Chest Infections: Noninfectious "Pneumonia" |

An Unusual Case of Pneumonia in a 20 Year Old FREE TO VIEW

Paramez Ayyappath, MD; Shine Shukoor, MD; Indira Kumari, MD
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KIMS Hospital, Kochi, India

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A135. doi:10.1016/j.chest.2016.02.140
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SESSION TITLE: Noninfectious “Pneumonia”

SESSION TYPE: Case Report Slide

PRESENTED ON: Sunday, April 17, 2016 at 01:00 PM - 02:00 PM

INTRODUCTION: Carcinoid tumours are rare tumors of the lung and is usually detected in middle aged. It is extremely rare in young adults and children. 9 out of 10 lung carcinoids are typical.

CASE PRESENTATION: 20 year old male presented with high grade fever, cough and purulent expectoration and severe breathlessness. He had history of Pneumonia 3 months back. He was hypoxic and examination revealed decreased intensity of breathsounds on left side of chest. CXR PA view revealed consolidation and suspected collapse of left lower lobe and lingula. He was initiated on CAP regimen and mucolytics and CXR repeated on next day showed a complete collapse of left lung. A CECT chest was done followed by bronchoscopy; which revealed an endobronchial lesion in left main bronchus. Biopsy of the tumour was consistent with atypical carcinoid. Left side pneumonectomy was performed and metastastic workup revealed lesions in liver for which he is presently undergoing treatment.

DISCUSSION: Atypical Carcinoid tumours are extremely rare tumours in young adults and a strong index of suspicion is required for the diagnosis of the same in younger population.

CONCLUSIONS: An early diagnosis is essential as the risk of metaststis is high in atypical carcinoids as compared to typical carcinoids. Almost all lung carcinoids detected during childhood and young adults are typical carcinoids. In our case an agressive atypical carcioid was the culprit. This case is discussed for the rarity of presentation.

Reference #1: Pediatric case of the day. Neuroendocrine carcinoma (atypical carcinoid/Kulchitzky-cellcarcinoma II), Lee GH, Dietrich RB, Pais B, et al., Radiographics, 1994;14(1):188-91.

Reference #2: Atypical carcinoid of the lung. A distinct clinicopathologic entity. T H Grote; W R Macon; B Davis; F A Greco; D H Johnson. Chest. 1988;93(2):370-375. doi: 10.1378/chest.93.2.370

DISCLOSURE: The following authors have nothing to disclose: Paramez Ayyappath, Shine Shukoor, Indira Kumari

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