Dipnech

Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia (DIPNECH) is a rare pulmonary condition characterized by the proliferation of neuroendocrine cells within the lungs. This condition is considered a precursor to neuroendocrine tumors of the lung, such as carcinoid tumors.

Pathophysiology

DIPNECH involves the diffuse proliferation of neuroendocrine cells in the bronchiolar epithelium. These cells can form small nodules known as tumorlets, which are typically less than 5 mm in diameter. Over time, these tumorlets can progress to larger neuroendocrine tumors.

Clinical Presentation

Patients with DIPNECH often present with non-specific respiratory symptoms, including:

• Chronic cough
• Dyspnea (shortness of breath)
• Wheezing

These symptoms are often mistaken for more common conditions such as asthma or chronic obstructive pulmonary disease (COPD).

Diagnosis

The diagnosis of DIPNECH is challenging and often requires a combination of imaging studies and histopathological examination. Common diagnostic tools include:

• High-resolution computed tomography (HRCT) of the chest
• Bronchoscopy with biopsy
• Pulmonary function tests

Histologically, DIPNECH is characterized by the presence of neuroendocrine cell hyperplasia and the formation of tumorlets.

Treatment

There is no standardized treatment for DIPNECH, and management is often tailored to the individual patient. Treatment options may include:

• Observation for asymptomatic patients
• Corticosteroids for symptomatic relief
• Surgical resection for localized disease
• Somatostatin analogs for symptom control

Prognosis

The prognosis for patients with DIPNECH varies. While some patients remain stable for years, others may progress to develop neuroendocrine tumors or experience significant respiratory impairment.

Related Pages

• Neuroendocrine cell
• Neuroendocrine tumor
• Carcinoid tumor
• Chronic cough
• Dyspnea
• Asthma
• Chronic obstructive pulmonary disease