Pulmonary hamartomas are usually solitary, nodular benign lesions in the parenchyma of the lung. They are rarely situated in endobronchial areas, and very few cases are reported with the mediastinum. A 56-year-old female patient got a CT-scan conducted due to coughing and breathlessness and was diagnosed with a nodular lesion in the medial mediastinum. The lesion was operated: it measured up to 4 cm in the largest diameter, had a smooth surface, was of rather soft but elastic consistency, and was extirpated. At pathology, on cut section, it was yellowish and lobular, and with a mixture of cartilaginous, fibrous and adipose tissues with some smooth muscle cell fibers and myxoid areas. The diagnosis of pulmonary hamartoma was made with atypical medial mediastinal localization. This rare presentation could pose some differential diagnostic problems in the clinical diagnosis of more frequent primary and metastatic malignant diseases.
Sclerosing hemangioma of the lung is a rare benign tumor that can metastasize
to regional lymph nodes. It is a neoplasm that originates from type II
pneumocytes and primitive respiratory epithelium. It is most common in
middleaged women in form of peripherally localized node. Tumor is composed of
two types of cells, and there are papillary, solid, sclerotic, and
hemorrhagic histological pattern. Preoperative and intraoperative diagnosis
of the tumor is difficult. In a 53-old female patient, radiologically was
discovered hyperdense nodule with smooth margins, which was followed for two
years, and then underwent enucleation of the tumor. The tumor was 25 mm in
diameter and consisting of round and cuboidal cells. Microscopically, it
showed papillary and solid arrangement. Based on immunohistochemical
analysis, we made a diagnosis of sclerosing hemangioma of the lung. Three
months after surgery, the patient was in good health condition. Because of
the numerous differential diagnostic dilemmas, diagnosis is almost always
based on permanent paraffin sections, using a wide range of
immunohistochemical analysis. Type of surgery depends on the tumor location,
and in case of larger tumors, lymph node dissection needs to be done as well.
Introduction. Tracheobronchial disruption is a rare disorder, usually
accompanied by a severe blunt chest trauma that quite rarely appears as an
isolated event. Case Report. This is a case report of a right main bronchus
disruption, due to an injury to the right hemithorax, caused by a falling
tree trunk. The disruption was accompanied by mediastinal emphysema,
fractures of the 4th and 5th ribs on the right side and compound sternal
fracture. The patient was operated in general anesthesia, through right
thoracotomy approach, followed by successful right main bronchus
reconstruction by interrupted suture technique, without anatomic resection
of the lung parenchyma. Conclusion. Although this injury is rare, with
suspicion of bronchial rupture, bronchoscopy confirms the diagnosis and
leads to better prognosis.
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