DEAR DR. GOTT: I spoke with a friend recently who said she was diagnosed with a hamartoma in her chest cavity. I corrected her and said she likely had a hematoma, but she was convinced she heard her doctor correctly. Can you tell me the right word?
DEAR READER: Without knowing your friend and her medical condition, I can only assume she is correct. I will outline the differences between the two words.
A hamartoma is a benign growth composed of an abnormal mixture of epithelial and mesenchymal elements. It is a part of any tissue that either grows faster or without the usual organization of its neighbor cells. It results from faulty development. Their growth is limited, so they are not actually tumors, even though they are often referred to as such. They are more common in men than women, and most people so diagnosed are smokers. Growths vary in size from 1 to 9 centimeters and consist of lobules of cartilage, fat, fibromyxoid tissue and, on occasion, smooth muscle and bone. The growth of these lesions is extremely slow, perhaps 3 millimeters per year.
A hematoma, on the other hand, develops from injury such as from a fall or banging one’s arm or leg against a hard object. Blood vessels under the skin tear, blood leaks into the surrounding tissue, and a bruise or contusion results. The lesion will often turn purple, dark red, yellow/green and a variety of colors as the blood is absorbed back into the body. The process can take up to four weeks. There are some that do not reabsorb and need to be removed by a physician. If not removed, they may calcify. In an extremity, they cause pressure to build and cut off circulation.
Generally speaking, bruises are not a cause for concern, and a person is generally fully aware of why a hematoma develops. Older adults, on the other hand, have less fat under the skin, and they tend to bruise easily. Aspirin and anticoagulants can cause bruising. Disorders that cause bleeding or a clotting disorder include hemophilia, thrombocytopenia, lupus, liver disease, leukemia and other less common disorders.
Because your friend referred to her chest cavity, she likely has a harmless hamartoma. My guess is her physician will continue to monitor it on a periodic basis to ensure it does not change in appearance.
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