Differentiating carcinoid syndrome from other diseases: Difference between revisions

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| rowspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |Carcinoid Syndrome<ref name="pmid30133565">{{cite journal |vauthors=Rubin de Celis Ferrari AC, Glasberg J, Riechelmann RP |title=Carcinoid syndrome: update on the pathophysiology and treatment |journal=Clinics (Sao Paulo) |volume=73 |issue=suppl 1 |pages=e490s |date=August 2018 |pmid=30133565 |pmc=6096975 |doi=10.6061/clinics/2018/e490s |url=}}</ref><ref name="pmid14693013">{{cite journal |vauthors=Hegyi J, Schwartz RA, Hegyi V |title=Pellagra: dermatitis, dementia, and diarrhea |journal=Int. J. Dermatol. |volume=43 |issue=1 |pages=1–5 |date=January 2004 |pmid=14693013 |doi= |url=}}</ref><ref name="pmid15100502">{{cite journal |vauthors=Savelli G, Lucignani G, Seregni E, Marchianò A, Serafini G, Aliberti G, Villano C, Maccauro M, Bombardieri E |title=Feasibility of somatostatin receptor scintigraphy in the detection of occult primary gastro-entero-pancreatic (GEP) neuroendocrine tumours |journal=Nucl Med Commun |volume=25 |issue=5 |pages=445–9 |date=May 2004 |pmid=15100502 |doi= |url=}}</ref><ref name="pmid151005022">{{cite journal |vauthors=Savelli G, Lucignani G, Seregni E, Marchianò A, Serafini G, Aliberti G, Villano C, Maccauro M, Bombardieri E |title=Feasibility of somatostatin receptor scintigraphy in the detection of occult primary gastro-entero-pancreatic (GEP) neuroendocrine tumours |journal=Nucl Med Commun |volume=25 |issue=5 |pages=445–9 |date=May 2004 |pmid=15100502 |doi= |url=}}</ref><ref name="BoraVithiavathi2012">{{cite journal|last1=Bora|first1=ManashKumar|last2=Vithiavathi|first2=S|title=Primary bronchial carcinoid: A rare differential diagnosis of pulmonary koch in young adult patient|journal=Lung India|volume=29|issue=1|year=2012|pages=59|issn=0970-2113|doi=10.4103/0970-2113.92366}}</ref><ref name="pmid25207053">{{cite journal |vauthors=Yazıcıoğlu A, Yekeler E, Bıcakcıoğlu P, Ozaydın E, Karaoğlanoğlu N |title=Synchronous bilateral multiple typical pulmonary carcinoid tumors: a unique case with 10 typical carcinoids |journal=Balkan Med J |volume=29 |issue=4 |pages=450–2 |date=December 2012 |pmid=25207053 |pmc=4115868 |doi=10.5152/balkanmedj.2012.081 |url=}}</ref><ref name="pmid14616879">{{cite journal |vauthors=Krausz Y, Keidar Z, Kogan I, Even-Sapir E, Bar-Shalom R, Engel A, Rubinstein R, Sachs J, Bocher M, Agranovicz S, Chisin R, Israel O |title=SPECT/CT hybrid imaging with 111In-pentetreotide in assessment of neuroendocrine tumours |journal=Clin. Endocrinol. (Oxf) |volume=59 |issue=5 |pages=565–73 |date=November 2003 |pmid=14616879 |doi= |url=}}</ref><ref name="van der LelyHerder2005">{{cite journal|last1=van der Lely|first1=Aart J.|last2=Herder|first2=Wouter W. de|title=Carcinoid syndrome: diagnosis and medical management|journal=Arquivos Brasileiros de Endocrinologia & Metabologia|volume=49|issue=5|year=2005|pages=850–860|issn=0004-2730|doi=10.1590/S0004-27302005000500028}}</ref><ref name="pmid28238592">{{cite journal |vauthors=Halperin DM, Shen C, Dasari A, Xu Y, Chu Y, Zhou S, Shih YT, Yao JC |title=Frequency of carcinoid syndrome at neuroendocrine tumour diagnosis: a population-based study |journal=Lancet Oncol. |volume=18 |issue=4 |pages=525–534 |date=April 2017 |pmid=28238592 |pmc=6066284 |doi=10.1016/S1470-2045(17)30110-9 |url=}}</ref>
| rowspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |Carcinoid Syndrome<ref name="pmid30133565">{{cite journal |vauthors=Rubin de Celis Ferrari AC, Glasberg J, Riechelmann RP |title=Carcinoid syndrome: update on the pathophysiology and treatment |journal=Clinics (Sao Paulo) |volume=73 |issue=suppl 1 |pages=e490s |date=August 2018 |pmid=30133565 |pmc=6096975 |doi=10.6061/clinics/2018/e490s |url=}}</ref><ref name="pmid14693013">{{cite journal |vauthors=Hegyi J, Schwartz RA, Hegyi V |title=Pellagra: dermatitis, dementia, and diarrhea |journal=Int. J. Dermatol. |volume=43 |issue=1 |pages=1–5 |date=January 2004 |pmid=14693013 |doi= |url=}}</ref><ref name="pmid15100502">{{cite journal |vauthors=Savelli G, Lucignani G, Seregni E, Marchianò A, Serafini G, Aliberti G, Villano C, Maccauro M, Bombardieri E |title=Feasibility of somatostatin receptor scintigraphy in the detection of occult primary gastro-entero-pancreatic (GEP) neuroendocrine tumours |journal=Nucl Med Commun |volume=25 |issue=5 |pages=445–9 |date=May 2004 |pmid=15100502 |doi= |url=}}</ref><ref name="pmid151005022">{{cite journal |vauthors=Savelli G, Lucignani G, Seregni E, Marchianò A, Serafini G, Aliberti G, Villano C, Maccauro M, Bombardieri E |title=Feasibility of somatostatin receptor scintigraphy in the detection of occult primary gastro-entero-pancreatic (GEP) neuroendocrine tumours |journal=Nucl Med Commun |volume=25 |issue=5 |pages=445–9 |date=May 2004 |pmid=15100502 |doi= |url=}}</ref><ref name="BoraVithiavathi2012">{{cite journal|last1=Bora|first1=ManashKumar|last2=Vithiavathi|first2=S|title=Primary bronchial carcinoid: A rare differential diagnosis of pulmonary koch in young adult patient|journal=Lung India|volume=29|issue=1|year=2012|pages=59|issn=0970-2113|doi=10.4103/0970-2113.92366}}</ref><ref name="pmid25207053">{{cite journal |vauthors=Yazıcıoğlu A, Yekeler E, Bıcakcıoğlu P, Ozaydın E, Karaoğlanoğlu N |title=Synchronous bilateral multiple typical pulmonary carcinoid tumors: a unique case with 10 typical carcinoids |journal=Balkan Med J |volume=29 |issue=4 |pages=450–2 |date=December 2012 |pmid=25207053 |pmc=4115868 |doi=10.5152/balkanmedj.2012.081 |url=}}</ref><ref name="pmid14616879">{{cite journal |vauthors=Krausz Y, Keidar Z, Kogan I, Even-Sapir E, Bar-Shalom R, Engel A, Rubinstein R, Sachs J, Bocher M, Agranovicz S, Chisin R, Israel O |title=SPECT/CT hybrid imaging with 111In-pentetreotide in assessment of neuroendocrine tumours |journal=Clin. Endocrinol. (Oxf) |volume=59 |issue=5 |pages=565–73 |date=November 2003 |pmid=14616879 |doi= |url=}}</ref><ref name="van der LelyHerder2005">{{cite journal|last1=van der Lely|first1=Aart J.|last2=Herder|first2=Wouter W. de|title=Carcinoid syndrome: diagnosis and medical management|journal=Arquivos Brasileiros de Endocrinologia & Metabologia|volume=49|issue=5|year=2005|pages=850–860|issn=0004-2730|doi=10.1590/S0004-27302005000500028}}</ref><ref name="pmid28238592">{{cite journal |vauthors=Halperin DM, Shen C, Dasari A, Xu Y, Chu Y, Zhou S, Shih YT, Yao JC |title=Frequency of carcinoid syndrome at neuroendocrine tumour diagnosis: a population-based study |journal=Lancet Oncol. |volume=18 |issue=4 |pages=525–534 |date=April 2017 |pmid=28238592 |pmc=6066284 |doi=10.1016/S1470-2045(17)30110-9 |url=}}</ref>
