Coexistence of lung cancer and hamartoma

Higashita, Ryuji; Ichikawa, Seiichi; Ban, Tetsuo; Suda, Yuji; Hayashi, Kôji; Takeuchi, Yasuo

doi:10.1007/bf02913527

Cited by 21 publications

(14 citation statements)

References 7 publications

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“…The typical pulmonary hamartoma is made up of benign-appearing mesenchymal fibromyxoid tissue with a variable extent of chondroid differentiation, fat, fibrous tissue, and smooth muscle, 6,30,39,73 associated with long-branching clefts of presumably non-neoplastic ciliated and nonciliated bronchial epithelium. 15,69 Though pulmonary hamartomas are benign neoplasms, an increased risk for the concurrent development of lung cancers, (especially adenocarcinoma of the same pulmonary lobe 1,8,22,29,33,60,71,75,79 ) has been reported. Exceedingly rare is the development of tumors within the hamartoma, such as carcinomas, 21,32,58,62,66,72,77,84 sarcomas, 2,3,50 or salivary gland-type tumors.…”

mentioning

confidence: 98%

Immunoreactivity for Sex Steroid Hormone Receptors in Pulmonary Hamartomas

Pelosi

Rosaí

Viale

2006

American Journal of Surgical Pathology

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Sex steroid hormone [ie, estrogen (ER), progesterone (PgR), and androgen (AR)] receptors have been identified previously in normal salivary glands and, more variably, in salivary gland and salivary gland-type tumors. No data are available, however, on their expression in pulmonary hamartoma, a benign biphasic tumor consisting of reactive epithelial cells and neoplastic fibromyxoid stroma, cartilage and fat, which shares some morphologic, immunophenotypic, and genotypic features to pleomorphic adenoma of major salivary glands. Thirty pulmonary hamartomas (15 in male patients and 15 in age-matched female patients), were evaluated for ER, PgR, and AR immunoreactivity, and also for mesenchymal, epithelial, and myoepithelial markers, in the fibromyxoid, epithelial, and chondroid components. ER immunoreactivity was encountered in 90% of hamartomas, PgRs in 90%, and ARs in 53% (P<0.001), but not in normal lung tissues. ARs were confined to males (P<0.001), with a marginal prevalence in the fibromyxoid component (P=0.067). PgRs and ERs were instead present in both sex, with the former being restricted to the fibromyxoid stromal component (P<0.001) and the latter preferentially located in epithelial cells (P=0.107). In most cases, fibromyxoid stroma and spindle cells surrounding the chondroid foci displayed simultaneous immunoreactivity for ERs, PgRs, and ARs, along with immunoreactivity for vimentin, S-100 protein, glial fibrillary acid protein, smooth muscle actin, and calponin but lack of staining for cytokeratins. This profile is consistent with an incomplete myoepithelial differentiation of the receptor-expressing mesenchymal cells. In conclusion, sex steroid hormone receptor expression is a nonrandom event in pulmonary hamartoma, and may be related to the development and growth of this tumor.

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mentioning

confidence: 98%

Immunoreactivity for Sex Steroid Hormone Receptors in Pulmonary Hamartomas

Pelosi

Rosaí

Viale

2006

American Journal of Surgical Pathology

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“…19 Subsequent studies also concluded that there was a small but significantly increased risk. 18,20 These authors were, however, not able to define a pathophysiologic link between hamartomas and associated lung cancer. Conversely, the search leading to a diagnosis of malignant lung cancer could incidentally lead to the discovery of an asymptomatic hamartoma.…”

Section: Discussionmentioning

confidence: 97%

“…21 Given the uncertainty, however, it is currently suggested that patients diagnosed with a hamartoma have a complete evaluation to rule out lung cancer. 18,20 The components of this complete evaluation are not defined but should probably include a CT of the chest. None of our 3 patients have radiographic or endoscopic evidence for lung cancer.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Hamartoma

Pollock

Hasan

Roy

et al. 2008

Clinical Pulmonary Medicine

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Pulmonary hamartomas are the most common benign tumor of the lung. As the term "hamartoma" suggests, these tumors were at one time considered to be embryological malformations. New evidence indicates, however, that hamartomas are benign tumors of mesenchymal origin and that "mesenchymoma" is a more appropriate term. Despite the fact that hamartomas, or mesenchymomas, have been described in the medical literature since 1904, there is not a consistent methodology for the diagnosis and management of these lesions. This report reviews the available literature regarding pulmonary hamartomas with 3 illustrative cases. An algorithm is proposed for the diagnosis and management of this benign respiratory neoplasm.

