The term bronchial adenoma covers a variety of tumours, of which approximately 90% are carcinoid tumours arising from cells of the APUD series.
These arise within large bronchi and typically, affect adults under the age of 45 years.
They are soft, fleshy nodules, and macroscopically, produce a dumb bell appearance. Histologically, the cells have a packeted architecture. The cells contain large numbers of dense-core agentaffin granules and secrete a variety of biogenic amines, especially serotonin.
Common clinical features include cough, haemoptysis (the tumour is vascular and bleeds easily), breathlessness, unilateral wheeze and recurrent infections. The condition may be mistaken for asthma because of wheezing dyspnoea.
The tumour is generally not visible on chest X-ray. The most common radiological abnormality is volume loss or lobar collapse. Diagnosis is generally made as a result of bronchoscopy.
Surgical resection is the treatment of choice.
Bronchial carcinoids are low grade malignancies and show a good prognosis, with an 80% 5 year survival rate.
Only rarely, does the carcinoid syndrome occur.
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