대한흉부영상의학회 Weekly Chest Cases

Case No : 359 Date 2004-09-11

Courtesy of Sang Hyun Paik, M.D., Jai Soung Park, M.D. / Soonchunhyang University Hospital, Bucheon, Korea
Age/Sex 22 / F
Chief ComplaintCough and left flank pain

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Diagnosis With Brief Discussion

Diagnosis: Bronchial carcinoid tumor
Radiologic Findings: Chest radiograph shows segmental increased opacity at left lingular division(A-1) and obliteration of LUL bronchi on lateral view. Precontrast CT scan shows scanty calcification in mass. Contrast-enhanced CT scan show a atelectasis with mucoid impaction at left lingular division and 1.5 X 1.0 cm sized, well enhanced protruding endobronchial mass at lobar bronchus of LUL. Suggestive main portion of mass is located at extrabronchial region and protruding to intrabronchial portion.
Bronchoscopy also reveals a hypervascular mass obstructing the left upper lobar bronchus.
Brief Review: Centrally located bronchial carcinoids may be predominantly intraluminal, assuming a polypoid configuration, may grow along the lumen of the bronchus, or may predominantly extraluminal, in which case they are known as “iceberg” lesions. Calcification is fairly common. The incidence of calcification is significantly greater in centrally located tumors and more frequent in the larger tumors. Sometimes the calcification takes the form of recognizable ossification and is so extensive that it occupies the whole of the tumor mass. Because bronchial carcinoid tumors are very vascular, marked enhancement may be seen following intravenous administration of contrast medium.
References: Amstrong P. Neoplasms of the lungs, airways and pleura. In: Amstrong P, Wilson AG, Dee P, Hansell DM eds. Imaging of diseases of the chest. 3rd ed. Mosby 2000:339-343.
Keywords: Airway, Benign tumor,

No. of Applicants : 28

▶ Correct Answer : 21/28, 75.0%

- Aditya Imaging Centre, Baroda, India Vivek Patel
- Annecy Hospital, France Gilles Genin
- Asan Medical Center, Korea Eun Jin Chae
- Centre d'imagerie Jacques Callot, Nancy, France Lionel Cannard
- CHU Grenoble, France Mathieu Rodiere
- CHU Nancy-Brabois, France Denis Regent
- CIM Saint Dizier, France JC Leclerc
- Dong-A University Hospital, Korea Ki-Nam Lee
- Hangang Sacred Heart Hospital, Korea Eil Seong Lee
- Hanyang University Hospital, Seoul, Korea Yo Won Choi
- Homs National Hospital, Homs, Syria Rami Abou Zalaf
- Hospital Donostia, Spain Fran Basterrechea
- Incheon Sarang Hospital, Korea Jung Hee Kim
- Jikei University of Medicine, Japan Shigeki Misumi
- Mallinckrodt Institute of Radiology, USA Jin Mo Goo
- MH(CTC), Pune, India Vivek Sharma
- National Taiwan University Hospital, Taiwan Tan Che Kim
- Pohang Hospital, Korea Jae Hyoung Park
- Seoul National University Hospital, Korea Heesun Park
- Sharma Clinic, Jaipur, India Dinesh Sharma
- Social Security Hospital, Ankara, Turkey Meric Tuzun

▶ Semi-Correct Answer : 5/28, 17.9%

- Cardinal Tien hospital, Taipei, Taiwan Shih Tze Chung
- Chonnam National University Hospital, Korea Yong-Ju Moon
- Marien Hospital, Hamm, Germany Davis Chiramel
- Ondokuz Mayis University, Samsun, Turkey Cetin Celenk
- Ulsan GoodMorning Hospital, Korea Sang Hoo Joo

대한흉부영상의학회 Korean Society of Thoracic Radiology

Archive of Old Cases

Case No : 359 Date 2004-09-11

Discussion

No. of Applicants : 28