Becher U M, Kaminski M, Grohe C, Pabst S, Juergens U R, Wilhelm K, Ahmadzadehfar H, Majores M, Büttner R, Nickenig G, Skowasch D
Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Bonn.
Dtsch Med Wochenschr. 2010 Mar;135(9):390-3. doi: 10.1055/s-0030-1249175. Epub 2010 Feb 23.
A 58-years-old non-smoking woman presented at our Thoracic Centre with increasing exertional dyspnea and on examination was found to have wheezing and decreased breath sounds over the left lung.
Chest X-ray revealed an atelectasis of the left anterobasal lung segment. Computed tomography revealed a 3.5 cm mass at the left inferior lobe. Bronchioscopy showed a total occlusion of the segmental bronchus because of an endobronchial tumor. Histology of a biopsy showed the tumor to be a carcinoid. Staging by whole-body ocreotide scintigraphy showed no evidence of metastases.
The patient recovered quickly from resection of the left inferior lobe and radical lymphadenectomy. Two years later, she has remained free of symptoms and without evidence of recurrence.
Although rare (ca. 1.0 % of all primary lung tumors), the differential diagnosis of dyspnea and uniliteral wheezing should include a bronchial carcinoid. It is a potentially curable tumor, if detected and treated early. An interdisciplinary approach is pivotal to its perioperative management.
一名58岁不吸烟女性因劳力性呼吸困难加重就诊于我们的胸科中心，检查发现左侧肺部有哮鸣音且呼吸音减弱。
胸部X线显示左前基底肺段肺不张。计算机断层扫描显示左下叶有一个3.5厘米的肿块。支气管镜检查显示由于支气管内肿瘤导致节段性支气管完全阻塞。活检组织学检查显示肿瘤为类癌。全身奥曲肽闪烁扫描分期显示无转移证据。
患者在左下叶切除及根治性淋巴结清扫术后恢复迅速。两年后，她仍无症状且无复发迹象。
尽管罕见（约占所有原发性肺癌的1.0%），但对于呼吸困难和单侧哮鸣音的鉴别诊断应包括支气管类癌。如果早期发现并治疗，它是一种潜在可治愈的肿瘤。多学科方法对其围手术期管理至关重要。
