Diffuse pulmonary neuroendocrine cell hyperplasia: radiologic and clinical features

The purpose of this study was to define the radiologic features of pulmonary neuroendocrine cell hyperplasia and correlate them with clinical findings.

Five women, ranging in age from 45 to 63 years, were diagnosed with pulmonary neuroendocrine cell hyperplasia. Two radiologists assessed the presence and extent of airway wall thickening, mosaic pattern, air trapping, ground-glass opacity, nodular opacity, and centrilobular opacity on high resolution CT. The CT findings were compared with physiologic data and histologic features.

On CT scans, mosaic pattern was the predominant finding in all patients. The extent of mosaic pattern was correlated with the forced expiratory volume in 1 s/forced vital capacity ratio (r = 0.8508, p = 0.0317). Nodular lesions were noted in three patients. Airway walls were thickened in four patients. In one patient, ground-glass opacity and centrilobular opacity were also noted on high resolution CT.

Pulmonary neuroendocrine cell hyperplasia is characterized by mosaic perfusion due to air trapping, airway wall thickening, and occasional small nodules on high resolution CT scans. The extent of mosaic perfusion correlates with physiologic evidence of airway obstruction.