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DIPNECH with Carcinoid Tumorlets

Imaging findings

CT chest shows a mosaic perfusion pattern (air trapping on expiratory CT) associated with multiple small, bilateral pulmonary nodules. Biopsy confirmed diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) and carcinoid tumorlets.

Key takeaways

DIPNECH is a rare pre-neoplastic condition characterized by generalized proliferation of pulmonary neuroendocrine cells. It leads to bronchiolitis obliterans (presenting as mosaic perfusion/air trapping) and can progress to form multiple carcinoid tumorlets or bronchial carcinoids.

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