Carcinoid syndrome caused by a pulmonary carcinoid mimics intestinal manifestations of ulcerative colitis:A case report

BACKGROUND Pulmonary carcinoids are rare,low-grade malignant tumors characterized by neuroendocrine differentiation and relatively indolent clinical behavior.Most cases present as a slow-growing polypoidal mass in the major bronchi leading to hemoptysis and pulmonary infection due to blockage of the distal bronchi.Carcinoid syndrome is a paraneoplastic syndrome caused by the systemic release of vasoactive substances that presents in 5%of patients with neuroendocrine tumors.Due to such nonspecific presentation,most patients are misdiagnosed or diagnosed late and may receive several courses of antibiotics to treat recurrent pneumonia before the tumor is diagnosed.CASE SUMMARY We report the case of a 48-year-old male who presented with cough,dyspnea,a history of recurrent pneumonitis,and therapy-refractory ulcerative colitis that completely subsided after the resection of a pulmonary carcinoid.CONCLUSION We report and emphasize pulmonary carcinoid as a differential diagnosis in patients with nonresponding inflammatory bowel diseases and recurrent pneumonia.

肺部球形病灶的诊断原则

肺部球形病灶多在其它疾病行胸片检查时偶然发现,除非明确为非恶性疾患,否则一定要考虑到肿瘤可能。位于巴登州海德尔堡胸科医院1984年～1997年共有1467例不明原因的肺部球形病灶患者行手术治疗,结果发现51％为恶性肿瘤,49％为良性疾病。虽然影像学检查和内窥镜检查技术的进步,手术方法诊断恶性病灶所占的比例基本不变(1970年～1980年,49％;1984年～1997年,51％)。肺癌所占的比例由38％升至42.5％,而转移性肺癌通过手术诊断由9.2％降至4.9％。良性疾病中结核病所占比例明显减少。