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Case Reports
. 2021 Feb 24;16(5):1032-1036.
doi: 10.1016/j.radcr.2021.01.062. eCollection 2021 May.

Pulmonary hamartoma: Feasibility of dual-energy CT detection of intranodular fat

Koji Takumi  1 , Hiroaki Nagano  1 , Tomohiro Harasawa  1 , Kazuhiro Tabata  2 , Takuya Tokunaga  3 , Takashi Yoshiura  1
Affiliations
Case Reports

Pulmonary hamartoma: Feasibility of dual-energy CT detection of intranodular fat

Koji Takumi et al. Radiol Case Rep. .

Erratum in

Abstract

We have reported 2 cases of pulmonary hamartoma focusing on detecting intranodular fat, which is one of CT features suggestive of pulmonary hamartoma, using dual-energy CT analyses. For patient 1, a 73-year-old man was pointed out to have a nodular opacity on chest radiograph of pretreatment workup for retinal detachment. In patient 2, a 66-year-old woman with uterine carcinoma admitted for preoperative assessment. Both patients underwent dual-energy CT examination and the pulmonary lesions exhibited a downward-sloping curve at lower X-ray energies on attenuation curve of virtual monochromatic images, which suggested fatty tissue. Dual-energy CT analysis can help diagnose pulmonary hamartoma with detection of intralesional fatty tissue.

Keywords: Dual-energy computed tomography (CT); Fat; Pulmonary hamartoma.

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Figures

Fig 1
Fig. 1
Case 1 - Axial lung window (A) and soft tissue window (B) CT images demonstrate a well-defined and heterogeneous solitary pulmonary lesion with calcification measuring 35 mm in diameter in the right lower lobe (arrow). The mean Hounsfield unit on 40 keV virtual monochromatic image (D) is lower than that on 70 keV virtual monochromatic image (C) (32.6 vs. 37.8 HU). Attenuation curve of virtual monochromatic images (E) exhibited a downward-sloping curve at lower X-ray energies. In-phase MR image (G) shows low signal intensity of nodule and out-of-phase image (F) shows loss of signal (arrowheads) in the nodule. Microscopically, it shows that the tumor consists of mature cartilage with adipose tissue (right lower corner) and fibrovascular without bronchial glands (H).
Fig 2
Fig. 2
Case 2 - Axial lung window (A) and soft tissue window (B) CT images demonstrate a well-defined and homogeneous solitary pulmonary nodule without calcification measuring 23 mm in diameter in the left upper lobe. The mean Hounsfield unit on 40 keV VMI (D) is lower than that on 70 keV VMI (C) (33.3 vs. 43.3 HU). Attenuation curve of virtual monochromatic images (E) exhibited a downward-sloping curve at lower X-ray energies. Microscopically, it shows that a variety of mesenchymal elements, including hyaline cartilage, fibrovascular stroma, bronchial glands (F), small amount of adipose tissue is also seen (right lower corner).
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