Lung hamartomas are usually an incidental radiological finding, as they cause no symptoms. However, some patients do have complaints related to the tumor, such as chest pain [1], hemoptysis, cough, wheezing and dyspnea caused by bronchial obstruction [2]. Because these signs overlap with those of pulmonary carcinoma [3], correct diagnosis is crucial, despite their excellent prognosis [4] [5]. Hamartomas have a slow growth rate [6], but rapid enlargement has also been described [7] and are usually single. When multiple, the Carney triad, consisting of an association between pulmonary chondroma, extra-adrenal paraganglioma and leiomyoblastoma [8] or partial Carney triad- hamartoma along with gastric smooth muscle tumors [9] should be considered.

Malignant transformation of lung hamartomas is possible [10], therefore patients must be periodically evaluated. Single nodules occur in men, whereas multiple tumors are characteristic for women. The condition more often occurs in males within their sixth or seventh decade of life [11].

• Collapse

  At admission, clinical evidence and chest radiographs showed a left upper lobe collapse. A CT scan was interpreted as a possible aspirated foreign body in the left upper lobe bronchus with distal left upper lobe collapse. [emedicine.medscape.com]

  Chest PA view showing right lower lung collapse (Mar. 13 — 1986). Fig. 2. Chest PA view showing improved right lower lung collapse (May 6 — 1986). Fig. 3. CT scan showing a mass obstructing the bronchus intermedius. Fig. 4. [kjim.org]

  If symptoms do appear, they may include the following: Persistent coughing or wheezing Shortness of breath or difficulty breathing Coughing up blood Rattling sounds in the lungs Higher likelihood of pneumonia Lung tissue collapse ### Cleveland Clinic [my.clevelandclinic.org]

• Sepsis

  As the patient became progressively unwell with signs of chest sepsis and failed to settle with medical therapy, an upper left lobectomy was undertaken. [emedicine.medscape.com]

  Das Medikament nach Anspruch 8, wobei das Medikament ein therapeutisches oder präventives Medikament gegen Sepsis ist. [google.com.na]

• Fishing

  It was conducted experiments on a group of 40 fibroids with apparently normal karyotype FISH, were used for the cosmid and PAC-probes covering the Lokalisierungsort of HMGIC- or HMGIY gene. [google.st]

• Confusion

  One has only to reflect some of which may still be confused with classical dis on the better understanding of many disease processes eases of great antiquity. [books.google.com]

  The triad is not to be confused with the related Carney-Stratakis syndrome or the unrelated Carney complex. [11, 12, 13, 14] A partial Carney triad may be seen when pulmonary hamartomas coexist with smooth muscle tumors of the stomach. [15] Preferred [emedicine.medscape.com]

  Pulmonary hamartoma, also lung hamartoma, is a benign lesion of the lung that may be confused with malignancy. [1] General Benign. [librepathology.org]

  Thus, further investigation with PET-CT of slow-growing, fat-containing masses is unwarranted, confusing, and contributes to patient radiation dose. [radiopaedia.org]

  Not to be confused with hematoma. A hamartoma [2] is a mostly benign, [3] focal malformation that resembles a neoplasm in the tissue of its origin. [en.wikipedia.org]

• Irritability

  If located endobronchially, they can cause irritation of bronchial mucosa resulting in persistent cough as a presenting symptom. [emedicine.medscape.com]

A lung hamartoma may be located in the peripheral areas (most cases) or may be endobronchial [12]. A thoracic radiography typically describes a small, well-circumscribed, possibly lobulated nodule or mass that may contain fat, bone or calcified areas [13]. The pathognomonic radiological aspect is that of "popcorn" calcium deposits, but stippled or curvilinear patterns can be noticed. Lesions can be found in any pulmonary lobe and usually do not cause cavitation. However, a certain diagnosis cannot be established using only plain radiography. A computer tomography (CT) scan offers an accurate description. 60% of lesions contain fat tissue, localized or disseminated inside the tumor and if fat is present and the CT aspect offers a certainty, no further investigations are needed [14]. High-resolution CT offers a better characterization of the architecture of the pathological process, while dynamic computer tomography scans may describe the hemodynamic features [15].

