Hamartoma overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]
Overview
A hamartoma (from Greek hamartion “bodily defect”) is a focal malformation that resembles a neoplasm in the tissue of its origin. This is not a malignant tumor, and it grows at the same rate as the surrounding tissues. It is composed of tissue elements normally found at that site but that are growing in a disorganized fashion.[1]They occur in many different parts of the body and are most often asymptomatic and undetected unless seen on an image taken for another reason (incidentaloma). The most common hamartomas occur in the lungs. About 5–8% of all solitary lung nodules, about 75% of all benign lung tumors, are hamartomas. They almost always arise from connective tissue and are generally formed of cartilage, fat, and connective tissue cells, although they may include many other types of cells. [2]
Historical Perspective
Hamartomas were first described by a German pathologist, Eugen Albrecht in 1904.[3]
Classification
Hamartomas may be classified into subtypes based on their location, such as; lung (most common), heart, hypothalamus, kidneys, or spleen. Other classifications can consider lesion class, dividing hamartomas into 4 different categories, such as; Bone-forming, cartilage-forming, fiber-forming and benign non–matrix-forming.
Pathophysiology
Hamartomatous tissue arises from developmental malformations, which consists on replication of normal tissue cells. Some genetic studies have shown the presence of acquired translocations, suggesting a neoplastic origin.[4]
Causes
Hamartomas may be caused by an abnormal formation of normal tissue.[5][6]
Differential diagnosis
Hamartomas must be differentiated from other diseases that cause abnormal tissue growth and calcifications, such as sarcoidosis, calcified metastases, and PTEN hamartoma tumor syndrome.[7]
Epidemiology and Demographics
Risk Factors
There are no established risk factors for hamartomas.
Screening
Natural History, Complications and Prognosis
If left untreated, hamartomas normally grow slowly and may progress to develop a considerable size, however pulmonary hamartomas have low or no malignant potential. Nevertheless, it is essential to rule out the presence of cancer. Common complications of hamartomas will depend on the location and size. Prognosis is generally regraded as excellent.[8]
Diagnosis
Staging
There is no established system for the staging of hamartomas.
History and Symptoms
Physical examination
Laboratory tests
Chest X-ray
On Chest X-ray, lung hamartomas have a popcorn like appearance. [9]
CT
MRI
Ultrasound
There are no ultrasound findings associated with hamartoma.
Other Diagnostic Studies
Treatment
Medical therapy
Surgery
Primary Prevention
There is no established method for prevention of hamartomas.
Secondary Prevention
Secondary prevention strategies following hamartomas include periodical imaging surveillance with CT scan.[10]
References
- ↑ Mitchell, Richard; Kumar, Vinay; Fausto, Nelson; Abbas, Abul K.; Aster, Jon (2011). Pocket Companion to Robbins & Cotran Pathologic Basis of Disease (8th ed.). Elsevier Saunders. pp. 147. ISBN 978-1416054542.
- ↑ Zakharov V, Schinstine M (2008). "Hamartoma of the lung". Diagn. Cytopathol. 36 (5): 331–2. doi:10.1002/dc.20790. PMID 18418855.
- ↑ Ober WB (1978). "Selected items from the history of pathology: Eugen Albrecht, MD (1872-1908): hamartoma and choristoma". Am. J. Pathol. 91 (3): 606. PMC 2018308. PMID 350057.
- ↑ Kumar V, Abbas AK, Aster JC. Robbins Basic Pathology. Elsevier Health Sciences; 2012.
- ↑ Hamartomas. Wikipedia https://en.wikipedia.org/wiki/Hamartoma Accessed on December 08, 2015
- ↑ Mester J, Charis E. PTEN hamartoma tumor syndrome. Handb Clin Neurol. 2015;132:129-37.
- ↑ Brown K, Mund DF, Aberle DR, Batra P, Young DA (1994). "Intrathoracic calcifications: radiographic features and differential diagnoses". Radiographics. 14 (6): 1247–61. doi:10.1148/radiographics.14.6.7855339. PMID 7855339.
- ↑ Marchiori E, Souza AS, Franquet T, Müller NL (2005). "Diffuse high-attenuation pulmonary abnormalities: a pattern-oriented diagnostic approach on high-resolution CT". AJR Am J Roentgenol. 184 (1): 273–82. doi:10.2214/ajr.184.1.01840273. PMID 15615988.
- ↑ Hamartomas. Wikipedia https://en.wikipedia.org/wiki/Hamartoma Accessed on December 08, 2015
- ↑ Amini B, Huang SY, Tsai J, Benveniste MF, Robledo HH, Lee EY (2013). "Primary lung and large airway neoplasms in children: current imaging evaluation with multidetector computed tomography". Radiol. Clin. North Am. 51 (4): 637–57. doi:10.1016/j.rcl.2013.04.005. PMID 23830790.