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Young and Non-Smoking: An Unusual Case of Bronchial Carcinoid
Ancuța-Alina Constantin1,2, Antonio-Andrei Cotea2, Florin Dumitru Mihălțan1,2
1Department of Cardio-Thoracic Pathology, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Abstract:
We report the case of a 30-year-old female, non-smoker, with no known allergies or occupational exposures, presenting with a two-year history of recurrent stridor and wheezing, recently exacerbating over the past two months. Physical examination and routine laboratory tests were largely unremarkable. Pulmonary function tests were within normal limits, with no significant bronchodilator response. Chest CT revealed a 15 × 13 mm perihilar right-sided lesion adjacent to the right pulmonary artery. Bronchoscopy identified a nearly obstructive, highly vascularized endobronchial lesion at the origin of the right lower lobe bronchus, with involvement of the carina between the right middle and lower lobe bronchi. Histopathology confirmed a typical bronchial carcinoid. The patient underwent open right middle and lower lobe bilobectomy. What renders this case unusual is the combination of a prolonged two-year diagnostic delay with initial misdiagnosis as asthma, the critical anatomical location of the tumor at the bronchus intermedius with early involvement of the right middle lobe carina, and the consequent necessity of bilobectomy despite an otherwise low-risk, typical carcinoid histology. This case underscores the importance of considering endobronchial neoplasms in young, non-smoking patients with refractory or atypical airway symptoms, and highlights the role of integrated imaging and bronchoscopic evaluation in guiding individualized surgical planning.
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