Endobronchial hamartoma coexisting with lung cancer

Key message

Clinicians should be careful when examining a case with endobronchial hamartoma with concurrent malignant disease because radiographic imaging and symptoms cannot clearly differentiate between both diseases.

We present the case of a 70‐year‐old man diagnosed with endobronchial hamartoma (EH) with concurrent malignant disease. Hamartomas are rarely identified as endobronchial lesions and only a few cases of EH with concurrent malignant disease are reported. Radiographic imaging and symptoms cannot reliably differentiate between EH and malignant bronchial nodules, thus careful examination is warranted.

Clinical Image

A 70‐year‐old man was hospitalized due to opacities seen on chest computed tomography (nodules in the right and left upper lobes of the bronchus) (Fig. 1). Right upper lobectomy was performed, because positron emission tomography (PET) revealed increased tracer concentration in this respective nodule, but not in the left upper bronchus nodule. Histopathological examination diagnosed a combination of adenocarcinoma and large cell carcinoma. The left upper lobe bronchus nodule size was below the resolution of PET and hence the possibility of a sub‐centimetre synchronous primary or metastasis was considered. On this suspicion, bronchoscopy was performed to examine the left upper bronchus nodule (Fig. 2A). Histopathological findings revealed a tumour with adipose and fibrous components covered by bronchial epithelium, leading to the diagnosis of endobronchial hamartoma (EH) (Fig. 2B). Hamartomas are rarely identified as endobronchial lesions (1.4%) [1]. In addition, only a few cases of EH with concurrent malignant disease are reported. Radiographic imaging and symptoms cannot reliably differentiate between EH and malignant bronchial nodules [2]. Therefore, such cases must be carefully examined, especially those where EH coexists with malignant diseases.

Figure 1.

Chest computed tomography revealed nodules in the right upper lobe and left upper lobe bronchus.

Figure 2.

Bronchoscopic visualization revealed a round‐shaped lesion partially obstructing the left upper lobe bronchus (A). Histopathological findings revealed a tumour with adipose and fibrous components covered by bronchial epithelium (B).

Disclosure Statement

Appropriate written informed consent was obtained for publication of this case report and accompanying images.

Miyoshi, S , Sugimoto, E , Kawakami, M , Taguchi, Y , Hamaguchi, N , Yamaguchi, O . (2020) Endobronchial hamartoma coexisting with lung cancer. Respirology Case Reports, 8(7), e00643 10.1002/rcr2.643