Chest
Volume 122, Issue 1, July 2002, Pages 202-205
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Clinical Investigations
Airways
Endobronchial Hamartoma

https://doi.org/10.1378/chest.122.1.202Get rights and content

Objectives

To describe clinical, endoscopic, radiographic, and follow-up characteristics of a series of patients in whom endobronchial hamartoma (EH) had been diagnosed.

Methods

Retrospective study of all cases of hamartoma diagnosed by bronchial biopsy between 1974 and 1997 in a tertiary referral hospital in Madrid, Spain.

Results

EH was diagnosed 47 patients during the study period. Four patients were excluded from the study because no clinical history was available. We analyzed the cases of 43 patients (37 men and 6 women), with a mean (± SD) age of 62 ± 12 years. Seven patients had a concurrent lung neoplasm, and the EH was an incidental endoscopic finding. Among the other 36 patients, 31 had a new onset of respiratory symptoms, most commonly, recurrent respiratory infections in 16 patients (44%) and hemoptysis in a further 12 patients (33.4%). Chest radiograph findings were abnormal in 38 of 43 patients. At bronchoscopy, the lesions were equally distributed throughout the right and left lungs with no clear lobar predilection. Endobronchial obstruction was evident in 26 patients (72.2%) without concurrent neoplasm, 17 of whom underwent resection with a rigid bronchoscope and laser, with total resolution in 13 patients. Partial resolution was achieved in four patients, two of whom needed a second endoscopic procedure. Five patients were treated with open lung surgery. Clinical and endoscopic follow-up was performed in 23 patients at 1 to 73 months (mean, 17 months), and recurrence was found in 4 patients.

Conclusion

EH frequently produces respiratory complaints and radiographic abnormalities. Patients with endobronchial obstructions had satisfactory responses to endoscopic therapy.

Section snippets

Materials and Methods

The Bronchoscopy Unit of the 12 de Octubre Hospital, a tertiary hospital with 1,800 beds, performed about 31,000 bronchoscopy procedures between 1974 and 1997. Since 1980, this hospital has served as a referral center for endoscopic therapy of endobronchial lesions by rigid bronchoscope and laser therapy.

In this study, we retrospectively analyzed the cases of all patients with bronchial biopsy-proven EH during a period of 23 years. The Bronchoscopy Unit database was analyzed in order to

Results

During the study period, 47 EHs were diagnosed in the Hospital 12 de Octubre. Four patients were excluded because their clinical histories were not available. Forty-three patients were studied (37 men and 6 women), with a mean (± SD) age of 62 ± 12 years (range, 29 to 81 years). Only nine patients were asymptomatic at the time of diagnosis. On presentation, the most frequent clinical symptoms were recurrent respiratory infections or obstructive pneumonia in 16 patients (37%) and hemoptysis in

Discussion

The endobronchial location of the benign hamartoma is a rare occurrence. In a 1950 study of lung carcinoma, bronchial adenoma, and lung hamartoma, Le Roux11 found 3,000 patients with lung carcinomas, 40 with bronchial adenomas, and 27 with lung hamartomas, of which only 8% were EHs. In the largest published series of pulmonary hamartomas, Gjevre et al7 analyzed 215 cases of hamartoma, of which only 1.4% were located endobronchially; the authors concluded that the hamartoma was a benign neoplasm

ACKNOWLEDGMENT

The authors gratefully acknowledge Dr. Robert Stirling for his help in editing this manuscript.

References (13)

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Presented at the European Respiratory Society Congress in Madrid, October 1999.

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