Tipik pulmoner karsinoid

Özet

Tipik pulmoner karsinoid çoğunlukla bronş duvarından gelişen, yavaş seyirli iyi diferansiye nöroendokrin tümördür; santral hava yolu odağı tekrarlayan enfeksiyon veya hemoptiziyle fark edilebilir. Kontrastlı toraks BT, endobronşiyal yumuşak doku nodülünü ve distal hava yolu daralmasını aynı anatomik hatta gösterir. Tümörün kontrastlanmasını veya bronş içi uzanımını kaçırmak kanama kaynağını ve distal akciğer hasarını açıklamadan bırakabilir; tipik alt tip tanısı ise BT ile konmaz.

Faz ve pencere

Kontrastlı tanısal

İntravenöz kontrastlı toraks BT'de endolüminal lezyon ve bronşta oluşturduğu daralma gösterilebilir; multiplanar görüntüler lezyonun hava yolu içindeki uzanımını değerlendirmeye yardımcı olur.

Kontrastsız

BT'de bronşlardaki mukus tıkaçlarıyla ayrı bir kitle gölgesi birlikte görülebilir.

Önerilen pencereler: Akciğer (G 1500 / M -600), Mediasten (G 350 / M 50).

BT bulguları

• Endobronşiyal yuvarlak yumuşak doku — bronş lümeninde yer alan, BT'de iyi sınırlı, yuvarlak veya hafif lobüle kitle.
• Canlı kontrastlanma — hipervasküler tümörün belirgin kontrast alması, komşu atelektazi ve mukus tıkacından ayrılmasına yardım eder.
• Bronş lümeninde endolüminal yerleşim — lezyon bronş içine uzanarak lümeni ileri derecede daraltabilir veya tıkayabilir.
• Postobstrüktif hacim kaybı — segment/lob atelektazisi, fissür yer değişikliği ve damar-bronş demetlerinde yaklaşma.
• Obstrüktif enfeksiyon — pulmoner karsinoid olgularında obstrüktif pnömonit görülebilir.

Ölçütler ve sınıflamalar

Tipik karsinoid histolojik mitoz sınırı

<2 mitoz / 2 mm²

Tipik karsinoidde nekroz

Yok

WHO pulmoner karsinoid histolojik sınıflaması

Tipik karsinoid düşük derecelidir; mitoz sayısı sınıra ulaşmaz ve nekroz yoktur. Atipik karsinoid, daha yüksek mitoz aktivitesi veya odaksal nekroz varlığıyla ayrılır. BT'de kontrastlanma ve morfoloji bu histolojik ayrımı güvenilir biçimde yapamaz.

Normalde

Normal ana ve lobar bronş lümenleri hava ile dolu, kesintisiz dallanır; çevre pulmoner arterler bronşlardan ayrı olarak aynı hiler demette ilerler. Lezyon tarafındaki bronş çapını karşı taraftaki eş bronşla kıyaslayın ve tümör seviyesinin distalindeki segment parankimini aynı lobun açık bronşla havalanan komşu segmentiyle karşılaştırın.

Ayırıcı tanı

Endobronşiyal mukus

BT'de orta ve periferik bronşlarda mukus tıkaçları görülebilir; bildirilen olguda bu tıkaçlar izlemde küçülürken kitle gölgesi kalıcı olmuştur.

Skuamöz hücreli karsinom

büyük hava yolu tümörlerinde infiltratif görünüm görülebilir; bu görünüm tek başına skuamöz hücreli karsinomu karsinoidden ayırmaz.

Endobronşiyal metastaz

bilinen bir primer malignite öyküsü ve birden fazla endobronşiyal lezyon bulunması metastaz olasılığını düşündürebilir.

Hamartom

bronş lümeninde yumuşak doku nodülü yapabilir; iç yağ ve karakteristik kaba kalsifikasyon tanıyı destekler.

Bronş tıkanıklığı endolüminal, ekstralüminal veya mikst mekanizmayla gelişebilir; BT'de bu mekanizmalar değerlendirilmelidir.