|[[Neuroendocrine tumor]] of [[midgut]] <ref name="pmid3227292">{{cite journal |vauthors=Sjöblom SM |title=Clinical presentation and prognosis of gastrointestinal carcinoid tumours |journal=Scand. J. Gastroenterol. |volume=23 |issue=7 |pages=779–87 |date=September 1988 |pmid=3227292 |doi= |url=}}</ref><ref name="pmid24059366">{{cite journal |vauthors=Ganeshan D, Bhosale P, Yang T, Kundra V |title=Imaging features of carcinoid tumors of the gastrointestinal tract |journal=AJR Am J Roentgenol |volume=201 |issue=4 |pages=773–86 |date=October 2013 |pmid=24059366 |doi=10.2214/AJR.12.9758 |url=}}</ref><ref name="symptoms">Signs and symptoms of carcinoid syndrome. National Cancer Institute. http://www.cancer.gov/types/gi-carcinoid-tumors/patient/gi-carcinoid-treatment-pdq</ref><ref name="pmid15887161">{{cite journal |vauthors=Modlin IM, Kidd M, Latich I, Zikusoka MN, Shapiro MD |title=Current status of gastrointestinal carcinoids |journal=Gastroenterology |volume=128 |issue=6 |pages=1717–51 |date=May 2005 |pmid=15887161 |doi= |url=}}</ref>
|style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Neuroendocrine tumor]] of [[midgut]] <ref name="pmid3227292">{{cite journal |vauthors=Sjöblom SM |title=Clinical presentation and prognosis of gastrointestinal carcinoid tumours |journal=Scand. J. Gastroenterol. |volume=23 |issue=7 |pages=779–87 |date=September 1988 |pmid=3227292 |doi= |url=}}</ref><ref name="pmid24059366">{{cite journal |vauthors=Ganeshan D, Bhosale P, Yang T, Kundra V |title=Imaging features of carcinoid tumors of the gastrointestinal tract |journal=AJR Am J Roentgenol |volume=201 |issue=4 |pages=773–86 |date=October 2013 |pmid=24059366 |doi=10.2214/AJR.12.9758 |url=}}</ref><ref name="symptoms">Signs and symptoms of carcinoid syndrome. National Cancer Institute. http://www.cancer.gov/types/gi-carcinoid-tumors/patient/gi-carcinoid-treatment-pdq</ref><ref name="pmid15887161">{{cite journal |vauthors=Modlin IM, Kidd M, Latich I, Zikusoka MN, Shapiro MD |title=Current status of gastrointestinal carcinoids |journal=Gastroenterology |volume=128 |issue=6 |pages=1717–51 |date=May 2005 |pmid=15887161 |doi= |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
Mild
Mild
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Pathognomonic radiological sign of [[midgut]] [[Neuroendocrine tumor|NET]].
Pathognomonic radiological sign of [[midgut]] [[Neuroendocrine tumor|NET]].
|-
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|[[Neuroendocrine tumor]] of [[lung]]<ref name="pmid18473355">{{cite journal |vauthors=Gustafsson BI, Kidd M, Chan A, Malfertheiner MV, Modlin IM |title=Bronchopulmonary neuroendocrine tumors |journal=Cancer |volume=113 |issue=1 |pages=5–21 |date=July 2008 |pmid=18473355 |doi=10.1002/cncr.23542 |url=}}</ref><ref name="JeungGasser2002">{{cite journal|last1=Jeung|first1=Mi-Young|last2=Gasser|first2=Bernard|last3=Gangi|first3=Afshin|last4=Charneau|first4=Dominique|last5=Ducroq|first5=Xavier|last6=Kessler|first6=Romain|last7=Quoix|first7=Elisabeth|last8=Roy|first8=Catherine|title=Bronchial Carcinoid Tumors of the Thorax: Spectrum of Radiologic Findings|journal=RadioGraphics|volume=22|issue=2|year=2002|pages=351–365|issn=0271-5333|doi=10.1148/radiographics.22.2.g02mr01351}}</ref><ref name="pmid1649924">{{cite journal |vauthors=Nessi R, Basso Ricci P, Basso Ricci S, Bosco M, Blanc M, Uslenghi C |title=Bronchial carcinoid tumors: radiologic observations in 49 cases |journal=J Thorac Imaging |volume=6 |issue=2 |pages=47–53 |date=April 1991 |pmid=1649924 |doi= |url=}}</ref><ref name="pmid5831899">{{cite journal |vauthors=Melmon KL, Sjoerdsma A, Mason DT |title=Distinctive clinical and therapeutic aspects of the syndrome associated with bronchial carcinoid tumors |journal=Am. J. Med. |volume=39 |issue=4 |pages=568–81 |date=October 1965 |pmid=5831899 |doi= |url=}}</ref>
