Tumor carcinoide endobrônquico: aspectos radiológicos em um caso clínico

Descrevemos um caso de paciente do gênero feminino, 21 anos, apresentando crises de dispneia e sibilância há 2 anos. Radiografia torácica evidenciou perda volumétrica do lobo inferior esquerdo e opacidade triangular basal retrocardíaca ipsilateral. Tomografia computadorizada mostrou formação expansiva sólida com ápice protruindo para o interior dos brônquios principal e lobar inferior esquerdos, promovendo atelectasia distal. Estudos anatomopatológico e imuno-histoquímico após biópsia transbrônquica da lesão diagnosticaram um tumor carcinoide típico, confirmado após ressecção tumoral com pneumectomia total esquerda.

Palavras-chave:
Tumor Carcinoide; Endobrônquico; Pulmonar; Típico; Diagnóstico por Imagem

Autoria

Rodolfo Mendes Queiroz ^**Correspondence: Address: Rua Bernardino de Campos, 980, Centro, Ribeirão Preto, SP – Brazil, Postal code: 14015-130. rod_queiroz@hotmail.com

Department of Radiology and Medical Imaging, Documenta – Hospital São Francisco, Ribeirão Preto, SP, BrazilDocumenta – Hospital São FranciscoBrazilRibeirão Preto, SP, BrazilDepartment of Radiology and Medical Imaging, Documenta – Hospital São Francisco, Ribeirão Preto, SP, Brazil

https://orcid.org/0000-0002-4893-4422

Danilo Brotto Ferreira de Santana

Rogério Nastri Filho

Gláucia Aparecida Magnani Landell

Department of Anatomical Pathology, Cytopathology and Histology; Anatomical Pathology and Cytopathology Unit, Prof. Dr. Humberto de Queiroz Menezes, Ribeirão Preto, SP, BrazilAnatomical Pathology and Cytopathology UnitBrazilRibeirão Preto, SP, BrazilDepartment of Anatomical Pathology, Cytopathology and Histology; Anatomical Pathology and Cytopathology Unit, Prof. Dr. Humberto de Queiroz Menezes, Ribeirão Preto, SP, Brazil

Paulo Roberto Félix

Marcus Vinícius Nascimento Valentin

*Correspondence: Address: Rua Bernardino de Campos, 980, Centro, Ribeirão Preto, SP – Brazil, Postal code: 14015-130. rod_queiroz@hotmail.com

SCIMAGO INSTITUTIONS RANKINGS

Figuras

Figuras (3)

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FIGURE 1
Chest radiographs in posteroanterior (A) and lateral (B) view revealing opacity at the left lung base (yellow arrowheads) within the retrocardiac space, appearing predominantly triangular with apex converging to the pulmonary hilum and base blurring of the edges of the diaphragm dome. Note the difference between the edges of the opacity in relation to the cardiac silhouette (*).

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FIGURE 2
Computed tomography scan of the thorax, mediastinal window, without contrast medium (A, C) and after administration of intravenous iodate contrast agent (B, D), revealing a left infrahilar lung mass causing subsegmentar atelectasis of the ipsilateral inferior lobe, with exophytic nodular component protruding into the lumen of the left main and lower subsegmental bronchi. We found scarce punctiform calcifications and diffuse linear foci (A, yellow arrow), as well as accentuated enhancement with contrast medium (B, D) in the extensive mass.

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FIGURE 3
A and B. HE staining, showing differentiated small cell epithelial proliferation with rounded, non-pleomorphic nuclei and granular chromatin, with a “salt and pepper” appearance of the tissue. C. Immunohistochemistry with chromogranin A showing cytoplasmic expression of gold-brown DAB in neoplastic cells.

FIGURE 1 Chest radiographs in posteroanterior (A) and lateral (B) view revealing opacity at the left lung base (yellow arrowheads) within the retrocardiac space, appearing predominantly triangular with apex converging to the pulmonary hilum and base blurring of the edges of the diaphragm dome. Note the difference between the edges of the opacity in relation to the cardiac silhouette (*).

FIGURE 2 Computed tomography scan of the thorax, mediastinal window, without contrast medium (A, C) and after administration of intravenous iodate contrast agent (B, D), revealing a left infrahilar lung mass causing subsegmentar atelectasis of the ipsilateral inferior lobe, with exophytic nodular component protruding into the lumen of the left main and lower subsegmental bronchi. We found scarce punctiform calcifications and diffuse linear foci (A, yellow arrow), as well as accentuated enhancement with contrast medium (B, D) in the extensive mass.

FIGURE 3 A and B. HE staining, showing differentiated small cell epithelial proliferation with rounded, non-pleomorphic nuclei and granular chromatin, with a “salt and pepper” appearance of the tissue. C. Immunohistochemistry with chromogranin A showing cytoplasmic expression of gold-brown DAB in neoplastic cells.

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E-mail: ramb@amb.org.br

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Tumor carcinoide endobrônquico: aspectos radiológicos em um caso clínico

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[1] *Correspondence: Address: Rua Bernardino de Campos, 980, Centro, Ribeirão Preto, SP – Brazil, Postal code: 14015-130. rod_queiroz@hotmail.com