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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Carcinoid tumors of the lung are rare in childhood. Still they have to be taken in account as a possible reason for chronic pneumonitis, (with) cough or even hemoptysis. Misinterpretation of symptoms is the cause for the frequently long time lapse before the correct diagnosis is established. The crucial examinations are the history of symptoms, chest X-ray, tomography, and bronchoscopy, which lead to the correct diagnosis in about 75% of the cases. Treatment of choice is operative, with the aim to conserve as much functioning lung as possible. Radiotherapy has only palliative effects. The prognosis is rather good for the carcinoid tumor of the lung in general, 80% achieve a 5 years survival rate. The carcinoid tumor of the lung is now as for the newest definition defined as a separate group and should not be mixed up with "bronchial adenomas". Adenoid cystic carcinoma (cylindroma) and mucoepidermoid carcinoma of the bronchus are defined as carcinomas and believed to arise from respiratory glands.
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PMID:[Carcinoid tumor of the lung in childhood--review and case report (author's transl)]. 728 26

We reviewed 69 patients with documented carcinoid tumors, 67 of whom had resectable disease. Operations included nine pneumonectomies, 31 lobectomies, 12 bilobectomies, five segmental resections, and 10 sleeve resections. Follow-up on 65 patients reveals 40 surviving beyond 5 years and 13 beyond 20 years since resection. There were no operative deaths and only one recurrence (local) that was subsequently successfully resected. Twenty patients had had recurrent unifocal pneumonitis or hemoptysis for up to 5 years prior to diagnosis. Two patients had the carcinoid syndrome. Biopsy was performed on 23 tumors and resulted in "moderate-to-severe" hemorrhage in six cases. Lymphatic spread was present in seven cases. All seven are alive and free of disease, six of whom have been followed from 5 to 24 years. Diseased resection margins were present in two cases, with both surviving 20 years after resection. All 10 sleeve resections were performed more than 5 years ago. We conclude that carcinoid tumors carry a favorable prognosis upon resection, even when intrathoracic lymphatic metastases are present and are resected. Lung-sparing resections including sleeve resections should be utilized. Recurrent pneumonia or hemoptysis or both requires diligent investigation. Biopsy of the tumors may be performed with care.
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PMID:Bronchial carcinoid tumors: twenty years' experience. 735 32

A 29-yr-old male developed Cushing's syndrome with severe hypokalaemia, alkalosis and hypernatraemia. He died with Pseudomonas septicaemia and Nocardia pneumonia. At autopsy he was found to have a carcinoid tumour of the thymus which was not suspected before death, and marked bilateral hyperplasia of the adrenal cortex.
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PMID:Carcinoid tumour of the thymus with Cushing's syndrome. 743 24

Bronchial carcinoid tumors are usually indolent, slow-growing tumors with an excellent prognosis. However, even typical carcinoids can metastasize to regional lymph nodes or to distant sites. Atypical carcinoids tend to behave more invasively with more frequent nodal and distant metastases. Despite this, long-term survival can be expected as many tumors grow and spread slowly. At the end of the spectrum are the highly aggressive small cell carcinomas which have a very poor prognosis despite aggressive chemotherapy. Clinically, carcinoid tumors are frequently asymptomatic. Symptoms are most frequently due to obstruction (pneumonia, 'asthma', coughing) or bleeding. Carcinoid syndrome is seen infrequently and usually signifies metastatic disease. Cushing's syndrome is occasionally seen in association with these tumors. The treatment of carcinoid tumors is surgical. Resection should be complete and encompass the regional lymph nodes.
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PMID:Bronchial and thymic carcinoid tumors: a review. 769 41

We would like to describe the characteristics of affection by carcinoid tumor in our surroundings. In so doing, we have reviewed the clinical histories of the 131 cases of carcinoid tumor diagnosed in our center between 1972 and 1990. The incidence has been 0.7 cases per 100,000 inhabitants per year. The age at diagnosis is from 8 to 88 years, and the proportion of men to women is practically 1. The most common locale affected the appendix (54 cases) followed by the bronchials (46 cases). The most common clinical presentation has been casual discovery and in the bronchials, in addition to hemoptysis and pneumonia. Carcinoid syndrome was found in only 4 cases, and of 17 determinations of indole acetic 5-hydoxi acid, only 2 resulted pathological. There were four cases of hepatic metastasis and two deaths related with the tumor.
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PMID:[Carcinoid tumor. An analysis of 131 cases]. 802 94

We present a 61-year-old man who was hospitalized because of dyspnea, abdominal pain and liver dysfunction accompanied by ascites due to hepatic metastasis of a thymic carcinoid 20 years after the primary tumor was excised. His symptoms and liver function were well controlled by prednisolone, 30 to 60 mg daily, for the next 2 years, with a reduction in the size of the hepatic tumors and in the accumulation of ascites. He subsequently contracted pneumonia due to methicillin-resistant staphylococci, developed disseminated intravascular coagulation (DIC) and died. Thus, prednisolone should be considered for treating patients with metastasis of a thymic carcinoid.
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PMID:Efficacy of steroid therapy on liver metastasis of thymic carcinoid. 818 Apr 43