Fludeoxyglucose positron emission tomography shows increased tumor avidity for this tracer. Magnetic resonance imaging (MRI) describes the heterogeneous nature and is usually the modality of choice for Carney triad follow-up [16]. Paraganglioma and other neurogenic malignancies are easily confirmed by iodine-131-meta-iodobenzylguanidine scintigraphy.

Severe consequences are associated with tumors causing bronchial obstruction. In these cases, imaging methods may discover bronchiectasis or destruction of the peripheral pulmonary tissue.

In cases where a clear diagnosis is impossible to make using imaging methods, a percutaneous needle aspiration may be required. Ultrasonography is used to guide this process and is valuable in abdominal Carney triad components identification. If unsuccessful, a biopsy should be performed, or tissue may be analyzed after surgical removal. If the tumor is endobronchial, a transbronchial biopsy via a flexible fiberoptic bronchoscopy is an option [11]. Histological analysis shows fibromyxoid stroma, small, cuboidal or columnar bronchial epithelial cells, fat, bone, smooth muscle, and cartilage.

Blood workup may include the carbohydrate antigen 19-9, that is sometimes present in lung hamartomas [17], while molecular biology, if available, may describe abnormalities of 12q14 and 6q21 domains [18] [19]. Furthermore, patients should be periodically monitored for lung cancer, as they have been demonstrated to have 6.6 times increased risk [20].

• Atelectasis

  Complications such as postobstructive pneumonia and lobar atelectasis may occur. Hemoptysis can occur if it impinges on vascular structures and causes invasion or perforation. [3] PH usually presents with a round shape and smooth margins. [emedicine.medscape.com]

  Post CABG, his clinical course was complicated by right upper lobe and left lower lobe atelectasis. Bedside bronchoscopy revealed a right upper lobe entrance mucus plug and a left lower bronchus endobronchial lesion (Fig. 1, Panel A). [eurekaselect.com]

  A solitary pulmonary nodule is an isolated, radiologically visible mass less than 3 cm in diameter without associated atelectasis or adenopathy. 1 – 3 These nodules are relatively common; they are found in one in 500 patients during routine chest radiography [aafp.org]

  They are usually asymptomatic and only occasionally cause symptoms, such as obstruction of bronchus causing atelectasis, pneumonitis, cough, expectoration, and chest pain. [ccij-online.org]

  […] of calcification may have no distinctive features. 13) However, lamination does not occur, and the “popcorn” pattern is common in hamartomas and rare in other lesions. 29) By Dovenbarger, pictures of chest X-ray of the endobronchial hamartomas show atelectasis [kjim.org]

• Pulmonary Coin Lesion

  Chondroid hamartomas account for 7-14% of pulmonary coin lesions. [4] Calcifications are often present in a diffuse or popcorn distribution (popcorn calcification). [9] In the CT scan of chest, well-defined sharply marginated lesion showing multiple intralesional [mjdrdypu.org]

A 63-year-old male was admitted for hospital treatment with obvious symptoms and signs of right-sided lobar pneumonia. His treatment was started with a combination of antibiotics Ceftriaxone and Ciprofloxacin. [ncbi.nlm.nih.gov]

A 63-year-old male was admitted for hospital treatment with obvious symptoms and signs of right-sided lobar pneumonia. His treatment was started with a combination of antibiotics Ceftriaxone and Ciprofloxa-cin. [scopemed.org]

Treatment is by surgical resection. The prognosis is excellent. Links: lung cancer [gpnotebook.co.uk]

Information on presentation, treatment and outcome were obtained. Results: Five patients aged 35.6 14.4 years had lung hamartoma. Two patients were asymptomatic, 2 had cough and 1 presented with haemoptysis. [ajol.info]

Histology confirmed that the cause of bronchial obstruction was a pulmonary hamartoma. [19] Radosavljevic and associates reported a 63-year-old man admitted for hospital treatment with symptoms and signs of right-sided lobar pneumonia. [emedicine.medscape.com]

The prognosis is excellent. Links: lung cancer [gpnotebook.co.uk]

