“Functioning” Pulmonary Neoplasms: I. The Carcinoid Tumor; II. The Hemangiopericytoma

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THE initial recognition of the so-called “carcinoid syndrome” by Thorson, Biörck, Björkman, and Waldenström,1 as a clinicopathologic entity, has expanded the knowledge of functioning tumors to include neoplastic entities not previously believed to possess any endocrine activity. Although the disorder was initially believed to be limited to metastasizing gastrointestinal carcinoid tumors, evidence has accumulated that some malignant and metastasizing bronchial tumors have the same propensity to produce the syndrome of hyperserotonemia. In 1957 a review of 21 cases of bronchial adenoma, encountered and treated at the Cleveland Clinic, was reported.2 Later, a case of malignant carcinoid diagnosed six months after the removal of a bronchial neoplasm3 aroused our interest in the possible serotonin-producing properties of these tumors; consequently, we have made a detailed study of the three such tumors encountered since that time.

An allied problem concerns the nature of the hemangiopericytoma. This type of tumor was originally recognized by Stout and Murray,4 and a series of cases was reported by McCormack and Gallivan.5 Korn, Bensch, Liebow, and Castleman,6 however, have suggested the resemblance of one of these tumors to the “multiple peripheral bronchial adenomas.”7 This stimulated us to make a detailed pathologic and biochemical study of a recent specimen of malignant hemangiopericytoma.

I. The Carcinoid Tumor

Report of Cases

Case 1. A 49-year-old white man was admitted to the Cleveland Clinic Hospital on January 31, I960, because of a pulmonary “coin lesion.” A routine chest roentgenogram revealed evidence of the lesion that in 1958 was diagnosed as “a small . . .



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