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Pulmonary hamartoma: unusual radiologic appearance
Masaharu Shinkai1, Hideo Kobayashi, Soichiro Kanoh
1Third Department of Internal Medicine, National Defense Medical College, Tokorozawa-city, Saitama, Japan.
Journal of Thoracic Imaging
|January 9, 2004
Summary
A rare pulmonary hamartoma presented as multiple tiny nodules on high-resolution computed tomography (HRCT). Histology confirmed a single lesion with entrapped lung structures, explaining the unusual imaging findings.
Area of Science:
- Pulmonology
- Radiology
- Pathology
Background:
- Pulmonary nodules are common incidental findings.
- Hamartomas are benign lung tumors, typically appearing as solitary, well-defined nodules.
- Atypical presentations of pulmonary hamartomas can pose diagnostic challenges.
Observation:
- A 50-year-old man presented with an incidentally detected pulmonary nodule.
- High-resolution computed tomography (HRCT) revealed a lesion resembling a cluster of multiple tiny nodules.
- Chest radiographs over 20 years showed a tumor doubling time of 4968 days.
Findings:
- Histologic examination confirmed a single pulmonary hamartoma with a "bunch of grapes" appearance.
- Entrapment of pulmonary alveoli and bronchioles within the hamartoma caused the unusual HRCT findings.
- Multicentric tumor bud appearance contributed to the lesion's morphology.
Implications:
- This case highlights an unusual presentation of a pulmonary hamartoma.
- Understanding rare morphologies is crucial for accurate HRCT interpretation and diagnosis.
- The slow growth rate suggests a benign nature, aiding in clinical management decisions.