Tuzaklar

• Atelektatik lob içindeki hiperdens alanı doğrudan tümör kabul etmeyin; kontrastlanan bronş içi nodülü multiplanar görüntülerde takip edin.
• Belirgin kontrastlanma tipik karsinoid için ipucudur, alt tip kanıtı değildir; tipik ve atipik karsinoidler BT morfolojisiyle kesin ayrılamaz.

Kendini dene

1. Bu olgu raporunda kontrastlı BT'de görülen endolüminal lezyon hangi bronşta ileri derecede obstrüksiyona yol açıyordu?

   • Sol ana bronş
   • Sağ üst lob bronşu
   • Sol alt lob bronşu
   • Sağ orta lob bronşu
   Cevabı göster

   Sol ana bronş. Raporda lezyonun distal trakea/karinadan sol ana bronşun proksimaline uzandığı ve bu bronşta tama yakın obstrüksiyona yol açtığı bildiriliyor.

2. Hangi histolojik bulgu bileşimi tipik pulmoner karsinoid ile uyumludur?

   • Mitoz <2/2 mm² ve nekroz yokluğu
   • Mitoz ≥2/2 mm² ve nekroz varlığı
   • Mitoz <2/2 mm² ve nekroz varlığı
   • Mitoz ≥2/2 mm² ve nekroz yokluğu
   Cevabı göster

   Mitoz <2/2 mm² ve nekroz yokluğu. Kaynakta tipik karsinoid örneğinde mitoz artışı olmadığı (<2 mitoz/2 mm²) ve nekroz bulunmadığı belirtiliyor.

İlgili konular

• Atipik pulmoner karsinoid
• Endobronşiyal metastaz

Kaynaklar

Bu sayfadaki 35 cümle ve 2 quiz sorusu aşağıdaki kaynaklardan alıntılarla otomatik olarak karşılaştırıldı; 10 cümle bu karşılaştırmada düzeltildi (2026-10-09).

