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Pathology · Neoplasia: pulmonary hamartoma
Sample itemA 50-year-old asymptomatic man has a 2 cm well-circumscribed solitary pulmonary nodule with popcorn calcification on chest imaging. The resected nodule consists of disorganised mature cartilage, fat and clefts lined by respiratory epithelium. What is the diagnosis?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Pulmonary hamartoma
Pulmonary hamartoma is the commonest benign lung tumour and presents as a coin lesion. It is made of disorganised normal tissues native to the lung, mainly cartilage, with fat and entrapped clefts of epithelium. Popcorn calcification on imaging favours it over malignancy.
Option by option
A. Pulmonary hamartoma (correct)
Correct. A mixture of mature cartilage, fat and epithelial clefts is the pattern of a hamartoma.
B. Tuberculoma
A tuberculoma shows caseating granulomatous necrosis rather than mature cartilage.
C. Bronchial carcinoid
Bronchial carcinoid shows nests of uniform neuroendocrine cells and is usually central and vascular.
D. Metastatic osteosarcoma
Metastatic osteosarcoma shows malignant spindle cells producing osteoid and not benign cartilage with fat.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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