The clinicopathological challenges of symptomatic and incidental pulmonary hamartomas diagnosis

Abstract

Pulmonary hamartomas (PHs) are the most common benign lung tumors. Usually, they are asymptomatic and incidentally discovered during assessment for other diseases or during the autopsy exam. In this context, we have performed a retrospective analysis of surgical resections in a 5-year series of patients diagnosed with PHs in the Clinic of Pulmonary Diseases, Iaşi, Romania, aiming to evaluate their clinicopathological features. A total of 27 patients with PH (40.74% males and 59.26% females) were evaluated. 33.33% of patients were asymptomatic, while the others exhibited variable symptoms, such as chronic cough, dyspnea, chest pain or weight loss. In most cases, PHs presented as solitary nodules, predominantly disposed in the right upper lobe (40.74% of cases), followed by the right lower lobe (33.34%), and left lower lobe (18.51%). The microscopic examination revealed a mixture of mature mesenchymal tissue, such as hyaline cartilage, adipose tissue, fibromyxoid tissue, and smooth muscle bundles, in variable proportions, associated with clefts of entrapped benign epithelium. A dominant adipose tissue component was observed in one case. PH was associated with a history of extrapulmonary cancer diagnosis, in one patient. Although considered benign lung tumors, PHs diagnosis and therapy may be challenging. Having in mind the possibility of recurrence or their occurrence as a part of specific syndromes, PHs should be thoroughly investigated for an appropriate patients' management. Their complex significance and the correlation with other types of lesions, including malignancies, may be further studied, by more extensive studies of surgical and necroptic cases.

Case Report: Giant lung hamartoma : An usual cause of lobectomy in a five-year child

“…Pulmonary hamartomas are benign tumors that often occur in middle-aged adults with male predominance. 4 Within the pediatric population, pulmonary hamartomas are significantly rarer. 5 It is an incidental finding in most cases, with a diameter ranging from 1 to 8 cm.…”

A rare case of asymptomatic giant pulmonary hamartoma

“…In the Gene Fusion/Rearrangement Panel used in our current study, we investigated 2 RAD51L-associated gene fusions and 8 HMGA2-related gene fusions. Among these fusion transcripts, HMGA2-LPP fusion transcripts (fusing exon 3 of HMGA2 to exon 9 of LPP) and LPP-HMGA2 fusion transcripts (fusing exon 7 of LPP to exon 4 of HMGA2 variant and exon 8 of LPP to exon 4 of HMGA2 variant) have been reported to be associated with pulmonary hamartoma [ 19 , 20 ]. However, we did not identify any of these reported gene fusions in the current case.…”

Posterior urethral hamartoma with hypospadias in a child: a case report and literature review

“…The proportion of each component is different, and it is usually named after the dominant component, which can be divided into chondroid hamartoma, chondromesenchymal hamartoma, angioid hamartoma, epithelioid hamartoma, etc. ( 16 ). The prognosis of hamartoma is good without postoperative radiotherapy or chemotherapy.…”