- Department of Pathology, Tokai University School of Medicine, Kanagawa, Japan
| | - Tomoki Nakagawa
- General Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Kanagawa, Japan
| | - Ryota Masuda
- General Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Kanagawa, Japan
| | - Masayuki Iwazaki
- General Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Kanagawa, Japan
| | - Tadashi Abe
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Koichiro Asano
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
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