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Atypical carcinoid presenting as mesothelioma.

P van Hengel1, F van Geffen, B A Kazzaz

  • 1Department of Pulmonology, Ziekenhuis Leyenburg, The Hague, The Netherlands.

The Netherlands Journal of Medicine
|April 28, 2001
PubMed
Summary

Atypical carcinoid lung tumors can mimic mesothelioma, presenting with pleural thickening and pain. Autopsies revealed this rare presentation, highlighting diagnostic challenges in asbestos-exposed patients.

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Area of Science:

  • Pulmonology
  • Oncology
  • Pathology

Background:

  • Mesothelioma is often suspected in patients with asbestos exposure presenting with pleural thickening.
  • Atypical carcinoid tumors are rare neuroendocrine neoplasms of the lung.

Observation:

  • Two patients with asbestos exposure history presented with pleuritic pain and dyspnea.
  • Chest X-rays revealed pleural thickening, initially suggesting mesothelioma.
  • Diagnosis was challenging, with symptomatic therapy initiated.

Findings:

  • Autopsy unexpectedly revealed atypical carcinoid of the lung in both patients.
  • One case showed pleural tumor spread; the other had significant fibrotic pleural reaction.
  • These are the first reported instances of atypical carcinoid causing a pseudomesothelioma presentation.

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Implications:

  • Atypical carcinoid should be considered in the differential diagnosis of pseudomesothelioma, especially in asbestos-exposed individuals.
  • This finding underscores the importance of thorough pathological examination for accurate diagnosis.
  • Further research may elucidate the mechanisms behind atypical carcinoid's pleural involvement.