Chung Cécile, Bommart Sébastien, Marchand-Adam Sylvain, Lederlin Mathieu, Fournel Ludovic, Charpentier Marie-Christine, Groussin Lionel, Wislez Marie, Revel Marie-Pierre, Chassagnon Guillaume
Department of Radiology, AP-HP. Centre, Hôpital Cochin, 75014 Paris, France.
Université de Paris, 85 Boulevard Saint-Germain, 75006 Paris, France.
J Clin Med. 2021 Jun 30;10(13):2950. doi: 10.3390/jcm10132950.
Diffuse pulmonary neuroendocrine cell hyperplasia (DIPNECH) is a rare pre-invasive disease whose pathophysiology remains unclear. We aimed to assess long-term evolution in imaging of DIPNECH, in order to propose follow-up recommendations. Patients with histologically confirmed DIPNECH from four centers, evaluated between 2001 and 2020, were enrolled if they had at least two available chest computed tomography (CT) exams performed at least 24 months apart. CT exams were analyzed for the presence and the evolution of DIPNECH-related CT findings. Twenty-seven patients, mostly of female gender ( = 25/27; 93%) were included. Longitudinal follow-up over a median 63-month duration (IQR: 31-80 months) demonstrated an increase in the size of lung nodules in 19 patients (19/27, 70%) and the occurrence of metastatic spread in three patients (3/27, 11%). The metastatic spread was limited to mediastinal lymph nodes in one patient, whereas the other two patients had both lymph node and distant metastases. The mean time interval between baseline CT scan and metastatic spread was 70 months (14, 74 and 123 months). Therefore, long-term annual imaging follow-up of DIPNECH might be appropriate to encompass the heterogeneous longitudinal behavior of this disease.
弥漫性肺神经内分泌细胞增生（DIPNECH）是一种罕见的侵袭前疾病，其病理生理学尚不清楚。我们旨在评估DIPNECH的影像学长期演变情况，以便提出随访建议。对2001年至2020年间在四个中心经组织学确诊为DIPNECH的患者进行研究，若他们至少有两次间隔至少24个月的胸部计算机断层扫描（CT）检查，则纳入研究。分析CT检查结果中与DIPNECH相关的表现及其演变情况。共纳入27例患者，其中大多数为女性（25/27；93%）。中位随访时间为63个月（四分位间距：31 - 80个月），结果显示19例患者（19/27，70%）的肺结节增大，3例患者（3/27，11%）出现转移扩散。其中1例患者的转移扩散局限于纵隔淋巴结，另外2例患者既有淋巴结转移又有远处转移。基线CT扫描至转移扩散的平均时间间隔为70个月（14、74和123个月）。因此，对DIPNECH进行长期年度影像学随访可能适合该疾病的异质性纵向行为。
