DOI: https://doi.org/10.36347/sjmcr.2026.v14i09.011

Pages: 1988-1991

Pulmonary hamartoma is the most common benign lung tumor, but its endobronchial (proximal, intraluminal) form is uncommon, accounting for roughly 3% to 20% of pulmonary hamartomas across published series. In smokers, its clinical, radiological, and bronchoscopic presentation can closely mimic a bronchogenic carcinoma, creating a genuine diagnostic pitfall. We report the case of a 66-year-old man, a former heavy smoker (40 pack-years, cessation 12 years earlier), admitted for low-volume hemoptysis that developed after one year of an isolated dry cough. Contrast-enhanced chest CT revealed an ill-defined, necrotic-centered tissue mass of the right lower lobe measuring 72 × 53 mm, together with cylindrical bronchiectasis in the right upper lobe and left lower lobe, and a suspicious, heterogeneously enhancing left adrenal nodule (15 × 13 mm). Flexible bronchoscopy showed a glistening, cauliflower-like endobronchial mass at the entrance of the bronchus intermedius, which remained passable to the scope. Histopathological examination of the endobronchial biopsies concluded in a bronchial hamartoma, with mature adipocytic nests within a loose, myxoid fibro-connective stroma and a regular, non-atypical ciliated respiratory epithelium — with no evidence of malignancy. This observation illustrates the diagnostic pitfall that endobronchial hamartoma can represent in a heavy smoker with hemoptysis, and underlines the essential role of histology in confirming the diagnosis before any radical therapeutic decision.