PubMed · 13525984
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R M CARES. 1958. The tuberous sclerosis complex.. https://doi.org/10.1097/00005072-195804000-00007
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A pulmonary nodule was incidentally detected in a 50-year-old man during a routine health evaluation. High-resolution computed tomography (HRCT) showed that the lesion had the appearance of a collection of multiple tiny nodules. Histologic examination of the resected specimen revealed a single hamartoma resembling a bunch of grapes. Pulmonary alveoli and bronchioles were entrapped within the hamartoma with tumor buds appearing in a multicentric manner, thereby producing the unusual HRCT findings. Review of chest radiographs taken over the previous 20 years indicated that the tumor doubling time was 4968 days.
Mesenchymal hamartoma of the liver is generally considered to be benign in nature, and surgical excision has been the treatment of choice. There have been 3 reports on the association of cytogenetic abnormalities with this tumor, and the possibility of malignant potential has been raised. The authors report a fourth case with a previously unreported complex chromosomal translocation between chromosomes 11, 17, and 19 at bands q12, p11, and q13.3, respectively in all cells examined and discuss the significance of this finding.
We document an uncommon variant of pulmonary hamartoma (PH), discovered in the left upper lobe of a 60-year-old man after an episode of pneumothorax, a unique clinical presentation for such an occurrence. The tumour showed a prominent leaf-like pattern and was mainly composed of mature fat with adipocytes of different size and scattered throughout lipoblasts and floret-like cells. A lobectomy was performed and more than 7 years after surgery the patient's course is still uneventful. This case represents an exceedingly rare example of an histologically malignant change in PH and bears a close clinicopathologic resemblance to atypical lipomatous tumours of soft tissues.