[Bronchial carcinoid tumors. Analysis of 41 cases]. / Tumores bronquiales carcinoides. Análisis de 41 casos.

OBJECTIVE: The objective of this study has been the description of the cases of carcinoid tumor diagnosed in our Pneumology Service along the last 15 years. METHODS: The study has been conducted retrospectively, including the period between January 1, 1987 and December 31, 2001. The clinical histories of all patients with a diagnosis of carcinoid tumor have been reviewed, collecting the demographic clinical, radiological, bronchoscopic, therapeutic, and evolutionary data. RESULTS. On the whole, 41 cases were diagnosed, 36 typical (88%) and 5 atypical (12%), representing 2% of the total of lung neoplasms. The average age was 50 years, and 66% patients were males, with 61% of smokers and ex-smokers. The most relevant clinical parameter was cough with 68% of cases. Chest X-ray was pathological in 88% and CAT in 100%. Bronchoscopy was done in 40 patients, being the localization of the tumor peripheral in 10% and central in 90%. In 37.5% the classical endoscopic image suggestive of this tumor was observed. The definitive diagnosis was obtained in 26 cases by bronchial biopsy, in 14 cases through thoracotomy, and in 1 case by CAT-guided fine-needle aspiration biopsy. Surgical treatment was carried out in 36 patients (88%). Five year follow-up has been completed in 16 (39%) patients, with 5 recurrences (2 local and 3 systemic). Five patients were lost for follow-up (12%), and in the 20 patients remaining (49%) the evolution is less than 5 years, with no recurrences up to now. There has not been any death. CONCLUSIONS: We conclude that carcinoid tumors are infrequent, most of them central in location, and are diagnosed preferably by bronchoscopy, although the number of cases with suggestive findings is less than 50%. The treatment is surgical except for contraindications, and the percentage of recurrences has been limited.

[Persistent hemoptysis secondary to extensive epithelioid angiosarcoma]. / Hemoptisis de repetición secundarias a un angiosarcoma epitelioide generalizado.

Pulmonary angiosarcoma is an unusual cause of diffuse pulmonary hemorrhage. Angiosarcomas are rare malignant vascular tumors accounting for 1% to 2% of all sarcomas. Angiosarcomas have been detected in nearly all organs, but lung involvement is unusual, accounting for less than 7%. The literature describes approximately 10 isolated cases of primary pulmonary angiosarcoma as opposed to the more common metastatic type. Given that primary and metastatic types are clinicopathologically similar, the presence of a distant primary sarcoma must be ruled out before a diagnosis of primary pulmonary angiosarcoma can be made. A pathological diagnosis requires a finding of polygonal or oval cells with atypical irregular nuclei and vascular spaces lined with such cells surrounded by hemorrhagic phenomena. Immunohistochemical analysis is positive for specific endothelial cell markers such as CD31 and factor VIII, and coexpression of keratin is a frequent finding.