Pulmonary nodules are commonly encountered in pulmonary practice. Etiologies could include infectious, inflammatory, and malignant. Placental transmogrification of the lung is an extremely rare etiology of pulmonary nodules. Such condition often presents as unilateral lesions in asymptomatic men. In general, such nodules are generally stable and grow extremely slowly. We highlight an unusual case of placental transmogrification of the lung (PLC) identified in a young female. The patient\'s bilateral nodules were larger than what has been previously cited in the literature and exhibited growth over an 8-year follow-up period.

OBJECTIVE: Pulmonary placental transmogrification (PT) is a benign lesion curable by resection, represented by an unusual peculiar morphological variation including placentoid bullous change in the pulmonary hamartoma. In this retrospective study, we aimed to examine the histopathological features of pulmonary hamartomas in lung, to evaluate the different histological components, especially PT, and to investigate importance of PT pattern and its relationship with other clinicopathological features.
METHODS: Thirty-five cases of pulmonary hamartomas were recruited from the records between 2001 and 2021, divided into two groups according to presence of PT, as PT (-) and PT (+) in pathological examination.
RESULTS: 77.1% of all patients were male. There was no significant difference between the two groups in terms of age, sex, comorbidity, presence of symptoms, tumor localization, and radiological findings (P > 0.05). Pulmonary hamartomas were resected totally from 28 patients (80%). Five of these patients (17.9%) had PT components in resection materials with varying degree between 5 and 80%, and all were from male patients. Examination with frozen sections were performed in 15 PT (-) and 5 PT (+) patients but diagnosis with frozen sections was not achieved in any of PT (+) patients. Most of materials included chondroid components (52.22 ± 29.7%) in both groups (P < 0.05).
CONCLUSIONS: The placental papillary projections are available patterns associated with a pulmonary hamartoma and these projections observed especially in frozen sections are very crucial to recognize PT pattern in hamartomas, as they can result in confusions in differential diagnosis of malignities.

Pulmonary hamartomas are rare tumors and are mostly found incidentally in patients investigated for other pathologies. They are frequently small in size, though with some being reported as large as 25 centimeters (cm). We are reporting a case of a huge pulmonary hamartoma (measuring 25.5 × 17.5 × 15.5 cm and weighing about 2200 grams (g)) in a 33-year-old lady with a short duration history of breathlessness. The tumor had origin from the medial border of the left lung, extending into almost the entire left hemithorax and partly into the anterior mediastinum, with no local invasion. The left lower lobe had compression atelectasis due to mass. The mass was successfully resected. The histopathology report showed predominant adipose tissue and cartilaginous differentiation. There were also a few foci of papillary projections with predominant vascular areas, resembling immature placental villi, suggestive of placental transmogrification of the mass.

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