Bronchopulmonary carcinoid

Carcinoid tumors are neuroendocrine malignant tumors which may develop anywhere in the body where neuroendocrine (hormone-producing) cells exist . 75% of carcinoids arise in the gastrointestinal (GI) tract, particularly the small intestine. 25% of carcinoid tumors arise within the bronchopulmonary system, reflecting the high density of Kultschitzky cells in the respiratory epithelium. Bronchial carcinoid tumors previously were termed bronchial adenomas because of their presumed benign nature. In general, patients with bronchopulmonary carcinoids have a favorable prognosis (1). Histologically, carcinoids are of two types : typical (less malignant) or atypical (more malignant), depending on the degree of cellular atypia (2 ). Typical carcinoid tumors account for 85- 90% of carcinoid tumors and are diagnosed at an earlier age (mean. 35-50 years) than the atypical variety . Atypical carcinoid tumors are generally larger, and are found in both central and peripheral distribution. Paraneoplastic clinical manifestation such as carcinoid syndrome (cutaneous flushing, bronchospasm, chronic diarrhea, and valvular heart disease) and Cushing’s syndrome are usually rare and are more common with atypical carcinoid tumors. These tumors can be diagnosed using bronchoscopy, percutaneous fine needle aspiration or biopsy or nuclear scanning using Octretide as the radiotracer. Somatostatin-receptor scintigraphy performed with indium-111 (111 In) octreotide and111 In pentetreotide is used to image many neuro-endocrine tumors, including carcinoids with somatostatin-binding sites. It is a sensitive and noninvasive technique for imaging primary carcinoid tumors and carcinoid metastatic spread. The study is further improved with use of SPECT scanning. ( 3) Surgery remains the definite cure for carcinoids.