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一名年轻女性典型类癌伴高热间歇性发热的罕见影像学表现:病例报告

Unusual Radiological Presentation of a Typical Carcinoid in a Young Female With High-Grade Intermittent Fever: A Case Report.

作者信息

Kannadasan Karpagam, Subramonian Sakthi Ganesh, Muralidharan Yuvaraj, Ramakrishnan Karthik Krishna, Natarajan Paarthipan

机构信息

Department of Radiology, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, IND.

出版信息

Cureus. 2024 Aug 13;16(8):e66777. doi: 10.7759/cureus.66777. eCollection 2024 Aug.

Abstract

Pulmonary carcinoids, particularly the typical variant, are low-grade neuroendocrine tumors (NETs) known for their often indolent behavior. Their rare and atypical presentations can pose significant diagnostic challenges. We present a case of a 39-year-old female with no significant past medical history who presented with high-grade intermittent fever, chills, rigors, and breathlessness, with symptoms persisting for approximately 20 days. Initial investigations, including chest X-ray and contrast-enhanced computed tomography scans, revealed a homogenously enhancing lesion in the left lower lobe, raising concerns of a malignant process. A percutaneous lung biopsy was performed to further evaluate the lesion. Histopathological examination confirmed a diagnosis of Grade 1 NET (typical carcinoid), supported by elevated levels of Synaptophysin and Chromogranin A on immunohistochemistry. This case highlights the varied clinical presentations of pulmonary carcinoid tumors and underscores the importance of comprehensive radiological and histopathological assessments for accurate diagnosis and effective management.

摘要

肺类癌,尤其是典型亚型,是低度神经内分泌肿瘤(NETs),以其通常惰性的行为而闻名。它们罕见且非典型的表现可能带来重大的诊断挑战。我们报告一例39岁女性,既往无重大病史,出现高热、寒战、畏寒和呼吸困难,症状持续约20天。包括胸部X线和增强计算机断层扫描在内的初步检查显示左下叶有一个均匀强化的病变,引发了对恶性病变的担忧。进行了经皮肺活检以进一步评估该病变。组织病理学检查确诊为1级NET(典型类癌),免疫组化显示突触素和嗜铬粒蛋白A水平升高支持这一诊断。该病例突出了肺类癌肿瘤多样的临床表现,并强调了全面的影像学和组织病理学评估对于准确诊断和有效管理的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aefe/11392029/46861478fae2/cureus-0016-00000066777-i01.jpg

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