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Weekly Chest CasesArchive of Old Cases

Case No : 1084 Date 2018-08-06

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  • Courtesy of So Young Choi, MD. / Eulji University Hospital
  • Age/Sex 37 / F
  • Chief ComplaintCough for 1 week
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4

Diagnosis With Brief Discussion

Diagnosis
Carcinoid tumor
Radiologic Findings
Figs 1. Chest PA shows alobulated margin mass in the left upper lung zone.
Fig 2. Chest CT scan shows a well-marginated, enhancing mass with distal mucoid impaction in the left upper lobe.
Figs 3-4. The apicoposterior segmental bronchus of the left upper lobe is obstructed by the mass.

Bronchoscopic biopsy was performed, and the mass was confirmed as carcinoid tumor pathologically.
Brief Review
Carcinoid tumors account for 1~2% of pulmonary neoplasms. They are considered to be neuroendocrine tumors. There are two types of carcinoidtumors, distinguished by histologic features: typical (80~90%) and atypical (10~20%) carcinoid. Most of the typical carcinoids are central in location.And atypical carcinoids are usually located peripherally. The centrally located typical carcinoids tend to manifest earlier with central airway obstruction symptoms and signs than do peripherally located atypical carcinoids. Carcinoids tend to be vascular and may demonstrate intense enhancement. Internal calcification can be seen (30%). Prognosis of carcinoids is dependent on histologic findings; typical carcinoids generally have an excellent prognosis, whereas atypical carcinoids have a worse prognosis.
References
1. Meisinger QC, Klein JS, Butnor KJ, Gentchos G, Leavitt BJ. CT features of Peripheral Pulmonary Carcinoid Tumors. AJR 2011; 197:1073-1080.
2. Chong S, Lee KS, Chung MJ et al. Neuroendocrine Tumors of the Lung: Clinical, Pathologic, and Imaging Findings. RadioGraphics 2006;26(1):41-57.
3. Jeung MY et al. Bronchial carcinoid tumors of the thorax: spectrum of radiologic findings. Radiographics 2002 Mar-Apr;22(2):351-65
4. Muller NL et al. Imaging of the chest. Chapter 26 Carcinoid tumors, pulmonary tumorlets, and neuroendocrine hyperplasia. Volume I. p542-548
Keywords
Airway, Neoplasm_Malignant,

No. of Applicants : 74

▶ Correct Answer : 27/74,  36.5%
  • - ZIGONG TCM HOSPITAL OF CHINA , China Cao Cunyou
  • - Kinki University Faculty of Medicine, , Japan MITSURU MATSUKI
  • - Showa University Fujigaoka Hospital , Japan KYOKO NAGAI
  • - Higashi-Ohmi General Medical Center , Japan AKITOSHI INOUE
  • - The University of Tokyo Hospital , Japan Akifumi Hagiwara
  • - King Abdulaziz University Hospital , Saudi Arabia Amr M. Ajlan
  • - NIMS, HYDERABAD , India BHASKAR K
  • - Vita Hospital , Brazil DIOGO LAGO PINHEIRO
  • - Other , Korea (South) SEONGSU KANG
  • - Seoul National University Hospital , Korea (South) Ju Gang Nam
  • - 罹…stanbul , Turkey AYHAN YILMAZ
  • - The Jikei university , Japan TAKU GOMI
  • - Seoul National University Hospital , Korea (South) HYOUNG IN CHOI
  • - Asan Medical Center , Korea (South) HONG SANG HYUP
  • - HHS , Canada S LEE
  • - Busan National University School of Medicine , Korea (South) YEONJOO JEONG
  • - Asan Medical Center , Korea (South) JOOAE CHOE
  • - Seoul National University Hospital , Korea (South) JI HEE KANG
  • - Mallinckrodt Institute of Radiology , United States Naganathan BS Mani
  • - Avrasya Hospital/ISTANBUL , Turkey MURAT ULUSOY
  • - Holy Family Hopsital , India RAJESH GOTHI
  • - Kizawa Memorial Hospital , Japan Shoji Okuda
  • - , Korea (South) JONGSUN LEE
  • - Hamamatsu University Hospital , Japan YUKI HAYASHI
  • - , Korea (South) HYUNGYU LEE
  • - Seoul Veterans Hospital , Korea (South) HYUN JUNG YOON
  • - Jiangsu province hospital , China WANGJIAN ZHA
▶ Correct Answer as Differential Diagnosis : 25/74,  33.8%
  • - The University of Kyoto Hospital , Japan TOMOAKI OTANI
  • - Saitama-Sekishinkai Hosptal , Japan MIHOKO YAMAZAKI
  • - Oita University, Faculty of Medicine , Japan Fumito Okada
  • - Beaulieu clinic Geneva , Switzerland GILLES GENIN
  • - Azienda Ospedaliera Universitaria Integrata di Verona , Italy GIAN ALBERTO SOARDI
  • - The first affiliated Hospital of Xiamen University , China Qing Qiang Guo
  • - Onomichi municipal hospital , Japan Hirofumi Mifune
  • - The University of Tokyo Hospital , Japan TOSHIHIRO FURUTA
  • - Narayana Multispeciality Hospital Jaipur Rajasthan , India JAINENDRA JAIN
  • - Gifu University Hospital , Japan Yo Kaneko
  • - University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
  • - , Japan NAOMI YUASA
  • - University of Florence , Italy MARIAELENA OCCHIPINTI
  • - Azienda Ospedaliera di Cremona , Italy Pietro Sergio
  • - Chonbuk National University Hospital , Korea (South) KUM JU CHAE
  • - Multimagem Diagn泥˜sticos , Brazil PEDRO PAULO TEIXEIRA E SILVA TORRES
  • - The University of Tokyo Hospital , Japan TAKU TAJIMA
  • - DECRH, Fredericton , Canada RAM P GALWA
  • - TB centre kasaragod. , India rikhy krishnan
  • - Korea University Guro Hospital , Korea (South) KYU-CHONG LEE
  • - Fortis hospital , Mohali , India SHALEEN RANA
  • - Teikyo University Hospital , Japan KAORU SUMIDA
  • - Ichinomiya Nishi Hospital , Japan Takao Kiguchi
  • - Diagnose.me (BV) / Royal Perth Hospital , Australia YURANGA WEERAKKODY
  • - the first affiliatited hospital of nanjing medical univercity , China HAI XU
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