Hamartoma of the lung is a special dysembryonic formation, consisting mainly of components of the bronchial wall and pulmonary parenchyma. The anomaly was first described in 1904.
General information
Hamartoma is a benign lung tumor that contains cartilage, vascular and fibrous structures. Pathology is usually localized in the thickness of the pulmonary parenchyma, due to its small size, it practically does not affect the functioning of organs.
A hamartoma is a single, rounded formation of dense consistency, the size of which varies from 0.5 to 5 cm. Among all lung tumors of a benign nature, hamartoma is most often detected (60% of cases). The disease is mainly diagnosed in males.
Etiology
Hamartoma of the lung develops as a result of impaired fetal development in the embryonic period. It consists of various kinds of elements of germinal tissues, as well as components of the organ in which it is located that are similar in nature. This is the main difference between hamartoma and teratoma. The latter, as a rule, consists of tissue primordia and elements foreign to the organ in which it is localized.
Classification
In total, there are several classifications of this pathology. By the predominance of tissue, a benign lung tumor happens:
- Lipomatous
- Organoid.
- Chondromatous.
- Angiomatous.
- Leiomyomatous.
Depending on the number of tumors, single and multiple pathology options are distinguished. According to localization, endobronchial, subpleural and intrapulmonary formations are distinguished.
Clinical picture
Hamartoma of the lung for a long time may not manifest characteristic symptoms. A progressive subpleural formation is usually accompanied by pain discomfort in the chest area. If a hamartoma is formed from the wall of the bronchus, as it develops, patency of the bronchi may be impaired. In this case, patients complain of a strong cough with separation of mucopurulent sputum, in rare cases, hemoptysis occurs.
Establishing diagnosis
Due to the fact that the pathology is mainly asymptomatic, it can be detected only during a routine examination. To obtain a more detailed clinical picture, the doctor prescribes an X-ray examination, in which round-shaped shadows of various sizes with smooth or wavy contours are detected. Usually calcareous inclusions are determined on radiographs. Their number is due to the intensity of the shadow. If you conduct a long dynamic study, you will notice that the size of the hamartoma of the lung changes very slowly. On the other hand, the intensity of calcareous deposits is progressing rapidly.
Formations of endobronchial nature are manifested by direct and indirect signs. In the first case, we are talking about a spherical tumor with smooth and clear edges, detected by x-ray examination. Indirect manifestations are atelectasis, hypoventilation and other signs indicating a violation of bronchial conduction.
A special role is given to differential diagnosis. It is extremely important not to confuse this pathology with peripheral lung cancer or tuberculoma.
What should be the treatment?
At the consultation, the doctor should first of all tell what constitutes lung hamartoma, the causes of the pathology and prescribe the appropriate treatment. Medical treatment, unfortunately, in the fight against this problem is ineffective. Medications are taken only to reduce symptoms.
Surgical intervention is recommended for all patients, without exception. If the doctor has confirmed the diagnosis of "lung hamartoma", surgery is considered an unconditional measure. If you suspect a different pathology (for example, peripheral cancer), thoracotomy should be preferred.
Hamartoma is removed by resection or husking of the lung tissue. The operation is performed using a video-assisted thoracoscopic technique that avoids traumatic incisions. With relative contraindications to this type of intervention, dynamic monitoring of the patient for several months is permissible. At the end of this period, the question of the operation is decided based on the presence or absence of an increase in shadow on the radiograph.
A slightly different approach requires endobronchial hamartoma. In this case, treatment implies the removal of an education by means of a bronchotomy or resection of an organ wall.
Forecast
Hamartoma grows very slowly, but can reach gigantic proportions. Its degeneration into a malignant formation is extremely rare. According to available statistics, the possibility of malignancy is no more than 7% of all cases. Malignancy can occur both in the epithelial and in the mesenchymal component of the formation with subsequent metastasis to the lymph nodes, liver and spine of a person.
We hope that all the information presented in this article will be really useful for you. Be healthy!