Bronchial carcinoid tumors (BCT) are the most frequent primary pulmonary neoplasms of childhood. Seventeen of 208 patients diagnosed as having BCT at the Massachusetts General Hospital were between 10 and 21 years of age. We reviewed our records of the 17 patients and 8 other pediatric cases and compared their findings with those of seven large series of adults. Distribution was equal between the sexes. The average age at diagnosis was 17 years; 4 patients were < or = 15 years old. The duration of symptoms prior to diagnosis varied from 2 weeks to 2.6 years, with a median duration of 8.5 months. In contrast to adults, no child was asymptomatic. The majority of children presented with wheezing and atelectasis in addition to the characteristic adult triad of cough, hemoptysis, and pneumonitis. Five patients presented with weight loss and one patient presented with hoarseness. One of the 17 pediatric patients presented with Cushing's syndrome and a functional BCT. Twelve of 14 patients were disease free for 9 months to 34 years after surgical resection. We conclude that BCT should be suspected in children with pneumonitis resistant to therapy, atelectasis, wheezing, and hemoptysis. Surgical resection will result in symptom-free recovery in the majority of cases in spite of low-grade malignancy.
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PMID:Bronchial carcinoid tumors in pediatric patients. 838 19

This study investigated 22 patients with histologically proven primary bronchial carcinoids and in particular the relationship between assessment parameters and survival. In each patient, age, sex, smoking habits, mode of presentation, results of diagnostic investigations, methods of treatment and pathological examination of resected specimens were recorded. Follow-up was possible in all patients for at least 5 years. Patients with atypical carcinoids were 10 years older than patients with typical ones. Eleven patients were smokers, all the patients with atypical and 4 patients with typical carcinoid. The most common presenting mode was pneumonia. Fiberoptic bronchoscopy was diagnostic in 11 cases. The survival rate for patients with typical carcinoid was 100%, while it was 57% in patients with atypical carcinoids. Patients with limited disease had a survival of 100%, while in stage III/IV patients showed a lower survival rate (50%). In conclusion, carcinoid tumors of the lung are tumors showing a good prognosis. Five-year survival indicated a significant difference between typical and atypical carcinoids and between limited and extensive disease. A precise staging is recommended for a better treatment and follow-up.
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PMID:Bronchial carcinoids. A review of 22 cases. 860 42

Carcinoid tumour of the thymus is a rare neuroendocrine tumour particularly at an advanced age. The authors report a case of a mediastinal mass in a man aged 85, the mass had remained asymptomatic for a long time. It was decided to achieve a diagnosis because the tumour was causing local compression: a mediastinal needle biopsy under computerised tomographic control confirmed that this was a carcinoid tumour and a study of the biopsy material using an electron microscope showed neurosecretory granules. A sternotomy enabled the tumour to be excised but a post-operative Pseudomonas pneumonia led to the death of the patient. This case underlines the diagnostic place of mediastinal needle biopsy in the presence of a mediastinal tumour. The technique can be carried out under computerised tomography or ultrasonography and this can be associated with a study of the biopsy specimen using electron microscopy which enables the diagnosis to be made before any therapeutic decisions. The treatment of choice of a carcinoid tumour of the thymus is surgery which confirms the tumour limits and also its thymic origin. Tumour excision can be completed using radiotherapy or even chemotherapy.
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PMID:[Carcinoid thymus tumor at an advanced age: diagnostic value of mediastinal needle biopsy with computerized tomography]. 871 Dec 39

Between 1981 and 1993, 27 bronchial carcinoids were diagnosed in patients living in the Swiss Canton of Ticino, with a mean age of 55 (24-78) years. The incidence was 0.79/100,000 inhabitants. Main symptoms were cough (41%), hemoptysis (30%) and bronchial obstruction such as pneumonia or atelectasis (26%). There were no cases with carcinoid crisis. Preoperative evaluation included chest X-ray (100%), bronchoscopic biopsy (84%), computed tomography (44%) and mediastinoscopy (15%). Some 69% of the patients underwent lobectomy and 15% segmental resection. Pneumonectomy was required for curative surgery in 2 patients. One patient underwent bronchoscopic resection. Surgery is generally indicated. The 5-year survival rate for typical carcinoid was 94% and was significantly reduced to 42% in atypical carcinoid cases (p = 0.02). Prognosis after radical surgery is favorable and depends mainly on lymph node involvement and the histological type of carcinoid.
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PMID:[Bronchus carcinoid tumor in the Tessin canton, retrospective analysis of 13 years and literature review]. 876 75


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