Anatomic Distribution and Clinical Presentation of Pulmonary Carcinoids: A Single-Institutional Study

Sep 21, 2026

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Pulmonary carcinoid tumors (PCTs) have traditionally been described as mainly central lung lesions that produce postobstructive symptoms. A contemporary rise in cross-sectional imaging and incidental pulmonary nodule detection may be changing this pattern, but recent evidence has been limited. This single-institution retrospective study evaluates how PCT clinical presentation and imaging characteristics have evolved over time.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages5

Reading Time13 min

AccessFree to download

Background

Methods

Results

Conclusions

ª 2024 The Authors. Published by Elsevier Inc. on behalf of The Society of Thoracic Surgeons. This is an open access article under the CC BY license ([http://creativecommons.org/licenses/by/4.0/](http://creativecommons.org/licenses/by/4.0/)). 2772-9931 [https://doi.org/10.1016/j.atssr.2024.10.019](https://doi.org/10.1016/j.atssr.2024.10.019) 299 Lung: Short Report Anatomic Distribution and Clinical Presentation of Pulmonary Carcinoids: A Single-Institutional Study Douglas H. Russ, MD,1 Julie A. Barta, MD,2 Nathaniel R. Evans 3rd, MD,3 and Gregory C. Kane, MD2 ABSTRACT BACKGROUND Pulmonary carcinoid tumors (PCTs) have historically manifested predominantly as central lung lesions causing postobstructive symptoms. However, nearly all case series of PCTs to date evaluate cohorts in years before 2010 . Because an increased volume of cross-sectional imaging studies results in more frequent detection of incidental lung nodules, we sought to evaluate whether the nature of this cancer’s clinical characteristics may be evolving by studying a contemporary series of patients. METHODS The study analyzed all patients with a diagnosis of PCT at Thomas Jefferson University Hospital (Philadelphia, PA) between 2006 and 2020 . The study evaluated tumor location within the bronchial tree (ie, central or peripheral), the presence or absence of symptoms at diagnosis, patient demographics, and nodule characteristics on computed tomography. RESULTS A total of 73 PCTs were analyzed in 72 patients. Most PCTs were detected incidentally (48 of 72; 95% CI: 55% -77%) and located peripherally (41 of 67; 95% CI: 49% -73%) . Logistic regression analysis demonstrated that the likelihood of PCTs having these features increased over the study period. CONCLUSIONS PCTs manifested predominantly as peripheral lung lesions detected incidentally on computed tomography, which contrasts with the existing literature. This may reﬂect the changing nature of PCT diagnosis as cross-sectional imaging volume has increased. Clinicians should be mindful that incidental solitary pulmonary nodules detected on chest imaging may represent PCT, especially if the lesions are slow growing. (Ann Thorac Surg Short Reports 2025;3:299-303) ª 2024 The Authors. Published by Elsevier Inc. on behalf of The Society of Thoracic Surgeons. This is an open access article under the CC BY license ([http://creativecommons.org/licenses/by/4.0/](http://creativecommons.org/licenses/by/4.0/)). P ulmonary carcinoid tumor (PCT) is a relatively rare neuroendocrine neoplasm accounting for 1% to 5% of all lung cancers.1 PCT is subclassiﬁed as low-grade (typical) or intermediate-grade (atypical) by the degree of mitotic activity observed on histopathologic examination. Studies demonstrate 10-year overall survival of approximately 90% for typical carcinoid and 50% for atypical carcinoid.2 In clinical practice, PCT often manifests as a solitary pulmonary nodule (SPN) on computed tomography (CT) scans, with numerous studies reporting a predominance of centrally located tumors causing postobstructive symptoms on presentation.2 Surgical resection remains the standard of care, with systemic chemotherapy Accepted for publication Oct 28, 2024 . 1Division of Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania; 2Division of Pulmonary, Allergy, & Critical Care Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania; and 3Division of Thoracic Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania Address correspondence to Dr Russ, Division of Medicine, Thomas Jefferson University Hospital, 1420 Locust St, Unit 20G, Philadelphia, PA 19102; email: [douglas.russ@jefferson.edu](douglas.russ@jefferson.edu). 300 RUSS ET AL AnnThorac Surg Short Reports CLINICAL PRESENTATION OF LUNG CARCINOIDS 2025;3:299-303 playing a limited role in advanced and unresectable disease.3 Most studies of PCT to date have analyzed patie

FAQs

Why did the authors investigate pulmonary carcinoids over time?

They aimed to determine whether clinical characteristics have evolved as incidental lung nodules become more frequently detected through increased cross-sectional imaging.

How were tumor location and symptoms assessed in the study?

Tumor location within the bronchial tree (central versus peripheral) and presence or absence of symptoms at diagnosis were evaluated, alongside patient demographics and CT nodule characteristics.

What did the study find about where PCTs tend to appear?

Most analyzed PCTs were detected incidentally and located in the lung periphery, contrasting with older literature emphasizing central lesions and postobstructive symptoms.

Sep 21, 2026

Uploaded by Ophelia