Background: Recurrent pneumonia necessitates thorough evaluation for underlying pathology, especially in cases with inadequate response to standard treatment.Although bronchial carcinoid tumors are rare, they are important differential diagnoses due to their indolent nature and potential to obstruct the airways.Case description: A 40-year-old previously healthy woman presented with intermittent fever and right-sided pleuritic chest pain.She had a history of two episodes of pneumonia affecting the same lung region, along with scant hemoptysis 6 months prior.Clinical examination revealed right lower zone crepitations and reduced air entry.Laboratory tests showed leukocytosis and elevated inflammatory markers, while sputum screening for tuberculosis was negative.Imaging revealed recurrent consolidation in the right lower lobe with mild pleural effusion despite empirical antibiotic therapy.Contrast-enhanced computed tomography (CECT) identified a suspicious lesion in the right lower lobe with distal atelectasis.Bronchoscopy revealed an endobronchial mass obstructing the truncus intermedius.Histopathological and immunohistochemical analysis confirmed a low-grade neuroendocrine tumor (NET) (typical bronchial carcinoid).The patient was referred for surgical management.Discussion: Bronchial carcinoid tumors account for approximately 2% of lung cancers and may present with nonspecific symptoms such as recurrent pneumonia, often due to impaired bronchial secretion clearance from proximal airway obstruction.Diagnosis relies on imaging and histological confirmation, with somatostatin receptor imaging offering additional diagnostic value.In typical carcinoids with low proliferative indices, surgical resection remains the treatment of choice and is associated with favorable outcomes.Conclusion: This case highlights the importance of maintaining a high index of suspicion for bronchial carcinoid tumors in patients with recurrent, localized pneumonia unresponsive to standard therapy.Prompt imaging and histological confirmation are essential to avoid diagnostic delays and ensure appropriate management.
Munasinghe et al. (Tue,) studied this question.