Prosch H
Medizinische Universität Wien, Univ. Klinik für Radiologie und Nuklearmedizin, Allgemeines Krankenhaus Wien, Währingergürtel 18-22, 1090, Wien, Österreich.
Radiologe. 2017 May;57(5):397-406. doi: 10.1007/s00117-017-0243-x.
Pulmonary carcinoids are rare low-grade malignant tumors, which arise from the neuroendocrine system. Approximately 80% of all pulmonary carcinoid tumors are the relatively low-grade typical carcinoids and 20% are the more aggressive atypical carcinoids. Most carcinoids arise from the central airways and only a minority of carcinoids are found in the lung periphery. While most of the peripheral carcinoids are asymptomatic, central carcinoids are symptomatic and present with hemoptysis, wheezing or bronchial obstruction. On computed tomography (CT), carcinoids frequently present as hypervascular pulmonary nodules in close proximity to the bronchial system. Due to the bronchial obstruction, many patients with pulmonary carcinoids present with post-obstructive pneumonia or atelectasis. While fluorodeoxyglucose positron emission tomography CT (FDG-PET/CT) is of limited value in typical carcinoids due to the high rate of false negatives, somatostatin analogs are promising tracers in staging as well as in the planning of peptide receptor radionuclide therapy.
肺类癌是一种罕见的低度恶性肿瘤,起源于神经内分泌系统。所有肺类癌肿瘤中约80%为相对低度的典型类癌,20%为侵袭性更强的非典型类癌。大多数类癌起源于中央气道,只有少数类癌位于肺外周。虽然大多数外周类癌无症状,但中央类癌有症状,表现为咯血、喘息或支气管阻塞。在计算机断层扫描(CT)上,类癌常表现为靠近支气管系统的高血管性肺结节。由于支气管阻塞,许多肺类癌患者会出现阻塞性肺炎或肺不张。虽然氟脱氧葡萄糖正电子发射断层扫描CT(FDG-PET/CT)在典型类癌中因假阴性率高而价值有限,但生长抑素类似物在分期以及肽受体放射性核素治疗的规划中是有前景的示踪剂。