A CASE OF BRONCHIAL CARCINOID AND GIANT BULLA IN A PATIENT WITH PROGRESSIVE SYSTEMIC SCLEROSIS

Pulmonary lesions are often observed in patients with progressive systemic sclerosis (PSS). A rare case of bronchial carcinoid that was found at operation for ruptured giant bulla in a patient with PSS is reported. The patient, a 37-year-old female, had been treated for PSS since 1971. She was admitted to our hospital because of dyspnea and chest pain in January 1981. Chest X-ray films revealed left pneumothorax. As continuous left thoracic drainage was ineffective, surgical treatment was undertaken. At operation a solid tumor (3×3cm) was newly recognized in the left S9, together with ruptured giant bulla in the left S8. Therefore, left lower lobectomy was performed. Histological examination revealed that the tumor was argynophilic bronchial carcinoid and the bulla had interstitial pneumonia. Although the postoperative course seemed uneventful, bone metastases (the fourth lumbar vertebral body) appeared 15 months after operation, and she died 17 months after operation.