Novković Dobrivoje, Skuletić Vesna, Vuković Jelena, Cerović Snezana, Tomić Ilija, Karlicić Vukojica, Stojisavljević Marko
Clinic for Lung Diseases, Military Medical Academy, Belgrade, Serbia.
Vojnosanit Pregl. 2013 May;70(5):516-21. doi: 10.2298/vsp1305516n.
Bronchial carcinoids belong to a rare type of lung tumors. If they do not expose outstanding neuroendocrine activity, they develop without clearly visible symptoms. They are often detected during a routine examination. According to their clinical pathological features, they are divided into typical and atypical tumors. Typical bronchial carcinoids metastasize to distant organs very rarely. Localized forms are effectively treated by surgery. The methods of conservative treatment should be applied in other cases.
We presented a 65-year-old patient with carcinoid lung tumor detected by a routine examination. Additional analysis (chest X-ray, computed tomography of the chest, ultrasound of the abdomen, skeletal scintigraphy, bronhoscopy, histopathological analysis of the bioptate of bronchial tumor, as well as bronchial brushing cytology and immunohistochemical staining performed with markers specific for neuroendocrine tumor) proved a morphologically typical lung carcinoid with dissemination to the liver and skeletal system, which is very rarely found in typical carcinoids.
The presented case with carcinoid used to be showed morphological and pathohistological characteristics of typical bronchial carcinoid. With its metastasis to the liver and skeletal system it demonstrated unusual clinical course that used to be considered as rare phenomenon. Due to its frequent asymptomatic course and varied manifestation, bronchial carcinoid could be considered as a diagnostic challenge requiring a multidisciplinary approach.
支气管类癌属于一种罕见的肺肿瘤类型。如果它们不表现出显著的神经内分泌活性,其发展过程中不会出现明显可见的症状,常在常规检查时被发现。根据其临床病理特征,可分为典型和非典型肿瘤。典型支气管类癌很少转移至远处器官,局限性病例通过手术可有效治疗,其他情况则应采用保守治疗方法。
我们报告了一名65岁患者,其类癌性肺肿瘤在常规检查时被发现。进一步分析(胸部X光、胸部计算机断层扫描、腹部超声、骨骼闪烁显像、支气管镜检查、支气管肿瘤活检组织的组织病理学分析,以及使用神经内分泌肿瘤特异性标志物进行的支气管刷检细胞学和免疫组化染色)证实为形态学典型的肺类癌,并已扩散至肝脏和骨骼系统,这在典型类癌中非常罕见。
所报告的类癌病例过去表现出典型支气管类癌的形态学和病理组织学特征。其转移至肝脏和骨骼系统,显示出不寻常的临床病程,过去被认为是罕见现象。由于其通常无症状病程且表现多样,支气管类癌可被视为一项需要多学科方法的诊断挑战。