|style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Neuroendocrine tumor]] of [[lung]]<ref name="pmid18473355">{{cite journal |vauthors=Gustafsson BI, Kidd M, Chan A, Malfertheiner MV, Modlin IM |title=Bronchopulmonary neuroendocrine tumors |journal=Cancer |volume=113 |issue=1 |pages=5–21 |date=July 2008 |pmid=18473355 |doi=10.1002/cncr.23542 |url=}}</ref><ref name="JeungGasser2002">{{cite journal|last1=Jeung|first1=Mi-Young|last2=Gasser|first2=Bernard|last3=Gangi|first3=Afshin|last4=Charneau|first4=Dominique|last5=Ducroq|first5=Xavier|last6=Kessler|first6=Romain|last7=Quoix|first7=Elisabeth|last8=Roy|first8=Catherine|title=Bronchial Carcinoid Tumors of the Thorax: Spectrum of Radiologic Findings|journal=RadioGraphics|volume=22|issue=2|year=2002|pages=351–365|issn=0271-5333|doi=10.1148/radiographics.22.2.g02mr01351}}</ref><ref name="pmid1649924">{{cite journal |vauthors=Nessi R, Basso Ricci P, Basso Ricci S, Bosco M, Blanc M, Uslenghi C |title=Bronchial carcinoid tumors: radiologic observations in 49 cases |journal=J Thorac Imaging |volume=6 |issue=2 |pages=47–53 |date=April 1991 |pmid=1649924 |doi= |url=}}</ref><ref name="pmid5831899">{{cite journal |vauthors=Melmon KL, Sjoerdsma A, Mason DT |title=Distinctive clinical and therapeutic aspects of the syndrome associated with bronchial carcinoid tumors |journal=Am. J. Med. |volume=39 |issue=4 |pages=568–81 |date=October 1965 |pmid=5831899 |doi= |url=}}</ref>
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| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
|-
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| colspan="2" |[[Small intestine cancer|Malignant neoplasms of small intestine]]
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Small intestine cancer|Malignant neoplasms of small intestine]]
|<nowiki>+/-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>+/-</nowiki>
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| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
|-
|-
| colspan="2" |[[Benign cutaneous flushing]]
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Benign cutaneous flushing]]
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
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| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
|-
|-
| colspan="2" |[[Anaphylaxis]]
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Anaphylaxis]]
| +
| +
| -/+
| -/+
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|History of exposure to [[Insect allergy|insect]] stings,food alllergy,rubber latex,food [[Additives|additives,]],allergy to medications,physical factors such s excercise and cold
|History of exposure to [[Insect allergy|insect]] stings,food alllergy,rubber latex,food [[Additives|additives,]],allergy to medications,physical factors such s excercise and cold
|-
|-
| colspan="2" |Histaminergic [[Angioedema]]
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |Histaminergic [[Angioedema]]
| +/-
| +/-
| +/-
| +/-
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* Any allergy to insects stings , foods or any ingestion within previous 24 hours
* Any allergy to insects stings , foods or any ingestion within previous 24 hours
|-
|-
| colspan="2" |[[Medullary carcinoma of thyroid|Medullary Thyroid Carcinoma]]
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Medullary carcinoma of thyroid|Medullary Thyroid Carcinoma]]
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>+/-</nowiki>

