Typical pulmonary carcinoid tumour

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Typical pulmonary carcinoid tumour
Synonyms	Typical bronchial carcinoid
Pronounce	N/A
Specialty	N/A
Symptoms	Cough, hemoptysis, wheezing, dyspnea
Complications	Metastasis, obstruction of airways
Onset	Usually in adulthood
Duration	Variable
Types	Typical, Atypical
Causes	Unknown, possibly genetic
Risks	Smoking, family history
Diagnosis	Biopsy, imaging studies
Differential diagnosis	Small cell lung cancer, Adenocarcinoma, Hamartoma
Prevention	Avoidance of smoking
Treatment	Surgical resection, chemotherapy, radiation therapy
Medication	Somatostatin analogs
Prognosis	Generally good with treatment
Frequency	Rare, <1% of all lung cancers
Deaths	N/A

[[File:Peripheral_typical_carcinoid_tumor_-_CT_scan_-_Case_266_(8583455406).jpg|Peripheral typical carcinoid tumor - CT scan [[File:Lung_carcinoid_-_very_high_mag.jpg|Lung carcinoid - very high magnification [[File:Typical_carcinoid_tumor_of_the_lung,_prominent_rosettes.jpg|Typical carcinoid tumor of the lung, prominent rosettes A typical pulmonary carcinoid tumour is a type of neuroendocrine tumour that arises in the lungs. These tumours are generally considered to be low-grade malignancies and are part of the spectrum of lung cancer. They are distinct from atypical carcinoid tumours, which have a higher potential for aggressive behavior.

Pathophysiology

Typical pulmonary carcinoid tumours originate from neuroendocrine cells in the bronchial epithelium. These cells are part of the diffuse neuroendocrine system and have the ability to produce various hormones and neuropeptides. The exact cause of these tumours is not well understood, but they are thought to arise from genetic mutations that lead to uncontrolled cell growth.

Clinical Presentation

Patients with typical pulmonary carcinoid tumours may present with a variety of symptoms, depending on the size and location of the tumour. Common symptoms include:

• Cough
• Hemoptysis (coughing up blood)
• Wheezing
• Dyspnea (shortness of breath)
• Chest pain

Some patients may be asymptomatic, and the tumour is discovered incidentally on imaging studies performed for other reasons.

Diagnosis

The diagnosis of a typical pulmonary carcinoid tumour is typically made through a combination of imaging studies and histological examination.

• Imaging: Chest X-ray and CT scan of the chest are commonly used to identify the presence of a mass in the lungs.
• Biopsy: A bronchoscopy with biopsy or a CT-guided needle biopsy may be performed to obtain tissue for histological analysis.
• Histology: Under the microscope, typical carcinoid tumours are characterized by uniform cells with moderate cytoplasm and round to oval nuclei. They have a low mitotic rate and lack necrosis, distinguishing them from atypical carcinoid tumours.

Treatment

The primary treatment for typical pulmonary carcinoid tumours is surgical resection. The type of surgery depends on the size and location of the tumour and may include:

• Lobectomy
• Segmentectomy
• Wedge resection

In cases where surgery is not feasible, other treatments such as radiotherapy or chemotherapy may be considered, although these are less effective for typical carcinoid tumours.

Prognosis

The prognosis for patients with typical pulmonary carcinoid tumours is generally favorable, with a high 5-year survival rate. These tumours tend to grow slowly and have a low potential for metastasis compared to other types of lung cancer.

See also

• Lung cancer
• Neuroendocrine tumour
• Bronchoscopy
• Lobectomy