Bronchial carcinoid tumor
These tumors are graded on histological appearance:
- Grade 1 describes well-differentiated tumors with a zellballen or nesting appearance.
- Grade 2 describes cells with atypical appearance or increased mitotic activity in otherwise well-differentiated cells.
- Grade 3 describes poorly differentiated cells.
Bronchial carcinoid tumors occur in adulthood with an approximate average age of diagnosis in the early to mid-50s. Common findings include cough, dyspnea, chest pain, hemoptysis, wheezing (as a result of either airway obstruction or, less often, carcinoid syndrome), and reoccurring pneumonia. ACTH-secreting tumors may result in Cushing syndrome. Excess serotonin secretion may cause carcinoid syndrome; however, carcinoid syndrome is more commonly a manifestation of gastrointestinal carcinoid tumors and may be a sign of metastasis with a primary bronchial carcinoid tumor.
D38.1 – Neoplasm of uncertain behavior of trachea, bronchus and lung
253003009 – Carcinoid Bronchial Adenoma
- Asthma – underlying cause of wheeze / cough
- Chronic obstructive pulmonary disease
- Bronchiectasis – history of chronic infections
- Interstitial lung disease – idiopathic pulmonary fibrosis, hypersensitivity pneumonitis, sarcoidosis, asbestosis
- Lung cancer – adenocarcinoma, squamous cell carcinoma, small cell carcinoma, non-small cell carcinoma, pleural mesothelioma
- Infectious – upper respiratory tract infections, pneumonia, tuberculosis, aspergillosis, blastomycosis, histoplasmosis, coccidioidomycosis, human immunodeficiency virus (HIV)
- Tropical pulmonary eosinophilia – caused by Wuchereria bancrofti; characterized by cough, asthma attacks, and splenomegaly
- Autoimmune – antiglomerular basement membrane disease (Goodpasture syndrome), granulomatosis with polyangiitis, eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome)
- Anaphylaxis – acute presentation of hypotension, wheeze / dyspnea, rash, nausea / vomiting, diarrhea
- Foreign body aspiration – acute cough, wheezing, hemoptysis
- Pulmonary edema
- Pulmonary embolism – tachycardia, dyspnea, hemoptysis; evaluate with Wells' criteria or Geneva score
- Congestive heart failure
- Myocardial infarction
- Dilated cardiomyopathy
- Cushing syndrome – pituitary adenoma, adrenal tumor, or corticosteroid use
- Gastrointestinal carcinoid tumor – primary tumor or metastasis