CRA36 ENDOBRONCHIAL HARMATOMA AS A RARE CULPRIT OF RECURRENT PNEUMONIA: A CASE STUDY

Thian Hao Ho 1, Madihah Abu Kassim 2.  Megat Razeem Abdul Razak2, Soon Lin How 3.
4.Institut Perubatan Respiratori, Kuala Lumpur
5.Hospital Tengku Ampuan Afzan,Kuantan
6.International Islamic University Malaysia, Kuantan

Introductions

Most of the pulmonary nodules  are benign .Harmatoma is  the most common benign tumour in respiratory system and incidence is about 0.025 - 0.32 %. These tumour occurs more commonly in men and usually in the elderly. Most of them are located and in the lung parenchyma and only small percentage of them lies in the endobronchial.  Most of them are discovered incidentally on Chest X Ray  or computed tomography scan with no symptoms. 

In rare instances, endobronchial harmatoma will present obstructions symptoms . In the early stages of its development, hamartoma is usually asymptomatic, and then, depending on its size and location, it manifests signs of irritation such as persistent cough or signs of obstruction such as dyspnea and recurrent pneumonia. 

Case presentations

We present a young patient with no comorbids presented with recurrent pneumonia in 2 years.  Contrast enhanced computed tomography thorax show right lower lobe collapse due to intra- luminal mass. Forceps biopsy through flexible bronchosopy histologically consistent with harmatoma. He went through endobronchial debulking of the lesion following which he improved clinically during postoperative. 

Discussions and conclusions 

Treatment of these endobronchial lesions has historically always been surgical removal of tumour. The use of bronchoscopy, particularly rigid bronchoscopy, has become a preferred method for treating such lesions, especially in cases with large lesions to prevent recurrent infections.