PMID- 33294353
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201210
IS  - 2213-0071 (Print)
IS  - 2213-0071 (Electronic)
IS  - 2213-0071 (Linking)
VI  - 31
DP  - 2020
TI  - A 68-year-old woman with a diagnosis of asthma and multiple fleeting pulmonary 
      nodules- a case report.
PG  - 101250
LID - 10.1016/j.rmcr.2020.101250 [doi]
LID - 101250
AB  - Diffuse idiopathic pulmonary neuroendocrine cell (DIPNECH syndrome) remains 
      unfamiliar to most clinicians even though it was first described almost 30 years 
      ago. Diagnosis is usually confirmed histopathologically after lung biopsy, but 
      often, a diagnosis or suspected diagnosis can be made radiographically. In this 
      paper, we present a case report of a 68-year-old female with shortness of breath 
      and fleeting pulmonary nodules observed on chest CT scan. She was initially 
      misdiagnosed with asthma based on an abnormal pulmonary function test which 
      revealed an obstructive ventilatory defect. The classic radiographic findings of 
      DIPNECH syndrome and the typical patient demographics that should arouse 
      suspicion of a DIPNECH diagnosis were also illustrated. DIPNECH syndrome is a 
      clinicopathological syndrome whereas focal NECH is a pathological diagnosis that 
      is often made incidentally on histological examination and is encountered in a 
      variety of settings, including in resected carcinoid tumors, in the context of 
      reactive changes concomitant with infection, in metastatic cancer, radiation 
      pneumonitis, intra-lobar sequestration, smokers, interstitial lung disease, and 
      lung adenocarcinoma. There are no proven treatments for DIPNECH syndrome. In 
      patients with obstructive ventilatory symptoms, bronchodilators with inhaled 
      steroids are usually prescribed. Some severe cases may require parenteral 
      steroids. Somatostatin analogs (SSA) have also been used in some cases with mixed 
      results. Rapamycin has been used in several cases based on the purported 
      activation of the mammalian target of rapamycin (mTOR) in DIPNECH. Some patients 
      with large carcinoid tumors may benefit from resection.
CI  - (c) 2020 The Author(s).
FAU - Alabi, Fortune O
AU  - Alabi FO
AD  - Pulmonary and Critical Care Physician, Florida Lung Asthma and Sleep Specialists, 
      Orlando, FL, USA.
FAU - Alabi, Christopher O
AU  - Alabi CO
AD  - Internal Medicine Intern and Research Associate, Florida Lung Asthma and Sleep 
      Specialists, Orlando, FL, USA.
FAU - Alkhateeb, Hadaya A
AU  - Alkhateeb HA
AD  - Medical Intern and Research Assistant, Florida Lung Asthma and Sleep Specialists, 
      Orlando, FL, USA.
FAU - Fanaian, Naim K
AU  - Fanaian NK
AD  - Central Florida Pathology Associate, USA.
FAU - Lama, Maximo E
AU  - Lama ME
AD  - Pulmonary and Critical Care Physician, Florida Lung Asthma and Sleep Specialists, 
      Orlando, FL, USA.
AD  - Pulmonary and Critical Care Physician, Florida Lung Asthma and Sleep Specialists, 
      Orlando, FL, USA.
FAU - Ghaneie, Ashkan
AU  - Ghaneie A
AD  - AdventHealth Medical Group, Central FL, USA.
LA  - eng
PT  - Case Reports
DEP - 20201112
PL  - England
TA  - Respir Med Case Rep
JT  - Respiratory medicine case reports
JID - 101604463
PMC - PMC7683343
OTO - NOTNLM
OT  - Adenocarcinoma
OT  - DIPNECH syndrome
OT  - Mosaic attenuation
OT  - Neuroendocrine cell hyperplasia
OT  - SSA
OT  - SSR
OT  - mTOR
COIS- The authors whose names are listed immediately below certify that they have NO 
      affiliations with or involvement in any organization or entity with any financial 
      interest (such as honoraria; educational grants; participation in speakers' 
      bureaus; membership, employment, consultancies, stock ownership, or other equity 
      interest; and expert testimony or patent-licensing arrangements), or 
      non-financial interest (such as personal or professional relationships, 
      affiliations, knowledge or beliefs) in the subject matter or materials discussed 
      in this manuscript.
EDAT- 2020/12/10 06:00
MHDA- 2020/12/10 06:01
PMCR- 2020/11/12
CRDT- 2020/12/09 06:15
PHST- 2020/09/14 00:00 [received]
PHST- 2020/09/30 00:00 [revised]
PHST- 2020/10/04 00:00 [accepted]
PHST- 2020/12/09 06:15 [entrez]
PHST- 2020/12/10 06:00 [pubmed]
PHST- 2020/12/10 06:01 [medline]
PHST- 2020/11/12 00:00 [pmc-release]
AID - S2213-0071(20)30464-0 [pii]
AID - 101250 [pii]
AID - 10.1016/j.rmcr.2020.101250 [doi]
PST - epublish
SO  - Respir Med Case Rep. 2020 Nov 12;31:101250. doi: 10.1016/j.rmcr.2020.101250. 
      eCollection 2020.