PMC4276084_01
CXR shows a poorly demarcated opacity in the right upper lobe (red arrow) with a normal aspect of the pulmonary hilum (white arrow).
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Non contrast CT shows the presence of a well demarcated endobronchial (right main bronchus) mass characterized by smooth margins and negative density (-89 HU).
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MD-CT scan of the chest was performed and revealed a beginning middle lobe pneumonia and presence of a mass within the bronchus intermedius consisting mostly of fat with minimal inclusions of soft tissue density (Fig. 2). Multiplanar reconstruction with axis parallel to the bronchus clearly showed that the lesion determined subtotal obstruction of the bronchus intermedius (Fig. 3).
Oblique multiplanar CT reconstruction (lung window) shows entirely the mass within the right main bronchus lumen just before the bifurcation of the anterior segmental bronchus of the upper lobe and posterior segmental bronchus of the upper lobe.
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MD-CT scan of the chest was performed and revealed a beginning middle lobe pneumonia and presence of a mass within the bronchus intermedius consisting mostly of fat with minimal inclusions of soft tissue density (Fig. 2). Multiplanar reconstruction with axis parallel to the bronchus clearly showed that the lesion determined subtotal obstruction of the bronchus intermedius (Fig. 3).
Non contrast CT axial section (pulmonary window) shows the endobronchial mass (red arrow) that obstructs the right main bronchus.
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The bronchial wall was very uneven and seemed to have a continuous solution on the outside, making its content not separable from the lesion (Fig. 4).
3D reconstruction (virtual bronchoscopy) at the carina level shows a smooth mass that obstructs the right main bronchus lumen.
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Virtual-bronchoscopy reconstruction from the non-enhanced CT scan displayed the mass within the bronchus intermedius (Fig. 5).
Macroscopic section of the lesion. Courtesy of Prof. Giorgio Cavallesco, Department of General and Thoracic Surgery, "S. Anna" Universitary Hospital, Ferrara, Italy.
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The macroscopic and microscopic sections of the lesion are shown in Figs. 6 and 7 respectively.
Microscopic section. Pulmonary hamartoma composed largely of fat: this unusual variant of hamartoma consists of mixture of fibromyxoid stroma and fat, without evidence of cartilagine. Seromucous glands and epithelial component, apparently derives from entrapped respiratory epithelium, are present into the hamartomatous mass (magnification 10x, EE). Courtesy of Rosa Rinaldi M.D., Department of Laboratory Medicine, Operative Unit of Anatomy-Pathology, Sant'Anna University Hospital of Ferrara, Ferrara, Italy.
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The macroscopic and microscopic sections of the lesion are shown in Figs. 6 and 7 respectively.