肺過誤腫の1例

A case of pulmonary hamartoma which is considered as one of the rare disease is reported with review of literatures. This case is 59 year-old house wife, who was first pointed out abnormal shadow on chest roentgenogram in 1952. Because lack of symptoms, she had no treatment until February 1966, when she began to feel obstruction of the right lung in deep inspiration. She was hospitalized to our ward.<br>On admission, chest roentgenogram revealed clear solid density, almost circle and 5cm in diameter, at the upper part of right lung. On laminogram this was best seen at the 9cm from back. There were no calcified or translucent areas in this density. Roentgenogram taken in September 1962, showed the same density, 4.2cm in diameter. This density slowly enlarged in the past 3 years.<br>Right upper lobectomy was performed with the diagnosis of benign tumor. Tumor was found posterior segment of right upper lobe, this tumor enlarged towards the right middle lobe. Tumor was easily separated from the lung tissue. The size was measured, 4.8×4.8×5.0cm, the surface was not smooth, and dark red. The consistency was relatively soft and elastic. Cut surface irregularly mixed with dark red and thin reddish white areas. Histological examination revealed the structure resembled to the hemangioma, with increased vascular tissues covered by the flat endothelium and between them there were moderately increased connective tissue. The other part of the specimen, showed glandular structure of cubic epithelium with ciliary fiber, and structure of chondrial cells.<br>Reviewing the literatures of pulmonary hamartoma, this is usually found after middle ages, which is at the same time, considered as cancer-age. Most of the soliary circle densities on chest rentogenogram were cancer and tubeaculoma. It is fairly difficult to diagnosis as benign tumor only by chest X-ray film. Hamartoma itself may become malignant. These facts tell us, if solitary circle density is found on chest roentgenogram, it is wise to undergo openchest surgery in the early occasion.