Revision as of 17:49, 2 May 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2]

Overview

Carcinoid syndrome must be differentiated from systemic mastocytosis, medullary thyroid carcinoma, irritable bowel syndrome, malignant neoplasms of the small intestine, benign cutaneous flushing, and recurrent idiopathic anaphylaxis.

Differentiating Carcinoid Syndrome from other Diseases

Carcinoid syndrome must be differentiated from:[1]

Diseases Clinical manifestations Para-clinical findings Gold standard Additional findings
Symptoms Physical examination
Lab Findings Imaging Histopathology
Abdominal pain Diarrhea Flushing Dyspnea Palpitations Other symptoms Wheezing Telangiectasia Hypotension Tachycardia Systolic murmur of tricuspid regurgitation Other physical findings Urinary 5-hydroxyindoleacetic acid (5-HIAA) Serum Chromogranin A (CgA) Other markers Abdominal computed tomography (CT) Abdominal MRI Somatostatin receptor scintigraphy [SRS], or Octreoscan Metaiodobenzylguanidine (MIBG) scintigraphy Other diagnostic studies
  • Transthoracic echocardiography
Carcinoid Syndrome[2][3][4][5][6][7][8][9][10] Neuroendocrine tumor of midgut [11][12][13][14] +

Mild

+ + + +

Dermatitis

Diarrhea

Dementia

Metastatic tumors in the liver: Right upper quadrant pain, hepatomegaly, and early satiety

+ +/- +/- + + - + + + +
  • Valve thickening with retraction and reduction in the mobility of the tricuspid valve

Pathognomonic radiological sign of midgut NET.

Neuroendocrine tumor of lung[15][16][17][18] + + + + +
+ +/- +/- + + - + +
Sensitive for detection of liver metastases if present + + - Typical low-grade:bland cells containing regular round nuclei with finely dispersed chromatin and inconspicuous small nucleoli.Mitotic figures are scarce and necrosis is absent.

Intermediate-grade atypical: presence of Neuroendocrine morphology and either necrosis or 2 to 10 mitoses per 10 HPF

Lung neuroendocrine tumor can be a/s with:
Irritable Bowel Syndrome +

Perioidic

- - - - - - - - - - - - - - - - Rome IV criteria
  • Recurrent abdominal pain, at least 1day/week in the last 3 months, a/s with 2 or more of the following criteria:

•Related to defecation

•Associated with a change in stool frequency

•Associated with a change in stool form (appearance)

Malignant neoplasms of small intestine +/- +/- - - +/- - - - +/- - - + Abdominal CT scan may be diagnostic of small intestine cancer. Findings on CT scan suggestive of small intestine cancer include intrinsic mass with a short segment of bowel wall thickening MRI and MRI enteroscopy are other advance modalities to diagnose and stage small intestinal cancers - - Enteroscopy, capsule endoscopy and double balloon enteroscopy Biopsy and histopathology
Crohn disease[19] +/- - - - - - - - - - - - - -
  • Focal ulcerations and acute and chronic inflammation
Benign cutaneous flushing - - + - - - - - - - - - - - - - - - - - - -
Systemic mastocytosis + + + + - +/- +/- + - - - - - -
Asthma exacerbation - - - + + + - - + - - - Chest X ray
Anaphylaxis + -/+ + + + +/- - + + - - - - - - - - History of exposure to insect stings,food alllergy,rubber latex,food additives,,allergy to medications,physical factors such s excercise and cold
Histaminergic Angioedema +/- +/- + + + + - + + - - - - - - - - - -
  • Take proper clinical history of previous similar episodes
  • Medication history
  • Any allergy to insects stings , foods or any ingestion within previous 24 hours
Medullary Thyroid Carcinoma - +/- +/- +/- - - - - - - - - - - -

