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Chondromatous Hamartoma of the Lung

1950; BMJ; Volume: 5; Issue: 4 Linguagem: Inglês

10.1136/thx.5.4.283

1468-3296

C. J. Carlsen, William Kiær,

Medical Imaging and Pathology Studies

Chondromatous hamartoma of the lung is a pulmonary "tumour" which, as a result of the progress made in thoracic surgery during the last decade, is now being reported as not particularly uncommon.Since a lack of familiarity with this tumour may give rise to clinical as well as to pathological errors, it seems justified to describe it in some detail.At the same time we will report our experience based on nine cases.The term hamartoma (&uocp'r&uet =to fail or to err) was first used in 1904 by the German pathologist Albrecht, who defined it as a tumour-like malformation of an organ, made up of the normal elements of that organ, but with abnormal mixing and quantity of the components and perhaps an abnormal degree of differentiation.The hamartomata originally described by Albrecht were cavernomata of the liver, cavernomata of the spleen, and tuberous fibromata of the medullary substance of the kidney.Goldsworthy (1934) andJaeger (1934) were the first to realize that the previously reported " chondromata " of the lung were not pure chondromata, but that they should be classified as hamartomas.The word " chondromatous" designated that cartilage was the dominant element.The first reports of hamartomata of the lung were published in 1845 and 1847, when Lebert and Bleu described one typical case each.Both called them primary chondromata, but they realized that the growths did not look like typical chondro- mata.All the subsequently reported primary " chondromata " of the lung parenchyma-for which we have been able to procure the original reports with adequate histological descriptions-have proved to be hamartomata.Cornil and Ranvier (1884) denied the existence of ordinary chondromata in the lung parenchyma, but an exception is that reported by Edling (1938), who has kindly lent us his preparations.In this instance none of the sections showed changes suggesting chondromatous hamartoma with certainty, and the histological appearance does not differ from that of a chondroma.More than 100 hamartomata of the lung have been reported so far, and all show a typical histological picture with slight variations which correspond to the findings in our nine cases.Hamartoma may occur anywhere in the lung; in the hilus (sometimes in relation to the large bronchi); in peripheral or subpleural situations, being sometimes attached to the pleura by a pedicle (Matras, 1929;Jaeger, 1934).They may in rare cases be encountered in the form of endobronchial polypi, but in this site they are not as common as true chondromata.The size may vary within wide limits, from that of a hemp-seed (McDonald, Harrington, and Clagett, 1945) to a mass occupying the entire pleural cavity (Busse, 4 Publication has been delayed because of our difficulty in importing radiographs from abroad.-ED.