1. Pulmonary Chromomycosis Caused by Exophiala phaeomuriformis in a Patient with a Typical Pulmonary Carcinoid Tumorpmc.ncbi.nlm.nih.gov
2. Severe Ectopic Adrenocorticotropic Hormone Syndrome Due to Pulmonary Carcinoid Tumor: A Case Report and Literature Reviewpmc.ncbi.nlm.nih.gov
3. Successful Treatment of Obstructive Pneumonia with Hemoptysis due to Non-Absorbable Suture-Related Granulationpmc.ncbi.nlm.nih.gov
4. Synchronous bilateral typical pulmonary carcinoid tumours diagnosed by robotic navigation bronchoscopy: A unique casepmc.ncbi.nlm.nih.gov
5. Multiple bronchial carcinoids associated with Cowden syndromepmc.ncbi.nlm.nih.gov
6. Excessive muscle paralysis due to pulmonary carcinoid -a case report.pubmed.ncbi.nlm.nih.gov
7. A case of multiple lung carcinoid tumors localized in the right lower lobe.pubmed.ncbi.nlm.nih.gov
8. Significance of 18F-fluorocholine PET/CT positive pulmonary lesions in prostate cancer patients.pubmed.ncbi.nlm.nih.gov
9. Coexisting Thymic and Pulmonary Carcinoid Tumors Associated with Multiple Endocrine Neoplasia Type1.pubmed.ncbi.nlm.nih.gov
10. Synchronous bilateral multiple typical pulmonary carcinoid tumors: a unique case with 10 typical carcinoids.pubmed.ncbi.nlm.nih.gov
11. Synchronous bilateral typical pulmonary carcinoid tumours diagnosed by robotic navigation bronchoscopy: A unique case.pubmed.ncbi.nlm.nih.gov
12. Volume Doubling Time of Pulmonary Carcinoid Tumors Measured by Computed Tomography.pubmed.ncbi.nlm.nih.gov
13. Diffuse intrapulmonary neuroendocrine cell hyperplasia.pubmed.ncbi.nlm.nih.gov
14. A case of typical pulmonary carcinoid tumor treated with bronchoscopic therapy followed by lobectomy.pubmed.ncbi.nlm.nih.gov
15. Atypical or typical adrenocorticotropic hormone-producing pulmonary carcinoids and the usefulness of 11C-5-hydroxytryptophan positron emission tomography: two case reports.pubmed.ncbi.nlm.nih.gov
16. Multiple bronchial carcinoids associated with Cowden syndrome.pubmed.ncbi.nlm.nih.gov
17. Cushing's syndrome secondary to typical pulmonary carcinoid with mutation in BCOR gene: A case report.pubmed.ncbi.nlm.nih.gov
18. Pulmonary Chromomycosis Caused by Exophiala phaeomuriformis in a Patient with a Typical Pulmonary Carcinoid Tumor.pubmed.ncbi.nlm.nih.gov
19. Severe Ectopic Adrenocorticotropic Hormone Syndrome Due to Pulmonary Carcinoid Tumor: A Case Report and Literature Review.pubmed.ncbi.nlm.nih.gov
20. Acute neurologic crisis after bronchoscopic biopsy: Carcinoid-like presentation of pulmonary mucoepidermoid carcinoma.pubmed.ncbi.nlm.nih.gov
21. Malignant mimicry: A rare case of pulmonary mucoepidermoid carcinoma presenting as obstructive pneumonia.pubmed.ncbi.nlm.nih.gov
22. Management of Adult Bronchiectasis: Consensus-Based Guidelines of the German Respiratory Society.pubmed.ncbi.nlm.nih.gov
23. Endobronchial Schwannoma Presenting as Persistent Cough: Diagnosis and Successful Bronchoscopic Resection.pubmed.ncbi.nlm.nih.gov
24. Beyond the usual - Atypical imaging presentation in lung cancer and implications for TNM-staging.pubmed.ncbi.nlm.nih.gov
25. Bronchial Mucoepidermoid Carcinoma in a Pediatric Patient: A Case Report.pubmed.ncbi.nlm.nih.gov
26. Typical carcinoid tumor originating from the tracheal carina managed with carinal resection and neo-carinal bronchoplastic reconstruction: a case report.pubmed.ncbi.nlm.nih.gov
27. Clinical Responses to Tarlatamab Among Patients With Pulmonary Carcinoid.pubmed.ncbi.nlm.nih.gov
28. Advanced pulmonary carcinoid managed with chemoimmunotherapy and antiangiogenic agent: A case report and literature review.pubmed.ncbi.nlm.nih.gov
29. Endobronchial lipoma presenting as a fat-attenuation lesion causing left upper lobar bronchial obstruction: A case report.pubmed.ncbi.nlm.nih.gov
30. Bronchial artery embolization before endobronchial resection to avoid severe bleeding in central airway obstruction: a single-center retrospective pilot study.pubmed.ncbi.nlm.nih.gov
