CTICasesDiffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia (DIPNECH) with Carcinoid Tumors
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Imaging findings
CT shows geographic areas of mosaic attenuation and air trapping on inspiratory and expiratory images, along with multiple pulmonary nodules. Outside imaging was misinterpreted as interstitial lung disease. Post-operative CT shows residual larger nodules. Biopsy of smaller nodules confirmed carcinoid tumorlets within a diffuse background of DIPNECH and bronchiolitis, likely secondary to hormone secretion.
Key takeaways
DIPNECH often presents in adult women with symptoms mimicking asthma. Imaging features include mosaic attenuation, air trapping, and multiple nodules/carcinoid tumorlets. It's important to recognize this pattern to avoid misdiagnosis, especially distinguishing from interstitial lung disease.
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