Resumen de A Pulmonary Inflammatory Chondroid Hamartoma With So-called Placental Transmogrification Feature in a Pleural Location. Pathogenic Considerations About This Unusual Disorder
Jesús Machuca Aguado, Inmaculada Sabariego Arenas, Miguel A. Idoate
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.
