81 Bronchial Carcinoid

Clinical Presentation

18-year-old woman with cough and hemoptysis

Radiologic Findings

PA (Fig. 81.1) and lateral (Fig. 81.2) chest radiographs demonstrate left lower lobe atelectasis. Contrast-enhanced chest CT (mediastinal window) (Figs. 81.3, 81.4) reveals a small, lobular, enhancing, partially endobronchial lesion obstructing the left lower lobe bronchus, with resultant volume loss, consolidation, and bronchiectasis (Fig. 81.4).

Diagnosis

Bronchial Carcinoid

Differential Diagnosis

• Mucoepidermoid Carcinoma

• Adenoid Cystic Carcinoma

• Central Lung Cancer (rare in adolescents and young adults)

Fig. 81.1

Fig. 81.2

Fig. 81.3

Fig. 81.4

Discussion

Background

Carcinoid is a rare malignant primary pulmonary neoplasm of neuroendocrine origin and accounts for approximately 2% of all lung neoplasms. Eighty to 90% of bronchial and pulmonary carcinoids are typical (<2 mitoses per 10 high-power fields and absent necrosis) and 10–20% are atypical (2–10 mitoses per 10 high-power fields and necrosis) carcinoids.