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“…[8][9][10] Yayınlarda hamartom ile karsinomun genellikle aynı lobda olduğu, [9,10] hamartomun kanser gelişim sürecine zemin hazırlayabileceği, bu olguların çoğunlukla geç-orta yaşlı erkekler olduğu ve adenokarsinomun daha sık görüldüğü belirtilmiştir. [10] Olgumuzda cinsiyet ve karsinom türü bu bulgulara benzer olmakla birlikte, hamartom ve kanserin ayrı loblarda olması farklılık göster-mektedir.…”

Section: Discussionunclassified

The diagnostic difficulty and surgical observation in a case with three different tumors coexisting in the lung

Arslan¹

2011

Turkish J Thorac Cardiovasc Surg

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Akciğer patolojilerinin tanı yöntemlerindeki tüm geliş-melere rağmen, cerrahi gözlem hala bir tanı yöntemi olarak önemini korumaktadır. Kronik bronşit tanısı olan sigara içicisi 76 yaşındaki erkek olgunun toraks bilgisayarlı tomografisinde, sağ intermedier bronş için-de, sağ üst ve sağ alt lobda değişik boyutlarda çoklu lezyonlar saptandı. Bronkoskopik olarak çıkarılan, sağ intermedier bronş içindeki lezyonun histopatolojik tanı-sı papillom olarak bildirildi. Sağ torakotomi yapılarak, pnömotomi ile çıkarılan alt lob lezyonunun histopatolojik tanısının kondroid hamartom olduğu belirlendi. Üst lob lezyonundan yapılan biyopsi, küçük hücreli dışı akciğer kanseri olarak bildirildi. Sağ retorakotomi ile sağ apikal segmentektomi uygulanan hastanın patolojik evresi, histopatolojik değerlendirme sonucunda evre IA (pT1N0M0) olarak saptandı. Hastaya ameliyat sonrası adjuvan kemoterapisi uygulanmadı. On altı aylık takip süresi sorunsuzdu. Akciğerde bulunan ve birden fazla olan kitlesel lezyonların her biri ayrı ayrı değerlendiril-melidir. Bu tür olgularda tüm tanısal girişimlere rağmen cerrahi gözlem, tanı için bazen tek yol olarak karşımıza çıkmaktadır.Anah tar söz cük ler: Hamartom; akciğer kanseri; papillom; senkron tümör.Despite all the advances in the diagnostic methods for lung pathologies, surgical observation still maintains its importance as a diagnostic method. Thoracic computed tomography revealed multiple lesions with different sizes in the right intermediate bronchus, the right upper lobe and the right lower lobe of a 76-year-old male smoker patient with the diagnosis of chronic bronchitis. The histopathological diagnosis for the lesion in the right intermediate bronchus resected with bronchoscopy was reported to be papilloma. The histopathological diagnosis of the lower lob lesion, wich was removed by pneumotomy via right thoracotomy, was found to be chondroid hamartoma. The biopsy performed from the upper lob lesion was reported as non-small cell carcinoma. The pathological stage of the patient was found as IA (pT1N0M0) in the histopathological evaluation following right apical segmentectomy performed through right rethoracotomy. No adjuvant chemotherapy was administered to the patient after the surgery. The 16-month follow-up period was without any problems. Multiple coexisting lesions in the lung should each be separately assessed. Surgical observation sometimes appears to be the only way of diagnosis in such cases despite all the diagnostic interventions.Key words: Hamartoma; lung cancer; papilloma; synchronize tumor. Günümüzde görüntüleme yöntemlerinin ve bronkoskopik işlemlerin daha yaygın kullanılması, akciğer kanserinde erken tanı oranını giderek artırmaktadır. Tüm bu gelişmelere rağmen olguların sadece %10-15 kadarı erken evrelerde, kalan kısmı ise ameliyat şansını kaybetmiş olarak hekime başvurmaktadır. [1] Hamartomlar, organın normal dokularının anormal proliferasyonu ile karakterizedir. En sık yerleşim yeri ise plevranın alt kısmıdır. Nadiren endobronşi-yal yayılım gösterir.[2] Tüm soliter pulmoner...

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Coexistence of lung cancer and hamartoma

Cited by 21 publications

References 7 publications

Immunoreactivity for Sex Steroid Hormone Receptors in Pulmonary Hamartomas

Immunoreactivity for Sex Steroid Hormone Receptors in Pulmonary Hamartomas

Pulmonary Hamartoma

The diagnostic difficulty and surgical observation in a case with three different tumors coexisting in the lung

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