Pulmonary hamartoma
Introduction
Introduction to pulmonary hamartoma Pulmonary hamartoma refers to a tumor-like malformation formed by the inclusion of all normal tissue components of the lung, but with abnormal components, abnormal alignment or abnormal degree of differentiation. Pulmonary hamartoma is not a true tumor (some researchers claim that it is a true tumor), but the dysplasia of the embryo leaves, originating from normal tissues in the lungs, mainly tumor-like lesions formed by cartilage, fibrous connective tissue and adipose tissue. Because of its nature and imaging characteristics, it is classified as a benign tumor. basic knowledge The proportion of illness: 0.004%-0.008% Susceptible people: more common in 40-year-old males Mode of infection: non-infectious Complications: pneumonia, atelectasis, bronchiectasis
Cause
Cause of pulmonary hamartoma
The source and pathogenesis of pulmonary hamartoma is not well understood. It is relatively easy to accept the hypothesis that a hamartoma is a piece of tissue of the bronchi that reverses and falls off during embryonic development and is surrounded by normal lung tissue. This part of the tissue grows slowly. It may also not grow in a certain period of time, and gradually develops to form a tumor in the future. The fact that most hamartomas occur after the age of 40 supports this hypothesis.
Prevention
Pulmonary hamartoma prevention
Although the disease is not very clear from the etiology, there is no effective preventive measure. At present, more attention should be paid to the careful choice of surgical methods. For patients who need surgery, try to preserve normal lung tissue and avoid excessive surgery. This has also become the principle of surgical treatment of such patients in recent years.
Complication
Pulmonary hamartoma complications Complications pneumonitis atelectasis bronchiectasis
The complications of this disease are rarely reported. For patients who need surgery, careful selection of surgical methods, preservation of normal lung tissue as much as possible, and prevention of excessive resection can also prevent intraoperative and postoperative complications. The occurrence of the disease, but if the tumor is large, the heart of the blood vessels, the lung tissue has compression symptoms, resulting in thoracic deformity, may also cause pneumonia, atelectasis, bronchiectasis and other complications, which make the condition worse or complicated Therefore, surgery should be performed as soon as clinical and X-ray can not rule out malignant tumors.
Symptom
Symptoms of pulmonary hamartoma Common symptoms Shortness of calcification, chest pain, bloody wheezing, bronchoconstriction
The hamartoma is generally a substantially dense sphere, oval, or lobulated or nodular, with most diameters falling below 3 cm. The age of the hamartoma is mostly over 40 years old, and more men than women. The vast majority of hamartomas (about 80% or more) grow in the peripheral part of the lungs, close to the visceral pleura of the lungs, sometimes protruding from the surface of the lungs, so there is generally no symptom in the clinic, and there is no positive sign in the examination. Cough, chest pain, fever, shortness of breath, blood stasis, and even hemoptysis can occur only when the hamartoma develops to a certain size enough to stimulate the bronchi or compress the bronchi to cause bronchial stenosis or obstruction. Such as wheezing or tubular breath sounds.
Examine
Pulmonary hamartoma
1, X-ray inspection
X-rays show uniform and dense shadows, uneven shadows, calcification, calcification, popcorn-like patterns, relatively low density at the periphery, may be adipose tissue, and popcorn signs are pulmonary hamartomas. The characteristic performance, but rare and not unique to pulmonary hamartoma, chest X-ray can detect the presence of SPN, size, with or without satellite foci, found obvious popcorn-like calcification, easy to observe the dynamics of the lesion, fiber The hamartoma has no calcification, and the fat density is difficult to judge in traditional X-ray films, often misdiagnosed.
2, CT examination
1 The lesion has a smooth edge, mostly round or round, with no burr sign, and may have a lobulation sign.
2 lesions are less than 5cm.
3 The mass is mostly a soft tissue density mass, which has a fat density area, which is a typical CT manifestation.
4 The calcification in the lesion is spotted or patchy, and the typical calcification is popcorn-like.
5 lumps are mostly located in the lungs, a few can be close to the hilar, or in the tracheal cavity, no enlarged lymph nodes in the hilar and mediastinum.
6 After the enhancement, the mass is not strengthened or only slightly strengthened.
Diagnosis
Diagnosis and diagnosis of pulmonary hamartoma
One. History, symptoms:
More common in adults, generally asymptomatic. The tumor is large, and it may have irritating cough, sputum, dyspnea caused by airway obstruction, obstructive pneumonia and other symptoms when growing in or near the bronchi. Occasionally hemoptysis and purpura.
two. Physical examination found:
More no positive signs, or limited breathing sounds and wheezing. When there is an inflammatory infection or obstructive atelectasis, the corresponding lung signs appear.
three. Auxiliary inspection:
(1) X-ray chest examination is the main method. The chest radiographs vary in size. The single circle or elliptical edge has smooth shadows and may have lobes. Sometimes the calcification or low density shadow is visible in the tumor.
(B) CT chest scan is more helpful for diagnosis.
(C) through the chest wall lung biopsy to help the diagnosis of peripheral tumors of the lung.
