Mishra Sarmendra, Karki Saurab, Baral Surakshya, Regmi Aavishkar Raj, Gurung Adarsh, Gyawali Pramisa, Rokaya Pranjal, Pandey Sushmita
Kist Medical College, Lalitpur.
Military Hospital Itahari, Sunsari.
Ann Med Surg (Lond). 2023 Apr 13;85(5):2194-2197. doi: 10.1097/MS9.0000000000000653. eCollection 2023 May.
Bronchial carcinoid tumours are rare, slow-growing, malignant, Low-grade neuroendocrine tumours that arise from Enterochromaffin (Kulchitsky) cells and are usually detected typically as indolent and solitary tumours. Approximately 2% of all lung tumours are bronchial carcinoid tumours.
The authors report a case of 55-years-old man who presented with a history of cough for 1 month and was initially diagnosed with a case of COVID-19. Then he was treated as a case of pneumonia as seen on high-resolution computed tomography. Later, contrast-enhanced computed tomography and bronchoscopy-guided biopsy were done which revealed a right lower lobe neuroendocrine tumour (carcinoid), which was successfully resected.
The majority of typical carcinoids are located in the central airways leading to bronchial obstruction with recurrent pneumonia, chest pain, and wheezing. During the COVID-19 pandemic, lung cancer patients were at higher risk of being affected by COVID-19. This study emphasizes that early identification and differential diagnosis are extremely difficult in the absence of comprehensive study and workup as the clinical and imaging findings of COVID-19 may resemble lung cancer. Although hilar and mediastinal lymph nodes are the most common metastatic sites for typical carcinoids, most lymphadenopathies are caused by a reactive inflammatory reaction.
Bronchial carcinoids are uncommon, malignant neuroendocrine tumours for which the only curative management is complete surgical resection. With full resection, the result of typical carcinoids with lymph node metastases is favourable.
支气管类癌肿瘤罕见,生长缓慢,为恶性低度神经内分泌肿瘤,起源于嗜银(库尔契茨基)细胞,通常表现为惰性孤立肿瘤。所有肺肿瘤中约2%为支气管类癌肿瘤。
作者报告一例55岁男性,有1个月咳嗽病史,最初被诊断为新冠肺炎病例。随后,根据高分辨率计算机断层扫描结果,他被当作肺炎病例治疗。后来进行了增强计算机断层扫描和支气管镜引导下活检,结果显示为右下叶神经内分泌肿瘤(类癌),该肿瘤已成功切除。
大多数典型类癌位于中央气道,导致支气管阻塞,出现反复肺炎、胸痛和喘息。在新冠肺炎大流行期间,肺癌患者感染新冠肺炎的风险更高。本研究强调,在缺乏全面研究和检查的情况下,早期识别和鉴别诊断极其困难,因为新冠肺炎的临床和影像学表现可能与肺癌相似。虽然肺门和纵隔淋巴结是典型类癌最常见的转移部位,但大多数淋巴结肿大是由反应性炎症反应引起的。
支气管类癌是罕见的恶性神经内分泌肿瘤,唯一的治愈性治疗方法是完整手术切除。完整切除后,伴有淋巴结转移的典型类癌预后良好。