Pulmonary Atypical Carcinoid Tumor in a 15-Year-Old Girl: a Case Report and Review of the Literature
A 15-year-old healthy girl presented with cough and dyspnea for 3 days duration. Her past medical history showed reactive airway and asthma since last year. Physical examination showed blood pressure: 125/85; pulse rate:\n124/min; respiratory rate: 20/min; and temperature: 36.7°C. Heart examination was normal. There were decreased breathing sounds over the left lung. There was no wheezing or rales. Abdominal examination was normal with no organo megaly. Extremities were normal with no clubbing, edema or cyanosis.\nLaboratory examination showed leuckocytosis (WBC=16.4×103/mL), hemoglobin was normal (Hb=12 gr/L) and erythrocyte sedimentation rate was 14.\nWith the clinical impression of pneumonia, a chest X-ray was performed; it showed lung infiltration and consolidation (). Spiral computed tomography scan of the chest showed a small hypodensity in left main bronchus (). According to this finding and the patient’s vague history of foreign body ingestion, rigid bronchoscopy was performed which showed a small polyp like mucosal projection in left main bronchus, measuring 1×0.5 cm. The mass was excised by bronchoscopy. The patient had an uneventful postoperative course. The specimen in the pathology department received as a small nodule of about 1 cm with grey color and soft consistency. Microscopic findings showed bland looking epithelial to spindle shaped cells with mild atypia and nesting pattern separated by delicate fibrovascular stroma (,). The cells were rich in mitosis, i.e. there was 4 mitosis/0 HPF. The cells were strongly positive with Synaptophysin. According to the WHO criteria (2004) the tumor was diagnosed as AC. The patient was scheduled for bronchial sleeve operation, but unfortunately she didn’t accept to perform any additional procedure, but now after about 6 months, she is doing well and symptom free.