31. Diagnostic Anatomic Imaging for Neuroendocrine Neoplasms: Maximizing Strengths and Mitigating Weaknesses.pubmed.ncbi.nlm.nih.gov
32. CT-Occult Primary Benign Tracheobronchial Neoplasms: A Single-Center 40-Case Clinicopathologic Series.pubmed.ncbi.nlm.nih.gov
33. CT Findings of Asthma and Asthma-Mimicking Conditions.pubmed.ncbi.nlm.nih.gov
34. Surgically Diagnosed Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia in Asymptomatic Patients.pubmed.ncbi.nlm.nih.gov
35. Clinical characteristics of diffuse idiopathic pulmonary neuroendocrine cell hyperplasia.pubmed.ncbi.nlm.nih.gov
36. CT Findings of Central Airway Lesions Causing Airway Stenosis-Visualization and Quantification: A Pictorial Essay.pubmed.ncbi.nlm.nih.gov
37. Solitary round pulmonary lesions in the pediatric population: a pictorial review.pubmed.ncbi.nlm.nih.gov
38. Tracheobronchial tumors.pubmed.ncbi.nlm.nih.gov
39. Pediatric pulmonary nodules: current state of knowledge, AI applications, and future directions.pubmed.ncbi.nlm.nih.gov
40. Primary Bronchial Hybrid Low-Grade Fibromyxoid Sarcoma/Sclerosing Epithelioid Fibrosarcoma With EWSR1::CREB3L1 Fusion: Diagnostic Insights From a Challenging Case in the Respiratory Tract.pubmed.ncbi.nlm.nih.gov
41. Evaluating Korean Lung-RADS Category 2b: Diagnostic Performance and Interreader Agreement in Lung Cancer Screening.pubmed.ncbi.nlm.nih.gov
42. Three-Tier Prognostic Stratification of Lung Carcinoids (NET G1-G2-G3) by Multivariable, Data-Driven Integration of Ki-67 and Mitotic Count.pubmed.ncbi.nlm.nih.gov
43. Historical Evolution of Terminology and Current Classification of Neuroendocrine Neoplasms of the Larynx and Mixed Neuroendocrine-Non-Neuroendocrine Neoplasms (MiNENs): A Narrative Review.pubmed.ncbi.nlm.nih.gov
44. What's new in neoplastic pulmonary pathology 2026: updates on grading, staging and molecular testing.pubmed.ncbi.nlm.nih.gov
45. Clinical utility of molecular profiling in rare lung neuroendocrine neoplasms.pubmed.ncbi.nlm.nih.gov
46. Diffuse cystic lung diseases-a primer for radiologists.pubmed.ncbi.nlm.nih.gov
47. A modified orthotopic left lung transplantation model in rats.pubmed.ncbi.nlm.nih.gov
48. Fleischner Society: Glossary of Terms for Thoracic Imaging.pubmed.ncbi.nlm.nih.gov
49. Methods to localize cell specific alterations within the 3D context of the lung.pubmed.ncbi.nlm.nih.gov
50. Human lungs fluid mechanics: an overview of current modelling techniques.pubmed.ncbi.nlm.nih.gov
51. Prone positioning in cone beam CT-guided robotic bronchoscopy case series: a strategy to minimize atelectasis and improve access to posteromedial lower lobe nodules.pubmed.ncbi.nlm.nih.gov
52. A review on diagnostic assessments of tracheal stenosis.pubmed.ncbi.nlm.nih.gov
53. Protein Expression of immune checkpoints STING and MHCII in small cell lung cancer.pubmed.ncbi.nlm.nih.gov
54. Pulmonary carcinoid harboring a <i>KRAS</i> G12C mutation identified through comprehensive genomic profiling and responding to sotorasib: A case report.pubmed.ncbi.nlm.nih.gov
55. Well-Differentiated Neuroendocrine Tumors of Lung: A Case Series Supporting the IARC/WHO Common Classification of Neuroendocrine Tumor Nomenclature and Grading.pubmed.ncbi.nlm.nih.gov
56. Thymic neuroendocrine tumours: molecular landscape, immune microenvironment and therapeutic perspectives.pubmed.ncbi.nlm.nih.gov
57. Metastatic neuroendocrine lesions in diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH): a narrative review and case series.pubmed.ncbi.nlm.nih.gov
58. Small biopsy diagnosis of anterior mediastinal masses: histologic, immunohistochemical, and molecular considerations.pubmed.ncbi.nlm.nih.gov
59. Stepwise diagnostic algorithm for high-attenuation pulmonary abnormalities on CT.pubmed.ncbi.nlm.nih.gov
60. Special Issue: EACR 2026 Congress: Innovative Cancer Science, 8-11 June 2026.pubmed.ncbi.nlm.nih.gov
