Abstract
Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) is a rare pulmonary disorder characterised by a proliferation of neuroendocrine cells within the lung. It is believed that a minority of the patients with DIPNECH can develop carcinoid tumors. Here, we report two new cases of DIPNECH with coexisting carcinoid tumors.
Highlights
Neuroendocrine (NE) cells are a component of pulmonary epithelium
Idiopathic type is defined as diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH)
NE cells are a component of pulmonary epithelium that comprises about 1% of all epithelial cells in an adult lung [1]
Summary
Neuroendocrine (NE) cells are a component of pulmonary epithelium. NE cell hyperplasia may be reactive or idiopathic. Histopathological examination showed two foci of typical carcinoid tumors, multiple tumorlets and widespread neuroendocrine hyperplasia. Carcinoid tumors and tumorlets were characterised by monotonous tumor cells with round/ovoid nuclei with stippled chromatin, indistinct nucleoli, forming nests, and trabeculae (Figure 1). After 7 years of uneventful follow-up, multiple lung nodules, the largest measuring 1.1 cm, probably representing new carcinoid tumors, were identified, on thoracic CT. 66-year-old, nonsmoker female, scheduled for cataract surgery, had a pulmonary nodule on routine chest X-ray examination. There were multiple tumorlets and neuroendocrine cell hyperplasia in the background. After 2 years from the operation, she developed multiple lung nodules, the largest measuring 1 cm, on thoracic CT (Figure 3).
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