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Medicine Respiratory dd83f532

A 45 year old female presents with hemoptysis and cough. Hemoptysis started 2 weeks ago followed by fever and cough. X-rays showed left upper lobe consolidation. Antibiotics were given. Fever improved but cough and hemoptysis persisted. BP 110/72 mmHg, Pulse 70/min. Bronchoscopy shows a mass filling the left bronchus. Likely diagnosis

A
Hamartoma
B
Carcinoid
C
Pulmonary tuberculosis
D
Sarcoidosis
High-Yield Explanation
Answer: b) Carcinoid (ROBBINS 9th ED, P-719)LUNG CARCINOIDSUsually in patients < 40 years of ageThe central tumors grow as fingerlike or spherical polypoid masses that commonly project into the lumen of the bronchus and are usually covered by an intact mucosaMost are confined to the mainstem bronchi.Others, however, penetrate the bronchial wall to fan out in the peribronchial tissue, producing the so-called collar-button lesionIntraluminal growth cause - persistent cough, hemoptysis, impairment of drainage of respiratory passages with secondary infections, bronchiectasis, emphysema, and atelectasisMost bronchial carcinoids do not have secretory activityOnly 10 % of bronchial carcinoids give rise to carcinoid syndromeMost do not metastasize to distant sitesFollow a relatively benign course for long periods Lung hamartomaHamartoma is the most frequent benign neoplasm of lung.X-ray: Coin lesionPopcorn calcification

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