Diagnosis of pulmonary hamartoma by bronchoscopic transbronchial biopsy

Intraparenchymal pulmonary hamartomas are benign lesions that cannot reliably be distinguished from malignant solitary pulmonary nodules by routine chest x-ray or computerized tomography. Thoracotomy or transthoracic needle aspiration or biopsy is usually required to establish the histologic diagnosis of hamartoma. We report a patient in whom a solitary pulmonary nodule was diagnosed as a pulmonary hamartoma by bronchoscopic transbronchial biopsy, obviating the need for a more invasive procedure. Fiberoptic bronchoscopy with transbronchial biopsies should be considered initially in the evaluation of a solitary pulmonary nodule. Special stains for cartilage and fat may aid in the diagnosis of pulmonary hamartomas.