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Pulmonary Hamartoma Mimicking Pulmonary Tuberculoma: An Unusual Presentation in a Patient With Positive IGRA Test
March 2014, Vol 145, No. 3_MeetingAbstracts Chest Infections | March 2014
Pulmonary Hamartoma Mimicking Pulmonary Tuberculoma: An Unusual Presentation in a Patient With Positive IGRA Test Georgios Athanasiou, MS; Ioan Arghir, MS; Valerios Kortzis, MS; Paraschiva Postolache, PhD; Oana Arghir, PhD Faculty of Medicine Ovidius University, Constanta, Romania
Chest. 2014;145(3_MeetingAbstracts):88A. doi:10.1378/chest.1825039
Abstract SESSION TITLE: Tuberculosis Case Report Posters SESSION TYPE: Case Report Poster PRESENTED ON: Sunday, March 23, 2014 at 01:15 PM - 02:15 PM INTRODUCTION: To reveal the risk of pulmonary hamartoma mimicking pulmonary tuberculoma. To explore the varied and unusual, clinical and radiological pattern of pulmonary hamartoma. CASE PRESENTATION: We report an unusual presentation of a stable solitary pulmonary nodule (SPN) in the lingula of a 63 yr-old white female patient, for 13 years. Suddenly, in the 14th year of evolution, she was admitted in our hospital for recurent hemoptysis and positive result of QuantiFERON TB Gold testing. CT scan reveals SPN with central lose substance and eccentric calcification area, mimicking pulmonary tuberculoma. She was subsequently treated for pulmonary tuberculosis. After 2 months of therapy, the nodule doubled initial volume and surgical intervention was recommended. Histopathologic exam confirmed lung hamartoma.The case survived. DISCUSSION: Lung hamartomas are more common in men than in women, and grow slowly over time, doubling in size about ever 4.2 years, according to the National Institute of Health.(1)
Hamartoma, as benign tumors of the lung, may present additional diagnostic difficulties in endemic area of tuberculosis.Tuberculoma, if not diagnosed and treated early, could cause significant extensive tuberculosis lung disease, while hamartoma could cause lung cancer.(2) The histology of the parenchymal mass 45 mm in size reveals the predominance of adipose and leiomyomatous differentiation and only one eccentric calcification caused by chondroid differentiation. CONCLUSIONS: The rapidly growing in size of the tumour, positive IGRA and the fatty histologic pattern make it an unusual presentation. Reference #1: http://www.ehow.com/about_5548404_symptoms-hamartoma.html Reference #2: Ribet CM, Jaillard-Thery S, Nuttens MC: Pulmonary hamartoma and malignancy. J Thorac Cardiovasc Surg 1994, 107(2):611-4. DISCLOSURE: The following authors have nothing to disclose: Georgios Athanasiou, Ioan Arghir, Valerios Kortzis, Paraschiva Postolache, Oana Arghir No Product/Research Disclosure Information
Pulmonary Hamartoma Mimicking Pulmonary Tuberculoma: An Unusual Presentation in a Patient With Positive IGRA Test Georgios Athanasiou, MS; Ioan Arghir, MS; Valerios Kortzis, MS; Paraschiva Postolache, PhD; Oana Arghir, PhD Faculty of Medicine Ovidius University, Constanta, Romania
Chest. 2014;145(3_MeetingAbstracts):88A. doi:10.1378/chest.1825039
Abstract SESSION TITLE: Tuberculosis Case Report Posters SESSION TYPE: Case Report Poster PRESENTED ON: Sunday, March 23, 2014 at 01:15 PM - 02:15 PM INTRODUCTION: To reveal the risk of pulmonary hamartoma mimicking pulmonary tuberculoma. To explore the varied and unusual, clinical and radiological pattern of pulmonary hamartoma. CASE PRESENTATION: We report an unusual presentation of a stable solitary pulmonary nodule (SPN) in the lingula of a 63 yr-old white female patient, for 13 years. Suddenly, in the 14th year of evolution, she was admitted in our hospital for recurent hemoptysis and positive result of QuantiFERON TB Gold testing. CT scan reveals SPN with central lose substance and eccentric calcification area, mimicking pulmonary tuberculoma. She was subsequently treated for pulmonary tuberculosis. After 2 months of therapy, the nodule doubled initial volume and surgical intervention was recommended. Histopathologic exam confirmed lung hamartoma.The case survived. DISCUSSION: Lung hamartomas are more common in men than in women, and grow slowly over time, doubling in size about ever 4.2 years, according to the National Institute of Health.(1)
Hamartoma, as benign tumors of the lung, may present additional diagnostic difficulties in endemic area of tuberculosis.Tuberculoma, if not diagnosed and treated early, could cause significant extensive tuberculosis lung disease, while hamartoma could cause lung cancer.(2) The histology of the parenchymal mass 45 mm in size reveals the predominance of adipose and leiomyomatous differentiation and only one eccentric calcification caused by chondroid differentiation. CONCLUSIONS: The rapidly growing in size of the tumour, positive IGRA and the fatty histologic pattern make it an unusual presentation. Reference #1: http://www.ehow.com/about_5548404_symptoms-hamartoma.html Reference #2: Ribet CM, Jaillard-Thery S, Nuttens MC: Pulmonary hamartoma and malignancy. J Thorac Cardiovasc Surg 1994, 107(2):611-4. DISCLOSURE: The following authors have nothing to disclose: Georgios Athanasiou, Ioan Arghir, Valerios Kortzis, Paraschiva Postolache, Oana Arghir No Product/Research Disclosure Information