Endobronchial Hamartoma Presenting as Recurrent Pneumonia and Chronic Cough.

Mihir Odak,Abbas Alshami,Ghadier Alsaoudi,Mohammed Alazzawi,James Cosentino

doi:10.7759/cureus.13717

Abstract

Pneumonia is an infection of the lungs that can result from various etiologies, including bronchial obstruction. It is estimated that 5.4% of community-acquired pneumonia occurs as a result of an endobronchial obstruction, classifying them as post-obstructive pneumonia. Pulmonary hamartomas are benign and exceedingly rare tumors. These hamartomas are usually asymptomatic and found incidentally on imaging, however, they can cause patients to develop post-obstructive pneumonia.We present a 40-year-old female with cough, fatigue, and recurrent right lower lobe pneumonia. Upon workup with bronchoscopy and biopsy, she was subsequently found to have an endobronchial hamartoma resulting in recurrent pneumonia in the same location. We are happy to report that the patient had a resection of the mass, as well as of the affected lung lobe, and has been pneumonia-free for five months. We hope to encourage a greater index of suspicion for endobronchial masses, including rare tumors, when a patient presents with recurrent pneumonia in the same location.

Highlights

Hamartomas are benign tumors that are characterized by an uneven mixture of connective tissue, cartilage, muscle, fibrous tissue, and adipose tissue [1]
We present a 40-year-old female with cough, fatigue, and recurrent right lower lobe pneumonia
We present a case of endobronchial hamartoma that presented as recurrent pneumonia

Summary

Introduction

Hamartomas are benign tumors that are characterized by an uneven mixture of connective tissue, cartilage, muscle, fibrous tissue, and adipose tissue [1]. The patient reported pleuritic chest pain localized to the right lower chest but denied shortness of breath, fever, chills, weight changes, nausea, symptoms of acid reflux, or difficulty swallowing. She had three right lower lobe pneumonias during the last eight months, with the most recent occurrence being in the previous six weeks when she was treated with cefuroxime and prednisone as an outpatient. Fine needle biopsy revealed a nodular aggregate of bland appearing chondroid tissue with a lobulated contour, without significant cellular pleomorphism, binucleation, or mitotic activity This confirmed a final diagnosis of an RLL endobronchial hamartoma. At her five-month follow-up appointment, she reported no further symptoms

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Disclosures