View source for Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia

[[Image:Lung carcinoid tumourlet - intermed mag.jpg|thumb|right|A [[carcinoid tumourlet]], as may be seen in the context of DIPNECH. (WC/Nephron)]]
'''Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia''', abbreviated '''DIPNECH''', is an uncommon lung pathology that is considered pre-neoplastic by the WHO.<ref name=pmid26104490>{{Cite journal  | last1 = Wirtschafter | first1 = E. | last2 = Walts | first2 = AE. | last3 = Liu | first3 = ST. | last4 = Marchevsky | first4 = AM. | title = Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia of the Lung (DIPNECH): Current Best Evidence. | journal = Lung | volume =  | issue =  | pages =  | month = Jun | year = 2015 | doi = 10.1007/s00408-015-9755-1 | PMID = 26104490 }}</ref>

==General==
*Rare - less than 50 reported based on a 2010 paper.<ref name=pmid22798306>{{Cite journal  | last1 = Tippett | first1 = VM. | last2 = Wathen | first2 = CG. | title = Diffuse idiopathic neuroendocrine cell hyperplasia: an unusual cause of breathlessness and pulmonary nodules. | journal = BMJ Case Rep | volume = 2010 | issue =  | pages =  | month =  | year = 2010 | doi = 10.1136/bcr.05.2010.3006 | PMID = 22798306 }}</ref>
*Usually women (15 of 19 cases<ref name=pmid17099078>{{Cite journal  | last1 = Davies | first1 = SJ. | last2 = Gosney | first2 = JR. | last3 = Hansell | first3 = DM. | last4 = Wells | first4 = AU. | last5 = du Bois | first5 = RM. | last6 = Burke | first6 = MM. | last7 = Sheppard | first7 = MN. | last8 = Nicholson | first8 = AG. | title = Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia: an under-recognised spectrum of disease. | journal = Thorax | volume = 62 | issue = 3 | pages = 248-52 | month = Mar | year = 2007 | doi = 10.1136/thx.2006.063065 | PMID = 17099078 }}</ref>).
*Typically non-smokers (16 of 19 cases<ref name=pmid17099078/>).

Clinical:<ref name=pmid26112453>{{Cite journal  | last1 = Chauhan | first1 = A. | last2 = Ramirez | first2 = RA. | title = Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia (DIPNECH) and the Role of Somatostatin analogs: A Case Series. | journal = Lung | volume =  | issue =  | pages =  | month = Jun | year = 2015 | doi = 10.1007/s00408-015-9754-2 | PMID = 26112453 }}</ref>
*Typical patient in 60s.
*Cough.

Treatment:
*Somatostatin analogs<ref name=pmid26112453/> - improves cough.

===Criteria===
''Marchevsky and Walts'' criteria - both 1 & 2 are required:<ref name=pmid26472691>{{Cite journal  | last1 = Marchevsky | first1 = AM. | last2 = Walts | first2 = AE. | title = Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH). | journal = Semin Diagn Pathol | volume = 32 | issue = 6 | pages = 438-44 | month = Nov | year = 2015 | doi = 10.1053/j.semdp.2015.08.002 | PMID = 26472691 }}</ref>
#Three or more separate small airways pulmonary neuroendocrine cell clusters.
#*Each cluster should have five or more pulmonary neuroendocrine cells.
#Three or more carcinoid tumourlets.

Notes:
*The ''Marchevsky and Walts'' definition is not universally accepted.
*[[World Health Organization]] (WHO) definition is vague.

==Gross==
*Multiple small pulmonary nodules.<ref name=pmid26104490/>

DDx:
*[[lung metastasis|Metastases to the lung]].

==Microscopic==
:See ''[[pulmonary neuroendocrine cell hyperplasia]]''.
:See ''[[typical lung carcinoid tumour]]''.

==See also==
*[[Neuroendocrine tumours]].

==References==
{{Reflist|2}}

[[Category:Diagnosis]]
[[Category:Pulmonary pathology]]