Custom Search

Pathology of Chondroid Hamartoma      

Dr Sampurna Roy MD   



 
Pulmonary Pathology Online

http://www. histopathology-india.net/Pulmonary Pathology.htm 

Chondroid "hamartoma" (adenochondroma, mixed mesenchymoma).

Despite their most popular name (chondroid hamartoma), it is likely that these lesions are benign connective tissue neoplasms rather than tumour-like malformations.  

They are generally regarded as hamartomas because they consist of a disorganized proliferation of  various connective and epithelial tissues normally found in the lung.

However, their rarity in childhood and continued growth in adult life favour their interpretation as benign neoplastic lesion.

The term adenochondoma implies a benign mixed neoplasm but the role played by the epithelial components may also be questioned.

It is now appreciated that epithelial structures are commonly entrapped in many lung tumors, both primary and metastatic and is likely that this is how the epithelial clefts of the so-called adenochondroma or chondroid hamartoma should be regarded.  

A name that reflects a purely mesenchymal nature appears appropriate and, since these tumours display a variety of connective tissues, the term mixed mesenchymoma has been recommended.

These lesions are fairly common, constituting about 10% of all ‘coin’ lesions in chest radiographs.

The age range is wide but they are rare in children and the peak age incidence is the sixth decade.

Sequential radiographs show that most first develop in adult life and slowly increase in size thereafter.

Most are parenchymal and asymptomatic but about 8% are endobronchial and cause coughing,dyspnoea or haemoptysis.

There are no significant pathological differences between parenchymal and endobronchial growths.  

Most measure 1 to 3 cm in diameter but they range up to 9 cm.

They are sharply circumscribed but lack in capsule and shell out easily at operation, after which there is little risk of recurrence.

Most are lobulated and the predominant tissue is cartilage, which may calcify or undergo osseous change. 

Other connective tissues commonly found include fat, fibrous tissue and loose mesenchyme with a myxoid appearance.

These various components are usually present in combination. All are well differentiated and  show no feature of malignancy.

Intersecting the connective tissue lobules are clefts lined by ciliated pseudostratified columnar epithelium, which is quite normal cytologically.

The retention of cilia is notable as these are usually lost when such epithelium becomes neoplastic.

These tumours have no malignant potential.

Differential diagnosis:

The differential diagnosis includes metastatic testicular teratome from which the malignant elements have been ablated by chemotherapy.

If the proposed nature of chondroid hamartomas (mixed mesenchymomas) outlined above is accepted, they are obviously closely related to benign connective tissue neoplasms composed of a single tissue – lipomas , chondromas , and fibromas for example – none of which is common in the lungs.

Like the mixed mesenchymomas, all these neoplasms may either lie entirely within the lung substance or protrude into major bronchi.

Epithelial clefts are not found in single tissue benign mesenchymal tumours, which resemble in every way their counterparts that occur more commonly in other parts of the body.

Like chondroid hamartomas, they appear to have  no malignant potential.

In this context it should be noted that the rare primary pulmonary fibrosarcomas , liposarcomas , chondrosarcomas and osteosarcomas are believed to be sarcomatous from their onset.

Carney's Triad:

Carney’s triad is a rare combination of three unusual neoplasms that affects young women.

The patients are generally in the second or third decade, the youngest recorded being a girl aged 9 years.

The condition is not familial.

The three tumours are extra-adrenal paraganglioma (chemodectomas), gastric epithelioid leiomyosarcomas (Gastrointestinal Stromal Tumour) and pulmonary chondromas.

All are generally multiple and early recognition of the syndrome is important in view of the malignant potential of the gastric lesions and paragangliomas.

The chondromas have no malignant potential.

                        

Further reading:

Multifocal mesenchymal hamartoma of the chest wall.

Reactive alveolar epithelium in chondroid hamartoma of the lung.

Giant cystic chondroid hamartoma.

Rare tracheal chondroid hamartoma masquerading as asthma in a 14-year-old girl.

