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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
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.
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.
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.