Case:29 years old female
Chief complaints: abnormal shadow on chest roentgenogram.
Present illness:She was indicated to have abnormal shadow
on chest roentgenogram on the routine health check up exam.
in the early October,1992. She visited for the further exami-
nation for the shadow in chest roentgenogram.
Her phyisical examination revealed normal breathing sounds
and no rales audible. She does not smoke cigarette.
Her chest X-ray revealed abnormal shadow on
left middle lung field. Erythrocyte sedimentation rate
was 4mm/1hour,12 mm/2hours. WBC was 6,400/mm3
CRP was 0.1 mg/dl.
Chest CT showed nodular shadow in left lung
with notch sign and without spiculation.

Chest CT and high resolution CT

Clinical course:
She was examined by bronchoscopy for the abnormal lung shadow,
but no specific result was obtained. Her high resolution CT sugge-
ste benign tumor and she refused to receive the surgery for the
lung tumor, because considering the benign nature of her lung
tumor. Since then four years has passed and she was re-examinded
by chest roentgenogram and chest CT on this August 1996.

Chest roentgenogam of August 1996
Chest CT and high resolution CT on August 8.1996

The tumor size on her chest roentgenogram showed slight increase
of its size.

Comment:
Her chest roentgenogram and CT was diagnosed as lung hamartoma.
Hamartomas typically are well-defined, solitary nodular without
lobular predilection. The majority are smaller than 4 cm in diame-
ter . Although some occasionally grow to a very large size.
Some studies habe reported an incidence of calcification as high
as 25 to 30 percent. Serial film may reveal slow or exceptiona-
lly rapid growth of these lesions.
Now she refuses to have thoracotomy because of considering her
benign lung lesion. However some reports describe the malignant
changes of lung hamartoma on occasion. How long could we observe
her lesion without lung surgery?

If you have any suggestions or comment, please send your
message here.
chijima@ymg.urban.or.jp

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