Published online Mar 16, 2022. doi: 10.12998/wjcc.v10.i8.2650
Peer-review started: November 4, 2021
First decision: December 27, 2021
Revised: January 4, 2022
Accepted: February 10, 2022
Article in press: February 10, 2022
Published online: March 16, 2022
Processing time: 126 Days and 11.2 Hours
It now seems that all pulmonary hamartomas (PHs) are large cystic-solid lesions that are difficult to diagnose. However, few cases of large cystic-solid PHs have been reported. The present case report presents a large cystic-solid PH and provides a literature review of the imaging features, formation mechanism and histopathological basis of PHs.
A 53-year-old woman with no clinical symptoms underwent a chest computed tomography (CT) examination at our hospital. Nonenhanced CT images revealed a large, flat tumor with multiple air-containing cysts in the left thoracic cavity and a cystic part confined to the medial side of the tumor; the solid part of the tumor showed abundant fat and lamellar soft tissue components. Multiple small blood vessels were detected in the solid part of the tumor on contrast-enhanced CT images. Given the large size of the lesion, the patient elected to undergo surgery. Histological examination revealed PH. A detailed review of the patient’s CT imaging showed that the lesion had a small vascular pedicle to the left lower lobe, which was a clue to its lung tissue histological origin. According to immunohistochemical staining, the confined multiple air-containing cysts were caused by the entrapment of respiratory/alveolar epithelium.
This case shows the imaging manifestations of a large PH. Heightened awareness of its formation mechanism and histopathological basis may alert radiologists to consider this diagnosis in their daily workflow.
Core Tip: We describe a large pulmonary hamartoma (PH) and its preoperative computed tomography (CT) imaging features, including multiple air-containing cysts, a rich blood supply and a vascular pedicle. The CT imaging features, formation mechanism, and histopathological basis of a large PH are summarized in this case report.