Shrateh Oadi N, Jobran Afnan W M, Jaber Saja, Kahla Ahmad, Shamieh Bashar S, Bakri Izzeddin A, Abu Asbeh Yousef
School of Medicine, Al-Quds University, Abu-Dis.
Departments of General Surgery.
Ann Med Surg (Lond). 2023 Mar 27;85(4):1154-1157. doi: 10.1097/MS9.0000000000000388. eCollection 2023 Apr.
About 2% of all lung malignancies are pulmonary carcinoid tumors, a family of neuroendocrine tumors. Rarely does a typical tracheal carcinoid of the trachea manifest as an endoluminal polypoidal tumor.
The author describe a 61-year-old nonsmoker who complained of growing nonexertional shortness of breath 5 years ago. She also had a wheezy chest and a dry cough. The results of the chest radiography and electrocardiogram revealed no noteworthy abnormalities. The results of the pulmonary function test supported the diagnosis of bronchial asthma. A patient's treatment has not advanced. After performing a bronchoscopy, a biopsy was taken and sent for pathological analysis. The endobronchial lining was found to have a subepithelial tumor infiltrate made up of nests of homogeneous bland cells with central nuclei and mild granular cytoplasm, according to histopathologic analysis. Considering all of these findings, the patient was diagnosed with a primary tracheal carcinoid tumor, which was misdiagnosed and treated as bronchial asthma.
People with stridor or trepopnea symptoms should undergo a computed tomography scan since central airway tumors can mimic the symptoms of bronchial asthma while a chest radiograph may be normal. Tracheal carcinoid that has not progressed to the mediastinum can be successfully removed with flexible bronchoscopy and electrocautery, but the excision site needs to be continuously watched for recurrence.
所有肺恶性肿瘤中约2%为肺类癌肿瘤,这是一类神经内分泌肿瘤。气管典型类癌很少表现为腔内息肉样肿瘤。
作者描述了一名61岁不吸烟女性,她在5年前开始出现非运动性气短加重。她还伴有喘息和干咳。胸部X线和心电图检查结果未发现明显异常。肺功能检查结果支持支气管哮喘的诊断。患者的治疗未见进展。在进行支气管镜检查后,取活检并送去做病理分析。根据组织病理学分析,发现支气管内膜有上皮下肿瘤浸润,由均匀一致的淡染细胞巢组成,细胞核位于中央,细胞质轻度颗粒状。综合所有这些发现,该患者被诊断为原发性气管类癌肿瘤,此前被误诊并当作支气管哮喘进行治疗。
有喘鸣或异常呼吸症状的患者应进行计算机断层扫描,因为中央气道肿瘤可模拟支气管哮喘症状,而胸部X线可能正常。未进展至纵隔的气管类癌可通过柔性支气管镜和电灼成功切除,但需要持续观察切除部位有无复发。