Bronchus intermedius carcinoid

Case contributed by Dr Dayu Gai

Presentation

3 months haemoptysis and shortness of breath

Patient Data

Age: 20-25 years
Gender: Male
X-ray

The right hemidiaphragm and heart border are obscured with mild ipsilateral volume loss suggestive of at least partial right lower and middle lobe collapse respectively. The left lung and pleural space are clear.  An obstructing bronchus intermedius lesion should be considered.

CT

The CT confirms right anterior and lateral basal lower lobe as well as middle lobe medial segment collapse. Hyperinflation of the unaffected right lung. There is a right main bronchus lesion extending into the bronchus intermedius. 

Nuclear medicine

DOTA-TATE PET study demonstrates avid tracer uptake in the right main bronchus endobronchial lesion, compatible with a carcinoid tumour.

Case Discussion

Pathology:
Right middle and lower lobe: typical carcinoid involving the right main bronchus and bronchus intermedius. Right middle and lower lobe bronchi uninvolved.

Good example of an obstructing lesion causing right middle and lower lobe partial collapse. In a young patient, pulmonary carcinoid is the top differential. The vast majority of pulmonary carcinoids are endobronchial (85%), as in this case.

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Case information

rID: 55137
Case created: 21st Aug 2017
Last edited: 22nd Aug 2017
System: Chest
Inclusion in quiz mode: Included

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