Dept of Respiratory and Critical Care Medicine, Karl-Landsteiner-Institute for Lung Research and Pulmonary Oncology, Klinik Floridsdorf, Vienna, Austria
Respiratory Medicine Dept, University of Ioannina Medical School, Ioannina, Greece.
Eur Respir Rev. 2021 Jan 6;30(159). doi: 10.1183/16000617.0115-2020. Print 2021 Mar 31.
Carcinoid tumours are rare neuroendocrine neoplasms that mostly occur in younger adults with low tendencies to metastasise. Based on their histological characteristics, they are divided into typical and atypical subtypes. The most common presenting symptoms are due to central airway obstruction. The first step in the diagnostic assessment should be a computed tomography (CT) scan, as it provides information both for local tumour extent and lymph node involvement. Bronchoscopy is the main tool for histological confirmation, evaluation of bronchial wall invasion and removal of endobronchial manifestation with subsequent resolution of atelectasis. Endobronchial ultrasound may be necessary to rule out lymph node metastasis. Somatostatin receptor scintigraphy in combination with CT can rule out further metastatic disease.Surgical resection using parenchyma-sparing techniques remains the gold standard for treatment. For selected patients, endobronchial therapy could be an alternative for minimal invasiveness. Long-term follow-up is suggested due to the high likelihood of recurrence.Here, we describe our clinical experience in a 35-year-old male patient who originally presented with haemoptysis and a central polypoid tumour in the left main bronchus revealed by a CT scan. The histological characteristics were indicative of a typical carcinoid. The patient was treated using an endobronchial approach only. No complications and no recurrences have been observed in a follow-up of 2 years.
类癌肿瘤是罕见的神经内分泌肿瘤,主要发生在具有低转移倾向的年轻成年人中。根据其组织学特征,它们分为典型和非典型亚型。最常见的表现症状是由于中央气道阻塞引起的。诊断评估的第一步应该是计算机断层扫描(CT),因为它提供了有关肿瘤局部范围和淋巴结受累的信息。支气管镜检查是组织学确认、评估支气管壁侵犯和清除支气管内表现以随后解决肺不张的主要工具。为了排除淋巴结转移,可能需要进行支气管内超声检查。生长抑素受体闪烁显像结合 CT 可以排除进一步的转移性疾病。使用保留实质的手术切除仍然是治疗的金标准。对于选定的患者,支气管内治疗可能是一种微创的替代方法。由于高复发可能性,建议进行长期随访。在这里,我们描述了我们在一名 35 岁男性患者中的临床经验,该患者最初表现为咯血,CT 扫描显示左主支气管内有一个中央息肉样肿瘤。组织学特征提示为典型类癌。该患者仅采用支气管内方法进行治疗。在 2 年的随访中,未观察到任何并发症和复发。