Primary typical pulmonary carcinoid tumor: an incidental finding

Abstract

Bronchopulmonary carcinoid tumors are rare tumors (only 0.5 to 2.5% of all pulmonary tumors) that arise from neuroendocrine cells known as Kulchitsky cells. They are characterized by slow growth and rarely metastasize beyond the lungs. However, they can occur in the central or peripheral parts of the lung. Secondary locations can be asymptomatic, but central carcinoids often present with obstructive signs including: recurrent pneumonias and hemoptysis. We report a rare, asymptomatic case of a primary bronchopulmonary carcinoid in a 62-year-old man. A 62-year-old man presented with history of intermittent right upper quadrant pain, especially after a high fat meal, for 6 months. Systemic examination was unremarkable. Ultrasonography of gall bladder showed cholelithiasis, and he was scheduled for cholecystectomy. On preoperative cardiology consult, the chest X-ray showed an incidental homogenous opacity in the right middle zone without any respiratory symptoms. Patient underwent fiber optic bronchoscopy and biopsy. Histopathologic examination showed monomorphic tumoral cells forming small nests, rosette-like arrangements, and cords with salt and pepper, stippled appearance nuclei. Patient underwent right middle lobectomy. The postoperative period was uneventful, and the patient was disease-free in the following 25 months. Carcinoid syndrome is very rare in patients with bronchopulmonary carcinoid tumors. Overall prognosis for patients with typical bronchopulmonary carcinoid tumors is favorable. If diagnosed in the early stages, the chances for radical treatment success are increased.