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Endobronchial carcinoid

Case contributed by Muthu Magesh
Diagnosis almost certain

Presentation

6-year history of cough, hemoptysis, dyspnea and wheeze. Generally 1 episode of hemoptysis per day and about 10 ml per episode.

Patient Data

Age: 40 years
Gender: Male
x-ray

Ill-defined increased opacity in the right parahilar lung.

No other significant abnormality.

ct

A well-defined endoluminal homogenously enhancing soft tissue attenuation lesion in the right main bronchus extending proximally towards the carina, laterally into the origin of right upper lobe bronchus and inferiorly into the bronchus intermedius causing right upper lobe bronchial luminal compromise with adjacent lung changes in the form of atelectatic strands and ground glass opacities involving the apical and anterior segments of the right upper lobe.

Single focus of calcification.

Case Discussion

Histopathologically proven case of bronchial carcinoid associated with punctuate calcification and bronchial stenosis with distal mild atelectasis and obstructive pneumonitis. Marked contrast enhancement is common due to vascularity and can mimic pulmonary varix or pulmonary artery aneurysm

CT is valuable to look for mediastinal extension and to reveal mucoid impaction

Bronchial fibroepithelial polyp is a differential diagnosis.

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