Differential diagnosis Benign chondroma Fibroma Bronchial lipoma Metastatic teratoma after chemotherapy Prognosis Malignant change has been reported, albeit extremely rarely; malignancies developing within a hamartoma include carcinomas, sarcomas and [e-immunohistochemistry.info]

Peripheral tumors are usually observed after the definitive diagnosis; central tumors may be excised. [4] The prognosis is excellent. [5, 6, 7, 8] Pulmonary hamartomas grow slowly, and most of them are smaller than 4 cm, although they may reach 10 cm [emedicine.medscape.com]

The prognosis is excellent. [3, 4, 5, 6] Pulmonary hamartomas grow slowly, and most of them are smaller than 4 cm, although they may reach 10 cm in diameter. [7] The tumors are usually solitary, although multiple tumors in the Carney triad have been reported [thehealthscience.com]

They are treated, if at all, by surgical resection, with an excellent prognosis: generally, the only real danger is the inherent possibility of surgical complications. [en.wikipedia.org]

[…] could be diagnosed as lipoma, myxoma, leiomyoma or fibroadenoma Epidemiology Most common benign neoplasm of lung Generally adults 40s to 60s, peripheral lesions more common in men Sites Mostly arise in peripheral lung; endobronchial in 10% of cases Etiology [pathologyoutlines.com]

Etiology The etiology of pulmonary hamartoma is not understood. A summary of the etiologic concepts.. . [mdedge.com]

(Etiology) The cause of development of Pulmonary Hamartoma is generally unknown It may be caused by certain genetic defects which are not yet well-characterised Research is currently being undertaken to identify the relevant causal factors What are the [dovemed.com]

Breast: 8 cases of hamartoma per 20,000 mammograms Kidney: renal hamartoma (angiomyolipoma) found in 40–80% of patients with tuberous sclerosis Etiology and Pathophysiology Functional disorder will depend on tissue of origin. [unboundmedicine.com]

Hodges suggested four etiologic theories; congenital malformation, hyperplasia of normal structure, neoplasia and response to inflammation. 18) The theory of congenital origin is accepted by most authors. [kjim.org]

Epidemiology Hamartomas account for 1% to 2% of all pulmonary neoplasms and are the most common benign tumour 3. The incidence in a series of 8000 post-mortems was 0.25%. The average age is 55 years. Endobronchial lesions more commonly occur in men. [e-immunohistochemistry.info]

[…] triad may be a distinct entity Descriptive term sometimes added to describe components, i.e. lipomatous, chondroid, chondromatous, fibrochondromatous, fibroleiomyomatous If lacks cartilage, could be diagnosed as lipoma, myxoma, leiomyoma or fibroadenoma Epidemiology [pathologyoutlines.com]

Epidemiology Pulmonary hamartomas or mesenchymomas are the most common form of benign lung tumours with an incidence of between 0.025% – 0.32% according to different necropsy studies. In a large series they constituted 7–14% of all coin lesions. [humpath.com]

Epidemiology Can be hard to assess because many hamartomas are asymptomatic Incidence Depends on organ system affected Breast hamartomas are not common; estimated incidence is 0.1–0.7%. [unboundmedicine.com]

Linguistic Variant - Portuguese, Brazil) 2015AB LNC-RU-RU (LOINC Linguistic Variant - Russian, Russia) 2015AB LNC-TR-TR (LOINC Linguistic Variant - Turkish, Turkey) 2015AB LNC-ZH-CN (LOINC Linguistic Variant - Chinese, China) 2015AB MCM (Glossary of Clinical Epidemiologic [doctor.am]

Breast: 8 cases of hamartoma per 20,000 mammograms Kidney: renal hamartoma (angiomyolipoma) found in 40–80% of patients with tuberous sclerosis Etiology and Pathophysiology Functional disorder will depend on tissue of origin. [unboundmedicine.com]

Pathophysiology Pathogenesis Hamartomas occur in the same location as the normal tissue (in the tissue of its origin) as opposed to choristomas, which grow in other tissues (different from its origin). [wikidoc.org]

Agents for the prevention and / or treatment of a lesion of mesenchymal origin The invention relates to agents for the prevention and / or treatment of a tissue change, whereby the tissue change comprises tissue of mesenchymal origin, using the means, [google.st]

