Long-Term Imaging Follow-Up in DIPNECH: Multicenter Experience.

Area of Science:

• Pulmonology
• Oncology
• Radiology

Background:

• Diffuse pulmonary neuroendocrine cell hyperplasia (DIPNECH) is a rare, pre-invasive lung condition with unclear pathophysiology.
• Understanding the long-term behavior of DIPNECH is crucial for developing appropriate patient management strategies.

Purpose of the Study:

• To evaluate the long-term evolution of imaging findings in patients with DIPNECH.
• To establish evidence-based recommendations for follow-up imaging in DIPNECH.

Main Methods:

• Retrospective analysis of chest CT scans from 27 histologically confirmed DIPNECH patients across four centers (2001-2020).
• Inclusion criteria required at least two CT exams separated by a minimum of 24 months.
• CT findings were analyzed for changes in lung nodules and the development of metastatic spread over a median follow-up of 63 months.

Main Results:

• Seventy percent (19/27) of patients showed an increase in lung nodule size over time.
• Eleven percent (3/27) of patients developed metastatic spread, with a mean interval of 70 months from baseline CT.
• Metastases involved mediastinal lymph nodes and/or distant sites.

Conclusions:

• DIPNECH exhibits heterogeneous longitudinal behavior, including nodule growth and delayed metastatic spread.
• Long-term annual imaging follow-up is suggested for comprehensive monitoring of DIPNECH patients.
• These findings support the need for extended surveillance protocols in managing DIPNECH.