61. The first CT-based classification system for pulmonary actinomycosis: correlating imaging patterns with therapeutic strategies and prognosis in a highly misdiagnosed disease.pubmed.ncbi.nlm.nih.gov
62. A rare incidence of primary pulmonary undifferentiated pleomorphic sarcoma detected as an endobronchial mass and treated by bronchoscopic resection: a case report and literature review.pubmed.ncbi.nlm.nih.gov
63. Pulmonary cavitary lesions: a captivating visual review.pubmed.ncbi.nlm.nih.gov
64. Contrast-Enhanced CT Finding of Hot Spot Sign Secondary to Supra Hilar Mass Causing Superior Vena Cava Syndrome: A Case Report.pubmed.ncbi.nlm.nih.gov
65. New insights into imaging of pulmonary metastases from extra-thoracic neoplasms.pubmed.ncbi.nlm.nih.gov
66. Incidentally Discovered Pulmonary Hamartoma: A Case Report and Review of the Literature.pubmed.ncbi.nlm.nih.gov
67. CT Imaging Features of Pulmonary Sarcoidosis: Typical and Atypical Radiological Features and Their Differential Diagnosis.pubmed.ncbi.nlm.nih.gov
68. Role of interventional pulmonology in intensive care units: A scoping review.pubmed.ncbi.nlm.nih.gov
69. Diagnosis of lung cancer by flexible fiberoptic bronchoscopy: a descriptive study.pubmed.ncbi.nlm.nih.gov
70. Synchronous Pulmonary and Cecal High-Grade Neuroendocrine Carcinomas Presenting as Hepatic Metastases: A Diagnostic Challenges and Literature Review.pubmed.ncbi.nlm.nih.gov
71. Neuroblastoma Metastasis to the Mandible in Children: A Case Report and Focused Narrative Review of Reported Cases.pubmed.ncbi.nlm.nih.gov
72. The forgotten airway: central airway pathology in the ICU.pubmed.ncbi.nlm.nih.gov
73. Typical endobronchial carcinoid tumor in a 15-year-old female: A case report.pubmed.ncbi.nlm.nih.gov
74. Head-to-head comparison of ¹⁸F-PSMA and ¹⁸F-FDG PET/CT in locoregionally advanced head and neck squamous cell carcinoma: a pilot study.pubmed.ncbi.nlm.nih.gov
75. Trop2-targeted PET/CT imaging with ⁶⁸Ga-MY6349 improves diagnostic accuracy and influences clinical management in breast cancer.pubmed.ncbi.nlm.nih.gov
76. Distinct mutation landscape with similar immune microenvironment in primary simultaneous operable squamous cell carcinoma and peripheral-type small-cell lung cancer.pubmed.ncbi.nlm.nih.gov
77. Mobile Cone-Beam CT-Guided Transbronchial Cryobiopsy of a <i>Penicillium</i> Granuloma via the Right Post-Eparterial Bronchus.pubmed.ncbi.nlm.nih.gov
78. Anatomically Based Analysis of Radioaerosol Distribution in Pulmonary Scintigraphy: A Feasibility Study in Asthmatics.pubmed.ncbi.nlm.nih.gov
79. Left atrial anatomy relevant to catheter ablation.pubmed.ncbi.nlm.nih.gov
80. A pulsatile endobronchial lesion: A vascular mimic of airway pathology.pubmed.ncbi.nlm.nih.gov
81. State-of-the-Art Mediastinal Staging in Non-Small-Cell Lung Cancer: Integration of Combined Endosonographic Techniques with Updated IASLC TNM 9th Classification.pubmed.ncbi.nlm.nih.gov
82. Missed Incidental Lung Cancer on Neck CT: Determinants and Impact on Diagnostic Delay and Stage Shift.pubmed.ncbi.nlm.nih.gov
83. Recent advances in artificial intelligence across interventional pulmonology: a narrative review.pubmed.ncbi.nlm.nih.gov
84. Clinical Application of Spiral CT Reconstruction Imaging in Patients with Tracheal Stenosis before Anesthesia.pubmed.ncbi.nlm.nih.gov
85. Pneumonia in normal and immunocompromised children: an overview and update.pubmed.ncbi.nlm.nih.gov
86. Lung imaging methods: indications, strengths and limitations.pubmed.ncbi.nlm.nih.gov
87. Symptomatic Sclerosing Pneumocytoma of Lung: A Diagnostic Challenge with Diverse Morphological Patterns.pubmed.ncbi.nlm.nih.gov
88. Invasive mucinous adenocarcinoma of the lung: integrating molecular landscape, imaging phenotypes, and translational therapeutic strategies.pubmed.ncbi.nlm.nih.gov
89. A Second Look at Refractory Edema: Delayed Diagnosis of Paraneoplastic Cushing's Syndrome in Small Cell Lung Cancer.pubmed.ncbi.nlm.nih.gov
