BENIGN TUMORS OF THE LUNG

Benign tumors of the lung are rare neoplasms. Few series are found in the literature, but in a 10-year

surgical review (1958 to 1968) from the Mayo Clinic, 130 patients were found to have benign

tumors.221 Like malignant tumors, benign tumors arising from epithelial, mesodermal, or endodermal

cell lines can develop in the lung. They may present as endobronchial lesions but are more commonly

peripheral nodules.222 Endobronchial tumors present with signs and symptoms related to airway

obstruction or bleeding. Tumors arising in peripheral airways or within pulmonary parenchyma usually

present as asymptomatic solitary pulmonary nodules. Types of benign lung tumors are listed in Table

79-4.

Hamartoma

The most frequent benign tumors are hamartomas, which represent 75% of benign lesions. They show a

predilection for men.223 A hamartoma consists of an abnormal arrangement of normal cells. In the lung,

the most frequent component is cartilage. A hamartoma usually presents as a solitary pulmonary nodule

with an extremely slow growth pattern. Classically, the radiographic appearance is that of a wellcircumscribed nodule that may contain popcorn calcification. If previous chest radiographs are

available, these tumors are found to have been present for many years. Their growth pattern is variable

but generally slow. These lesions can be diagnosed by CT if appropriate calcification is demonstrated.

Needle aspiration is frequently diagnostic of a cartilaginous benign lesion.

CLASSIFICATION

Table 79-14 Benign Tumors of the Lung

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Controversy exists regarding whether these lesions should be excised for pathologic diagnosis.

Certainly, they do not require excision unless they are proximally located and cause symptoms related

to endobronchial obstruction or when carcinoma cannot be ruled out. If transthoracic needle aspiration

biopsy confirms the presence of a hamartoma, many surgeons elect to follow patients with annual chest

radiography rather than surgical excision. Occasionally, significant growth during follow-up necessitates

excision.

Other Benign Tumors

Other benign tumors may present as endobronchial lesions (commonly fibromas, lipomas, chondromas

and granular cell myoblastomas). These tumors may be removed endoscopically but frequently require

excision when the diagnosis is in doubt or if endoscopic excision has been incomplete. Peripheral tumors

often are removed for diagnosis.

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