Endobronchial hamartoma

Giant

endobronchial hamartoma resected by fiberoptic bronchoscopy electrosurgical snaring. CT scan demonstrating a vegetating neoplasm of the left main bronchus (white arrow) without signs of extrabronchial infiltration.

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A bronchial hamartoma falls under the same spectrum of pathology as a pulmonary hamartoma (except for their location), but a hamartoma in a bronchial location is less common than a peripheral pulmonary location. Bronchial hamartoma accounts for only around 1.4-10% of all intrathoracic hamartomas.

Epidemiology

The mean age of patients at presentation ranges between the 6 to 7decades. There may be a slight male predominance.

Pathology

As with other hamartomas, bronchial hamartomas are comprised of mature cartilage and fat elements, as well as muscle and bone elements also present in some cases.

Variants

endobronchial lipomatous hamartoma

Radiographic features

CT

Bronchial hamartomas typically contain fat (HU of -40 to -120), calcification (HU of >200), or a combination of both.

There may be associated distal lung collapse or airway dilatation.

Treatment and prognosis

Although bronchial hamartomas are benign they can be associated with bronchial obstruction and bleeding in some cases. Endoscopic treatment with rigid bronchoscopy and lasers provides an excellent outcome and can be offered in patients with lesions causing obstruction.