Distinguishing Bronchial Carcinoid from Benign Bronchocele using ⁶⁸Ga-DOTATOC PET/CT Imaging

Bronchial carcinoids are low-grade neuroendocrine tumors with slow growth rates and the potential to spread to nearby lymph nodes. Here we present a challenging case of bronchial carcinoid visualized alongside an adjacent benign bronchocele. Chest computed tomography (CT) identified the endobronchial mass with unclear morphological and diagnostic insights. A differential diagnosis of several benign and malignant etiologies was made. Subsequently, an endobronchial biopsy confirmed lung carcinoid. For better evaluation, a ⁶⁸Ga-labeled 1,4,7,10-tetraazacyclododecane-N,N',N'',N'''-tetraacetic acid-d-Phe1-Tyr3-octreotide (⁶⁸Ga-DOTATOC) positron emission tomography/CT scan was performed. The scan revealed a locally confined endobronchial mass with intense ⁶⁸Ga-DOTATOC expression. Adjacent benign bronchocele was visualized with insignificant ⁶⁸Ga-DOTATOC expression. Histopathological examination of the resected upper lobe confirmed these findings. This case highlights the importance of somatostatin receptor imaging in accurately identifying the extent of carcinoid tumors in the primary, nodal, and metastatic domains.