Hamartoma of the lung
The content of the article:
- Causes and risk factors
- Forms of the disease
- Disease stages
- Symptoms
- Diagnostics
- Treatment
- Possible complications and consequences
- Forecast
- Prevention
Lung hamartoma (chondroadenoma, lipochondroadenoma, hamartochondroma) is a benign lung tumor of dysembryonic origin, formed by the tissue of the distal bronchi, pulmonary parenchyma and some other structures.
Hamartoma of the lung on x-ray
This is one of the most frequently observed benign tumors in pulmonology. Its favorite place of localization is the anterior segments of the lower lobe of the right lung. The tumor can be located both in the thickness of the pulmonary parenchyma, and subpleurally (superficially). Localization of hamartoma on the bronchial wall is extremely rare.
Hamartomas of the lung have the appearance of rounded formations covered with a dense capsule. Their diameter varies from 5 mm to 12-13 cm (on average - 2-4 cm). The histological composition of the tumor is heterogeneous: it contains cells of the glandular epithelium, adipose, lymphoid and cartilaginous tissues, smooth muscle and connective tissue fibers, vascular elements and small accumulations of osteocytes.
The disease is more often diagnosed in males aged 30 to 50 years. The risk of malignant transformation of lung hamartoma is minimal.
Causes and risk factors
The exact cause of lung hamartoma is unknown. It is believed that the tumor appears as a result of disturbances in the process of embryogenesis at the stage of laying and formation of tissues of the lungs and bronchi, that is, it can be considered as one of the congenital malformations of the lungs.
Genetic abnormalities increase the likelihood of developing lung hamartoma
The likelihood of developing lung hamartoma increases:
- the impact of mutagenic factors on the body of parents (salts of heavy metals, pesticides, radioactive radiation);
- genetic disorders;
- hereditary predisposition.
Forms of the disease
Depending on the prevalence of hamartomas, they are local (limited tumor node) and diffuse (affecting the whole lobe of the lung).
According to the peculiarities of the histological structure, the following types of hamartomas are distinguished:
- hamartochondromas (chondromatous hamartomas of the lung) - mainly composed of hyaline cartilage;
- leiomyomatous hamartomas of the lung - the main part of the tumor is represented by bronchoalveolar structures and smooth muscle tissues;
- lipogamartomas (lipogamartochondromas) - adipose (adipose) tissue predominates;
- fibrogamartomas (fibrogamartochondromas) - the main part of the tumor is represented by fibrous tissue.
It looks like a hamartoma of the lung
Disease stages
According to the clinical course, there are three stages of the course of lung hamartoma:
- Asymptomatic course.
- Scant clinical manifestations.
- Expanded symptomatology associated with compression of the growing tumor of the surrounding tissues.
Symptoms
As a rule, hamartomas of the lung do not show themselves for many years. A tumor during this period can be detected by chance on a chest x-ray associated with another disease.
As the hamartoma grows, it begins to squeeze the bronchi, lung parenchyma, diaphragm, chest wall. Patients complain of pain in the chest area from the side of the lesion, which intensifies when trying to take a deep breath. In addition, shortness of breath and coughing occur. With significant physical exertion, hemoptysis may occur.
As the hamartoma of the lung grows, patients complain of chest pains that worsen when inhaling
When a hamartoma compresses the lumen of a large bronchus, a clinical picture similar to the symptoms of central lung cancer develops. Endobronchial growth of a tumor causes a violation of the patency of the bronchus, as a result of which the patient develops segmental or lobar atelectasis, obstructive pneumonia, which is accompanied by the appearance of signs characteristic of chronic pneumonia.
Multiple hamartomas of the lung as an independent form of the disease are extremely rare. Most often they arise against the background of the Carney triad or Cowden syndrome. With the Carney triad, lung hamartomas are combined with extraadrenal paraganglioma and gastric leiomyoblastoma. Cowden syndrome is characterized by the presence of a patient with hamartomas of the lung, multiple benign tumors of internal organs, as well as an increased risk of developing cancer of the gastrointestinal tract, genitourinary system, thyroid and mammary glands.
Diagnostics
Diagnosis of hamartoma of the lung is carried out on the basis of anamnesis, X-ray data, magnetic resonance imaging or computed tomography, bronchoscopy, histological examination of a biopsy obtained during a transthoracic puncture biopsy of a tumor formation.
Hamartoma requires differential diagnosis with bronchopulmonary cancer, tuberculoma, echinococcosis.
Patients with suspected lung hamartoma should be evaluated by a pulmonologist, oncologist, and thoracic surgeon.
Hamartoma of the lung requires differential diagnosis
Treatment
With an insignificant size of hamartoma, the absence of clinical manifestations of the disease and tumor growth, patients are only subject to dynamic observation by a pulmonologist.
Indications for surgical treatment are the growth of hamartoma and its compression of the surrounding tissues. Depending on the size of the lesion and the exact location of its localization, surgical intervention can be performed by thoracotomy (open) or thoracoscopic (endoscopic) access.
Possible complications and consequences
The most common complication of lung hamartoma is obstructive pneumonia. Malignancy of the tumor is very rarely observed.
Forecast
The prognosis for lung hamartoma depends on the amount of surgery, but is generally favorable. With enucleation of a tumor or segmental resection of the lung, the ability to work of patients is restored in a short time. With removal of the pulmonary lobe (lobectomy), the prognosis is slightly worse.
Prevention
Specific measures for the prevention of lung hamartoma have not been developed. In the presence of cases of the disease in close relatives, married couples at the stage of pregnancy planning are recommended medical genetic counseling.
Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
