PMC5587872_01
A: Dense calcified mass (arrow) overlying the left hilum associated with linear atelectasis extending laterally from the hilum and hyperinflation of the left upper lobe consistent with partial airway obstruction and peripheral air trapping. B: Chest X-ray Lateral View: Partial left upper lobe collapse and hilar calcifications. C: CT Chest Coronal View Without Contrast: Densely Calcified rounded mass causing LUL Bronchus narrowing and Calcified left hilar lymph nodes. D: CT Chest Axial View with contrast: Irregular Lobulated Calcified mass in LUL Bronchus causing plate like atelectasis with bilateral calcified hilar lymph nodes. E: CT Chest without contrast Axial View: Plate like LUL Partial Atelectasis due to LUL Bronchus narrowing. F: Caclified Lymphnodes in the Left Supra-hilar region. G: LUL Bronchus narrowing from a calcified endobronchial mass with surrounding non-calcified tissue. H: CT Chest Coronal View: Classic appearance of "popcorn calcification" in the left supra hilar region.
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The results of the chest X-ray showed previously known healed calcified lymph nodes most prominent in the left hilar region and development of a new long linear density which was about 5mm thick arising from left hilar region superiorly and extending laterally, when compared with the old roentgenograms. (Fig. 1A-B). Chest CT done subsequent to the chest X-ray showed a densely calcified nodule in the left perihilar region, narrowing of the left upper lobe (LUL) bronchus with plate like atelectasis of the LUL (Fig. 1C-H).
A: LUL Endobronchial Mass with smooth surface and inferolateral calcification. B: The anterior segment of the left upper lobe completely obstructed with scaring tissue and protrusion of the mass.
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There was evidence of calcification in the inferior and lateral aspect of the mass (Fig. 2A-B).
A: Benign lobulated mature cartilage () covered by respiratory epithelium () (H&E biopsy specimen x2). B: The benign Hyaline cartilage is hypercellular with slightly irregular surface (x10). C: Inflammatory polyp () and osseous metaplasia of peribronchial cartilage () and adjacent fat () (H&E resection specimen x2). D: Disordered mass forming proliferation of mature cartilage, fibrovascular connective tissue, benign adipose tissue and slit like entrapped respiratory epithelium, consistent with Hamartoma. (H&E resection specimen x2).
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An ill-defined mass was seen close to the hilum, consisting of, multiple islands of benign cartilage, slit like bronchial epithelium and adipose tissue in a disorganized manner suggestive of pulmonary hamartoma. (Fig. 3A-D).