CTICasesDiffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia (DIPNECH)
Imaging findings
High-resolution chest CT shows numerous, small, scattered bilateral pulmonary nodules. Expiratory CT scans demonstrate extensive, multi-lobar air trapping and mosaic attenuation. Pulmonary function testing confirms severe, non-reversible airflow obstruction. Open lung biopsy confirms diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) with multiple carcinoid tumorlets.
Key takeaways
DIPNECH is a rare, underrecognized pre-neoplastic pulmonary condition characterized by the proliferation of neuroendocrine cells within the bronchial mucosa. It presents on CT as multiple pulmonary nodules (representing carcinoid tumorlets) associated with air trapping due to constrictive bronchiolitis. It predominantly affects middle-aged, non-smoking females and causes progressive, often refractory airflow obstruction.
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