Minimizing the size of the arterial stump would prevent this complication ( 16 ). [jtd.amegroups.com]

NCI_CTEP-SDC (Cancer Therapy Evaluation Program - Simple Disease Classification) 2015AB NCI_CareLex (Content Archive Resource Exchange Lexicon) 2015AB NCI_DCP (NCI Division of Cancer Prevention Program) 2015AB NCI_DICOM (Digital Imaging Communications [doctor.am]

In case of serious discomforts such as Haemoptysis, you should seek immediate medical treatment to prevent complications. References : [primehealthchannel.com]

1. Lien YC, Hsu HS, Li WY, et al. Pulmonary hamartoma. J Chin Med Assoc. 2004;67:21–26.
2. Thomas JW, Staerkel GA, Whitman GJ. Pulmonary hamartoma. AJR Am J Roentgenol. 1999;172(6):1643.
3. Jacob S, Mohapatra D, Verghese M. Massive chondroid hamartoma of the lung clinically masquerading as bronchogenic carcinoma. Indian J Pathol Microbiol. 2008;51(1):61-2.
4. Zakharov V, Schinstine M. Hamartoma of the lung. Diagn Cytopathol. 2008;36(5):331-2.
5. Guo W, Zhao YP, Jiang YG, et al. Surgical treatment and outcome of pulmonary hamartoma: a retrospective study of 20-year experience. J Exp Clin Cancer Res. 2008;27:8.
6. Hutter J, Reich-Weinberger S, Hutarew G, et al. Giant pulmonary hamartoma--a rare presentation of a common tumor. Ann Thorac Surg. 2006;82(2):e5-7.
7. Adachi Y, Araki K, Metsugi H, et al. A case of relatively rapid enlargement of a pulmonary hamartoma. J Jap Assoc Chest Surg. 2012;26:673-6.
8. Rodriguez FJ, Aubry MC, Tazelaar HD, et al. Pulmonary chondroma: a tumor associated with Carney triad and different from pulmonary hamartoma. Am J Surg Pathol. 2007;31(12):1844-53.
9. Carney JA, Stratakis CA. Familial paraganglioma and gastric stromal sarcoma: a new syndrome distinct from the Carney triad. Am J Med Genet. 2002;108(2):132-9.
10. Basile A, Gregoris A, Antoci B, et al. Malignant change in a benign pulmonary hamartoma. Thorax. 1989;44(3): 232-3.
11. Pollock AB, Al Hasan M, Roy TM, et al. Pulmonary hamartoma- an algorithmic approach to the diagnosis and management. Clin Pulm Med. 2008;15:35-9.
12. Cosío BG, Villena V, Echave-Sustaeta J, et al. Endobronchial hamartoma. Chest. 2002;122(1):202-5.
13. Chai JL, Patz EF. CT of the lung: patterns of calcification and other high-attenuation abnormalities. AJR Am J Roentgenol. 1994;162(5):1063-6.
14. Klein JS, Braff S. Imaging evaluation of the solitary pulmonary nodule. Clin. Chest Med. 2008;29(1):15-38.
15. Jeong YJ, Lee KS, Jeong SY, et al. Solitary pulmonary nodule: characterization with combined wash-in and washout features at dynamic multi-detector row CT. Radiology 2005;237:675–83.
16. Erb RE, Delbeke D, Falke TH. Magnetic resonance imaging of Carney''s triad. South Med J. 1994;87(9):951-5.
17. Okabayashi K, Hiratsuka M, Noda Y et al. Giant hamartoma of the lung with a high production of carbohydrate antigen 19-9. Ann Thor Surg. 1993;55(2):511-513.
18. Johansson M, Dietrich C, Mandahl N et al. Recombinations of chromosomal bands 6p21 and 14q24 characterise pulmonary hamartomas. Br J Cancer. 1003;67(6):1236-41.
19. Bini A, Grazia M, Petrella F, et al. Multiple chondromatous hamartomas of the lung. Interact Cardiovasc Thorac Surg. 2002;1:78–80.
20. Ribet M, Jaillard-Thery S, Nuttens M. Pulmonary hamartoma and malignancy.J Thor Cardiovasc Surg 1994;107(2):611-4.