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Vol. 58. Issue 4.
Pages 363 (April 2022)
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Vol. 58. Issue 4.
Pages 363 (April 2022)
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A Pulmonary Inflammatory Chondroid Hamartoma With So-called Placental Transmogrification Feature in a Pleural Location. Pathogenic Considerations About This Unusual Disorder
Hamartoma condroide inflamatorio con transmogrificación placentaria de localización pleural. Consideraciones patogénicas sobre esta inusual enfermedad
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Jesús Machuca Aguadoa, Inmaculada Sabariego-Arenasb, Miguel A. Idoatea,
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midoate@us.es

Corresponding author.
a Pathology, Virgen Macarena University Hospital and School of Medicine, University of Seville, Seville, Spain
b Thoracic Surgery Departments, Virgen Macarena University Hospital and School of Medicine, University of Seville, Seville, Spain
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A 53-year-old male patient was examined following incidental observation of an unsuspected mass on a chest X-ray. Computed tomography scan and videothoracoscopy revealed a solid pleural mass. A subsequent bone scan demonstrated multifocal radiotracer uptake within coarse intratumoral calcifications. Histopathological examination showed a benign mesenchymal proliferation with abundant long, fine projections consisting of mature cartilaginous nodules, mature fat and a dense lymphoplasmacytic infiltrate with lymphoid aggregates. The tumor was lined by an epithelial monolayer staining positive for cytokeratin and TTF-1, but not for calretinin, WT1 or podoplanin, thus indicating respiratory epithelium rather than mesothelium (Fig. 1). The tumor was labeled as pleural inflammatory chondroid hamartoma. Inflammation, a significant finding here, has not hitherto been reported in conjunction with hamartoma 1. The characteristic projections that we have described were previously reported with the odd term of placental transmogrification because its similarity with the chorionic villi 2. We postulate that this pseudo-villus appearance is a consequence of the combination of the metaplastic transformation of the mesenchymal tissue and the respiratory epithelial hyperplasia, all this due to a chronic inflammation. There was no evidence of any immune disorder, and the reason for this inflammatory infiltrate remains uncertain.

Fig. 1.

(A) Videothoracoscopic removal of pleuropulmonary tumor from anterior segment of left upper lobe. (B) The tumor displayed long villus-like papillae completely lined by epithelium. Note prominent cartilaginous stromal component H&E, 4×. (C) Dense lymphoplasmacytic infiltrate surrounding and intermingling with cartilaginous stroma. H&E, 20×. (D) Immunostaining for TTF-1 confirmed that villi were lined by respiratory epithelium. Immunohistochemistry, 40×.

(0.28MB).
Conflict of interest

Miguel A. Idoate serves as a consultant of Pathology Department of University Hospital Virgen Macarena and has no conflict of interest.

Inmaculada Sabariego-Arenas serves as a consultant of Thoracic Surgery Department of University Hospital Virgen Macarena and has no conflict of interest.

Jesús Machuca-Aguado serves as a consultant of Pathology Department of University Hospital Virgen Macarena and has no conflict of interest.

References
[1]
U.S. Salminen.
Pulmonary hamartoma: a clinical study of 77 cases in a 21-year period and review of literature.
Eur J Cardiothorac Surg, 4 (1990), pp. 15-18
[2]
R. Xu, M. Murray, J. Jagirdar, Y. Delgado, J. Melamad.
Placental transmogrification of the lung is a histologic pattern frequently associated with pulmonary fibrochondromatous hamartoma.
Arch Pathol Lab Med, 126 (2002), pp. 562-566
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Archivos de Bronconeumología

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