Diffuse pulmonary neuroendocrine cell hyperplasia with probable carcinoid

Case contributed by Domenico Nicoletti
Diagnosis probable

Presentation

10 pack-year smoking history and complained of shortness of breath upon admission; the remaining review of symptoms was negative.

Patient Data

Age: 80 years
Gender: Female

In the upper lobe of there is a nodule with regular margins, without calcifications, with intense enhancement attributable to carcinoid. In both lungs are visible numerous small nodules with a diameter up to 7 mm. There is also a mosaic appearance as air trapping.

Case Discussion

Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) is a rare disorder and information on this disease is limited, especially with regard to its management and prognosis. It has become generally accepted that DIPNECH is a precursor lesion to pulmonary carcinoid tumors.

The majority of patients are middle-aged women who present with symptoms of cough and dyspnea, obstructive abnormalities on pulmonary function testing and pulmonary nodules, and bronchiectasis.

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