90. A multigenomic liquid biopsy biomarker for neuroendocrine tumor disease outperforms CgA and has surgical and clinical utility.pubmed.ncbi.nlm.nih.gov
91. International Society of Paediatric Surgical Oncology (IPSO) Surgical Practice Guidelines.pubmed.ncbi.nlm.nih.gov
92. Aspirated Soybean Mimicking Endobronchial Tumour Removed With a Cryoprobe.pubmed.ncbi.nlm.nih.gov
93. Tracheobronchial mucoepidermoid carcinoma in four pediatric patients.pubmed.ncbi.nlm.nih.gov
94. Radiomic and Clinical-Pathological Factors Predictive of Postoperative Recurrence in Lung Neuroendocrine Tumors: A Pilot Study.pubmed.ncbi.nlm.nih.gov
95. Advanced Deep Learning Fusion Model for Early Multi-Classification of Lung and Colon Cancer Using Histopathological Images.pubmed.ncbi.nlm.nih.gov
96. Commentary: an eye on PET quantification.pubmed.ncbi.nlm.nih.gov
97. Synchronous Ovarian and Cervical Malignancies: A Case Report of Neoadjuvant Chemotherapy Followed by Interval Debulking Surgery and Niraparib Maintenance.pubmed.ncbi.nlm.nih.gov
98. Human biomarker navigator.pubmed.ncbi.nlm.nih.gov
99. Peptides as integrative modulators for clinical prognosis and targeted therapy in pancreatic cancer.pubmed.ncbi.nlm.nih.gov
100. Thoracotomy for Urgent Repair of Lung Torsion Identified as an Incidental Finding.pubmed.ncbi.nlm.nih.gov
101. Staged uniportal video-assisted thoracoscopic bilateral lower lobectomy for bilateral intralobar pulmonary sequestration complicated by <i>Aspergillus</i> infection: a case report.pubmed.ncbi.nlm.nih.gov
102. Beyond the Usual Suspects: Rare Causes of Hemoptysis.pubmed.ncbi.nlm.nih.gov
103. A preclinical animal study to evaluate the operability and safety of domestic one-way endobronchial valves.pubmed.ncbi.nlm.nih.gov
104. Functional and structural evaluation in the lungs of children with repaired congenital diaphragmatic hernia.pubmed.ncbi.nlm.nih.gov
105. Non-small cell lung carcinoma (NSCLC): Implications on molecular pathology and advances in early diagnostics and therapeutics.pubmed.ncbi.nlm.nih.gov
106. Identification of imaging-based pulmonary and extrapulmonary treatable traits in COPD: a review.pubmed.ncbi.nlm.nih.gov
107. Systematic review of PET imaging features and clinical applications in pulmonary NUT carcinoma.pubmed.ncbi.nlm.nih.gov
108. Evaluation of Cavitary Lung Lesions with ¹⁸F-FDG PET/CT: Differentiating Benign from Malignant Lesions.pubmed.ncbi.nlm.nih.gov
109. Clinicopathological analysis of 124 cardiac tumors: a single-center retrospective study.pubmed.ncbi.nlm.nih.gov
110. Bronchoscopic photodynamic therapy for endobronchial metastatic papillary thyroid carcinoma causing lobar airway obstruction: a case report.pubmed.ncbi.nlm.nih.gov
111. Metastatic renal cell carcinoma to the thyroid gland with tracheal invasion: A case report.pubmed.ncbi.nlm.nih.gov
112. Hepatoid adenocarcinoma of the lung with normal serum alpha-fetoprotein managed with thoracic radiotherapy followed by tislelizumab plus lenvatinib: a case report and systematic review.pubmed.ncbi.nlm.nih.gov
113. Lymph Node Assessment with Multiparametric Ultrasound: Normal Values, Morphologic Patterns, and Diagnostic Algorithms.pubmed.ncbi.nlm.nih.gov
114. Cryobiopsy Outperforms Fine-Needle Aspiration for Mediastinal Lymphadenopathy: A Within-Patient Diagnostic Accuracy Study and Clinical Predictors of Success.pubmed.ncbi.nlm.nih.gov
115. When Hiccups Speak Louder Than Cough: A Case Report of An Unusual Presentation of Lung Abscess.pubmed.ncbi.nlm.nih.gov

Eğitim amaçlıdır; hasta başında tanı ve tedavi kararının yerine geçmez, tıbbi tavsiye değildir. Metinler yapay zekâ desteğiyle yazıldı ve otomatik bir adımda kaynak alıntılarıyla karşılaştırıldı; bu bir tıbbi doğrulama değildir ve içerik uzman radyolog incelemesinden geçmedi. Klinik kararlarda güncel kılavuzları, kurum protokollerini ve radyoloji raporunu esas alın.