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Pulmonary carcinoid

Case contributed by Henry Knipe
Diagnosis certain

Presentation

Immigration x-ray.

Patient Data

Age: 60 years
Gender: Male

This case is part of the new Radiopaedia.org Rapids course - test your skill in quickly picking abnormal cases from normal cases. 

x-ray

Rounded opacity projects over the right heart border. No other masses. No pleural effusion. No lymphadenopathy. 

ct

Pulmonary nodule seen at the inferior aspect of the right hilum. Calcified pleural plaques in keeping with history of previous asbestos exposure. No lymphadenopathy or other lesion. 

The pulmonary nodule was monitored and was slowly growing over a number of years. EBUS-guided biopsy was indeterminate, and the patient proceeded to right lower lobectomy. 

Histopathology:

Specimen: Right lower lobe

Size: 18x16x16mm

Site: 7mm from pleural surface

Histological type: Typical carcinoid tumor with predominantly a trabecular pattern. Mitotic activity amounts to less than one mitotic figure per 2mm squared fields. There is a pushing well demarcated advancing front to the tumor.

Case Discussion

This case is a nice variant on the retrocardiac lung cancer, which is more typically in the left lower lobe. There are no specific features to suggest a radiographic diagnosis of carcinoid.

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