Case Study: Solitary Pulmonary Hamartoma with Complications in a 14-year-old Girl

Summary

Pulmonary hamartomas are rare, benign lesions of the lung and may be multiple in number. Recently, a 14-year-old girl presented with clinical symptoms of tuberculosis, and after transthoracic biopsy, the diagnosis was confirmed as a solitary hamartoma of the right lung, complicated by recurrent interstitial infections. However, a surgical resection was done, and the patient is now free of symptoms.

Background

Pulmonary hamartomas are uncommon benign lesions of the lung and comprise nearly 8% of all lung tumors. They are usually incidental, small-sized, solitary, peripherally located, asymptomatic lesions that are incidentally detected on a chest X-ray or CT scan, or at autopsy. Occasionally, they may be very big in size and may clinically mimic thymoma, tuberculosis, congenital malformations or malignancy. Recently, a 14-year-old girl presented with clinical symptoms of tuberculosis, and the final diagnosis was found to be a large chondroid hamartoma. We learnt a lot from the case.

Case Presentation

A 14-year-old girl presented with recurrent productive and irritative coughs for the last year. Occasional hemoptysis and intermittent low-grade fever was present. She had features of malnutrition. On clinical examination, basal crypts were present in the lower right lung, anterior aspect. S1/S2 normal. BP: 110/66 mm Hg. Pulse rate: 86/min. Respiratory rate: 26/min. Dullness was present over the right lung, mid to lower zone. Bilateral cervical lymph nodes were enlarged, discrete, hard and multiple, up to 1.5 cm in diameter.

Investigations

Routine hemogram revealed neutrophilic leukocytosis, high ESR, moderate hypochromic microcytic anemia and thrombocytosis. Sputum for AFB was negative. IgE level was ...

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