For metastasis

-

References

  1. Metcalfe DD (2000). "Differential diagnosis of the patient with unexplained flushing/anaphylaxis". Allergy Asthma Proc. 21 (1): 21–4. PMID 10748948.
  2. Rubin de Celis Ferrari AC, Glasberg J, Riechelmann RP (August 2018). "Carcinoid syndrome: update on the pathophysiology and treatment". Clinics (Sao Paulo). 73 (suppl 1): e490s. doi:10.6061/clinics/2018/e490s. PMC 6096975. PMID 30133565.
  3. Hegyi J, Schwartz RA, Hegyi V (January 2004). "Pellagra: dermatitis, dementia, and diarrhea". Int. J. Dermatol. 43 (1): 1–5. PMID 14693013.
  4. Savelli G, Lucignani G, Seregni E, Marchianò A, Serafini G, Aliberti G, Villano C, Maccauro M, Bombardieri E (May 2004). "Feasibility of somatostatin receptor scintigraphy in the detection of occult primary gastro-entero-pancreatic (GEP) neuroendocrine tumours". Nucl Med Commun. 25 (5): 445–9. PMID 15100502.
  5. Savelli G, Lucignani G, Seregni E, Marchianò A, Serafini G, Aliberti G, Villano C, Maccauro M, Bombardieri E (May 2004). "Feasibility of somatostatin receptor scintigraphy in the detection of occult primary gastro-entero-pancreatic (GEP) neuroendocrine tumours". Nucl Med Commun. 25 (5): 445–9. PMID 15100502.
  6. Bora, ManashKumar; Vithiavathi, S (2012). "Primary bronchial carcinoid: A rare differential diagnosis of pulmonary koch in young adult patient". Lung India. 29 (1): 59. doi:10.4103/0970-2113.92366. ISSN 0970-2113.
  7. Yazıcıoğlu A, Yekeler E, Bıcakcıoğlu P, Ozaydın E, Karaoğlanoğlu N (December 2012). "Synchronous bilateral multiple typical pulmonary carcinoid tumors: a unique case with 10 typical carcinoids". Balkan Med J. 29 (4): 450–2. doi:10.5152/balkanmedj.2012.081. PMC 4115868. PMID 25207053.
  8. Krausz Y, Keidar Z, Kogan I, Even-Sapir E, Bar-Shalom R, Engel A, Rubinstein R, Sachs J, Bocher M, Agranovicz S, Chisin R, Israel O (November 2003). "SPECT/CT hybrid imaging with 111In-pentetreotide in assessment of neuroendocrine tumours". Clin. Endocrinol. (Oxf). 59 (5): 565–73. PMID 14616879.
  9. van der Lely, Aart J.; Herder, Wouter W. de (2005). "Carcinoid syndrome: diagnosis and medical management". Arquivos Brasileiros de Endocrinologia & Metabologia. 49 (5): 850–860. doi:10.1590/S0004-27302005000500028. ISSN 0004-2730.
  10. Halperin DM, Shen C, Dasari A, Xu Y, Chu Y, Zhou S, Shih YT, Yao JC (April 2017). "Frequency of carcinoid syndrome at neuroendocrine tumour diagnosis: a population-based study". Lancet Oncol. 18 (4): 525–534. doi:10.1016/S1470-2045(17)30110-9. PMC 6066284. PMID 28238592.
  11. Sjöblom SM (September 1988). "Clinical presentation and prognosis of gastrointestinal carcinoid tumours". Scand. J. Gastroenterol. 23 (7): 779–87. PMID 3227292.
  12. Ganeshan D, Bhosale P, Yang T, Kundra V (October 2013). "Imaging features of carcinoid tumors of the gastrointestinal tract". AJR Am J Roentgenol. 201 (4): 773–86. doi:10.2214/AJR.12.9758. PMID 24059366.
  13. Signs and symptoms of carcinoid syndrome. National Cancer Institute. http://www.cancer.gov/types/gi-carcinoid-tumors/patient/gi-carcinoid-treatment-pdq
  14. Modlin IM, Kidd M, Latich I, Zikusoka MN, Shapiro MD (May 2005). "Current status of gastrointestinal carcinoids". Gastroenterology. 128 (6): 1717–51. PMID 15887161.
  15. Gustafsson BI, Kidd M, Chan A, Malfertheiner MV, Modlin IM (July 2008). "Bronchopulmonary neuroendocrine tumors". Cancer. 113 (1): 5–21. doi:10.1002/cncr.23542. PMID 18473355.
  16. Jeung, Mi-Young; Gasser, Bernard; Gangi, Afshin; Charneau, Dominique; Ducroq, Xavier; Kessler, Romain; Quoix, Elisabeth; Roy, Catherine (2002). "Bronchial Carcinoid Tumors of the Thorax: Spectrum of Radiologic Findings". RadioGraphics. 22 (2): 351–365. doi:10.1148/radiographics.22.2.g02mr01351. ISSN 0271-5333.
  17. Nessi R, Basso Ricci P, Basso Ricci S, Bosco M, Blanc M, Uslenghi C (April 1991). "Bronchial carcinoid tumors: radiologic observations in 49 cases". J Thorac Imaging. 6 (2): 47–53. PMID 1649924.
  18. Melmon KL, Sjoerdsma A, Mason DT (October 1965). "Distinctive clinical and therapeutic aspects of the syndrome associated with bronchial carcinoid tumors". Am. J. Med. 39 (4): 568–81. PMID 5831899.
  19. Hara AK, Swartz PG (2009). "CT enterography of Crohn's disease". Abdom Imaging. 34 (3): 289–95. doi:10.1007/s00261-008-9443-1. PMID 18649092.

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