ABSTRACT
Primary pulmonary carcinoid tumors are a group of relatively rare lung neoplasms.In the 2015 World Health Organization classification of lung tumors,lung carcinoid tumors(including both the classical and atypical types)were included in the category of pulmonary neuroendocrine tumors along with large cell neuroendocrine carcinomas and small cell lung carcinomas.Due to the low in-cidence and lack of specific clinical manifestations,the diagnosis and management of pulmonary carcinoid tumors remain relatively challenging.Current consensus supports surgery as the only curative option for localized,resectable pulmonary carcinoid tumors.How-ever,some inconsistencies exist between the guideline recommendations for systemic therapies that have resulted in a lack of consen-sus in regard to the standardized treatment for the metastatic or unresectable disease.This review intends to summarize the latest rec-ommendations for the diagnosis and multidisciplinary treatment of pulmonary carcinoid tumors.
ABSTRACT
Objective To investigate the value of 18 F-fluorodeoxyglucose (18 FDG)positron emission tomography and computer tomography (PET/CT)in the diagnosis and localization of ectopic ACTH syndrome (EAS)induced by lung cancer,and to increase the accuracy rate of diagnosis of EAS.Methods 8 patients were histopathologically proven to be lung cancer.18 FDG PET/CT wholebody and brain scan were performed;magnetic resonance imaging (MRI),99m Tc-octreotide (OCT)imaging and inferior petrosal sinus sampling (IPSS)were done in all patients.On 18 FDG PET/CT images,the SUVmax values of lesions and the SUVmax ratio of lesion tissue to normal lung tissue were calculated.Results ① 8 patients with EAS included 2 cases of carciniod,4 cases of atypical carciniod,and 2 cases of small cell lung cancer.The ACTH levels in inferior petrosal sinus and peripheral veins of 8 patients had no difference.②The chest CT showed there were pulmonary nodules in 6 cases (75%),among them 2 cases were atypical lesions.5 cases of pituitary adenomas were found by MRI (25%),and OCT imaging was positive in 2 cases (25%).③The 18 FDG PET/CT showed nodular,mass like or patch samples with high metabolic activity in 8 cases (100%)of pulmonary lesions.The SUVmax of tumor was 0.72 to 14.05 (3.67±4.68),and the ratio of SUVmax of lesion tissue to normal lung tissue was 1.69 to 27.54 (8.14 ± 9.63).18 FDG hypermetabolism was found in 8 cases of bilateral adrenal hyperplasia,while 4 cases showed pituitary tumor.Conclusion Lung cancer is a common source of EAS,especially carcinoid.18 FDG PET may show lower glucose metabolism.18 FDG PET/CT should be used as an assisted method to diagnose EAS.
ABSTRACT
Objective To investigate the prognostic factors and survival of patients with bronchopulmonary carcinoid tumors (BPC) after surgical treatment .Methods The clinical data of 87 patients undergoing surgery for BPC from Jan .2002 to Dec .2008 were reviewed retrospectively .Kaplan-Meier method was used to analyze the survival of the patients .The risk factors such as age , gender ,smoking history ,histological type ,tumor size ,were analyzed by Cox proportional hazards regression model .Results The 1-,3-and 5-year overall survival rates were 85 .1% ,71 .3% and 63 .2% .Univariate analysis revealed that age (P=0 .016) ,smoking history(P=0 .007) ,histological type(P=0 .000) ,tumor stage(P= 0 .000) ,tumor size(P= 0 .006) lymph node metastasis(P=0 .000) ,surgery type (P= 0 .045) and postoperative chemotherapy (P= 0 .000) were prognostic factors .Multivariate analysis showed that histological type(P=0 .008) ,tumor stage(P=0 .000) ,lymph node metastasis(P=0 .033) were independent prognostic factor .Conclusion The survival rate of the BPC patient after surgical treatment is high ,histological type ,tumor stage and lymph node metastasis were independent prognostic factors .
ABSTRACT
Objective:approach to the diagnostic value of 18F-FDG PET/CT on primary bronchial-pulmonary carcinoid.Methods:7 cases of peripheral bronchial-pulmonary carcinoid checked with CT and 18F-FDG PET/CT were analyzed retrospectively,the image characteristics,PET/CT standard uptake values were measured and compared with pathology results.Results:carcinoid were found 1 on apex and frontal of the upper right lung each,1 on middle lobe,2 on lower right lung,and 1 on apicoposterior segment of the upper left lung and posterior of lower segment each.The diameter were 3.4￣ 6.2 cm,average 5.4 cm.CT shows the lesions were round or irregular nodus with clear edge and even density similar to soft tissue,2 among which were slightly lobulated,1 with spicular sign and 1 with patching shade around.18F-FDG in all 7 cases were slight or significantly increased,SUV valued 3.3?1.4(2.8￣5.3),2 cases showed uneven distribution with irregular patching and linear defect.FDG uptake in mediastinal and celiac lymph nodes were increased in 1 case.All cases were later proven to be atypical neuroendocrine carcoma carcinoid by surgical pathology and 1 case with mediastinal lymph nodes metastasis Conclusion:bronchial-pulmonary carcinoid can clearly be shown by abnormal FDG concentration on PET image,and its malignancy can be judged base on concentration and structural changes,meanwhile,CT can precisely locate the lesion and provide detailed data of its relationship with surrounding tissue.