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Case Reports
. 2017 Dec;96(49):e9085.
doi: 10.1097/MD.0000000000009085.

Endobronchial hamartoma mimicking malignant lung tumor contralateral endobronchial metastasis: A case report

Sheng-Song Chen  1 , Hong Zhou, Bo Tong, Ling-Ling Yu, Si-Si Fan, Zu-Ke Xiao
Affiliations
Case Reports

Endobronchial hamartoma mimicking malignant lung tumor contralateral endobronchial metastasis: A case report

Sheng-Song Chen et al. Medicine (Baltimore). 2017 Dec.

Abstract

Rationale: Endobronchial hamartoma, the most common benign lung tumor, is located in the bronchus, and it easily mimics lung cancer or bronchial metastasis. Endobronchial hamartoma can cause coughing, hemoptysis, and pulmonary infection; thus, it should be treated right away by surgery or fiberoptic bronchoscopy.

Patient concerns: We report a rare case of endobronchial hamartoma in which the clinical symptoms and imaging overlapped strongly with malignant lung tumor contralateral endobronchial metastasis.

Diagnoses: Endobronchial hamartoma coexisting with a malignant lung tumor.

Interventions: Fiberoptic bronchoscopy was conducted, and the pathologic diagnosis was hamartoma. A second fiberoptic bronchoscopy was conducted, and fine-needle aspiration cytology of the enlarged lymph nodes indicated squamous cell carcinoma.

Outcomes: The clinical symptoms were relieved, and the treatment options were docetaxel, cis-dichlorodiamineplatinum, and endostatin.

Lessons: Fiberoptic bronchoscopy needs to be guided by imaging and can be considered an effective method for the diagnosis of endobronchial hamartoma.

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Conflict of interest statement

The authors report no conflicts of interest.

Figures

Figure 1
Figure 1
Chest CT revealed a crumby-shaped soft tissue density in the upper right lobe of the right lung (arrows), swollen lymph nodes in the hilar and mediastinum (asterisk), and a “neoplasm,” with a smooth surface and normal mucosa breaking into the upper left bronchus in the left lung (arrowheads) (shown in A, B, C and D).
Figure 2
Figure 2
Endobronchial hamartoma (arrows) was moved by fiberoptic bronchoscopy (shown in A, B, and C). The pathologic diagnosis of the “neoplasm” was hamartoma, presenting with irregular arrangement of bone tissue, fibrous tissue, and adipose tissue, viewed under a microscope (shown in D) (hematoxylin and eosin stain, original magnification ×10).
Figure 3
Figure 3
PET/CT scan showed a 45 mm × 25 mm mass, high-density shadow, behaving as a cavity and burrs with high uptake in the right lung (SUVmax10.6) (arrows). Multiple enlarged lymph nodes could be seen in the right pulmonary hilum and mediastinum with high uptake (SUVmax11.6) (arrows) (shown in A, B, C, and D).
Figure 4
Figure 4
The second fiberoptic bronchoscopy image (left upper bronchus) (A) and fine-needle aspiration cytology (B).
Figure 5
Figure 5
Fine-needle aspiration cytology in right hilar lymph nodes indicated squamous cell carcinoma (tendency) (original magnification ×20).
See this image and copyright information in PMC

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