DIPNECH: when to suggest this diagnosis on CT.

Area of Science:

• Pulmonary Medicine
• Radiology
• Pathology

Background:

• Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) is an under-recognized condition.
• It involves the proliferation of neuroendocrine cells in the bronchial wall, considered a pre-invasive lesion for lung carcinoid tumors.
• DIPNECH affects middle-aged women, presenting with dyspnea or incidentally found during lung carcinoid tumor resection.

Purpose of the Study:

• To describe the characteristic computed tomography (CT) features of DIPNECH.
• To correlate CT findings with histological data.
• To assist radiologists in diagnosing DIPNECH and distinguishing it from other conditions causing mosaic perfusion.

Main Methods:

• Review of literature on DIPNECH.
• Analysis of CT imaging findings in DIPNECH patients.
• Correlation of radiological findings with histopathological results.

Main Results:

• CT scans suggestive of DIPNECH show mosaic attenuation and multiple small nodules.
• DIPNECH is associated with bronchial obstruction and tumorlet formation.
• The condition is found in 5.4% of patients undergoing surgical resection for lung carcinoid tumors.

Conclusions:

• Radiologists can suspect DIPNECH based on characteristic CT findings like mosaic attenuation and small nodules.
• Correlation with histology is crucial for accurate diagnosis.
• Differentiating DIPNECH from other causes of mosaic perfusion is important for appropriate patient management.