Pulmonary chondroid hamartoma with unusual presentation.

Fine needle aspiration biopsy of pulmonary hamartomas. Radiologic, cytologic and immunocytochemical study of 15 cases.

Pulmonary chondroid hamartoma presenting as an inflatable neck mass. Case report and clinicopathologic analysis.

Pulmonary hamartoma.

The aspiration cytology of pulmonary hamartomas.

Endobronchial hamartoma. Report of 7 cases.

Malignant change in a benign pulmonary hamartoma.

Mesenchymoma of the lung (so called hamartoma): a review of 154 parenchymal and endobronchial cases.

Benign endobronchial mesenchymal tumors: their relationship to parenchymal pulmonary hamartomas.

Multiple pulmonary chondromatous hamartomas.

The triad of gastric epithelioid leiomyosarcoma, functioning extra-adrenal paraganglioma, and pulmonary chondroma.

April 2015

 

Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)

 

submit to reddit

 

Histopathology-India.net

Dermpath-India

Dermato pathology Cases

Pathopedia-India.com

Surgical-Pathology.com

Pathology-India.com

Pancreatic Pathology Online

Gallbladder Pathology Online

Paediatric Pathology Online

Paraganglioma-Online

Endocrine Pathology Online

Eye Pathology Online

Ear Pathology Online

Cardiac Path Online

Lung Tumour-Online

Mesothelioma-Online

Pulmonary Pathology Online

Nutritional Pathology Online

Environmental Pathology Online

Pathology Quiz Online

GI Path Online

Soft Tissue Pathology

Case Index

Infectious  Disease Online

E-book - History of  Medicine with special reference to India

 

Anatomy and Histology of the Normal Lung and Airways

Examination of pulmonary and pleural biopsies

Useful  chromatic and immunostains in pulmonary pathology

Percutaneous Needle and Trucut Biopsy Specimen

Bronchial Biopsy Specimen

Transbronchial Biopsy Specimen

Transbronchial Biopsy in Lung Transplant Recipients

Examination  and Handling of Open Lung Biopsy Specimens

Lobectomy and Pneumonectomy Specimen

Histo pathological reporting of Pulmonary Parenchymal Biopsies

Histo pathological reporting of Pulmonary biopsies in cases of Idiopathic Pulmonary  Fibrosis

Closed pleural biopsy for neoplasm or inflammatory lesions 

Open pleural biopsy and pneumo nectomy or pleural  stripping

Anatomical Distribution of Pulmonary  Disease

Congenital Cystic Adenomatoid  Malformation

Broncho pulmonary Sequestration

Acute Respiratory Distress Syndrome

Neonatal Respiratory Distress Syndrome

Complications of Neonatal Respiratory Distress Syndrome

Sarcoidosis

Extrinsic Allergic Alveolitis (Hypersensitivity Pneumonitis)

Pathology of Eosinophilic Granuloma of the Lung

Pathological Diagnosis of Granulomatous Lung Diseases

Infectious Granuloma of the Lung

Influenza (Orthomyxo viruses)

Parainfluenza Virus Infection

Cytomegalo virus infection

Respiratory syncytial virus infection

Measles

Varicella

Chlamydial Infection

Q Fever (Coxiella burnetii)

Mycoplasma pneumonia

Pneumococcal Pneumonia (Lobar Pneumonia)

Broncho pneumonia

Klebsiella  pneumoniae

Haemophilus influenza Infection

Legionellosis (Legionnaires' Disease)

Staphylococcal Infection

Streptococcal Infection

Tuberculosis

Atypical Mycobacterial Infection

Mycobacterium Avium Intracellulare

Mycobacterium Kansasii Infection

Histoplasmosis (Histoplasma Capsulatum)

Coccidioido mycosis

Cryptococcus

Blastomycosis


   Disclaimer  ;  Privacy Policy  ; Advertising Policy  ;  E-mail 

           Copyright © 2015  histopathology-india.net
           All rights reserved