Introduction: Diffuse idiopathic pulmonary neuroendocrine hyperplasia (DIPNECH) is a rare condition that is likely underdiagnosed owing to the lack of established and validated diagnostic criteria. These clinical guidelines are empirical and created on the basis of a limited number of studies. This study was designed to validate the existing criteria and to identify new clinical parameters that can accurately diagnose DIPNECH.Methods: Patients with DIPNECH were identified from a cohort that underwent surgical lung resection for pulmonary carcinoids. The study cohort included a total of 105 consecutive cases with neuroendocrine lesions. Initial diagnostic predictors of DIPNECH were selected from the literature. We employed univariate and multi-variate models to evaluate the association of clinical, pathologic, radiologic variables with the likelihood of DIPNECH.Results: Univariate analysis identified age, sex, chronic obstructive pulmonary disease diagnosis, obstructive abnormalities, pulmonary nodules, mosaicism, absolute numbers of pulmonary neuroendocrine lesions (PNELs), and the number of tumorlets as significant DIPNECH predictors (for p < 0.05). After adjustment for sampling variations, the ratio of the total number of PNELs to the number of bronchioles was found to be considerably higher in DIPNECH category. Multivariate analysis identified the total number of PNELs and multiple pulmonary nodules (>10) as independent predictors of DIPNECH. The performance of our criteria revealed an accuracy of 76% in detecting DIPNECH cases.Conclusions: We proposed a set of diagnostic criteria for DIPNECH on the basis of an expert-panel approach integrating pathological features, radiology, and clinical data. Our findings will help identify DIPNECH patients, without a pathological confirmation of a neuroendocrine lesion. Before the implementation of these criteria in clinical practice, they require further validation in multi-institutional cohorts.(c) 2020 The Authors. Published by Elsevier Inc. on behalf of the International Association for the Study of Lung Cancer. This is an open access article under the CC BY-NC-ND li-cense (http://creativecommons.org/licenses/by-nc-nd/ 4.0/).
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Royal Free Hosp, Neuroendocrine Tumour Unit, London NW3 2QG, EnglandRoyal Free Hosp, Neuroendocrine Tumour Unit, London NW3 2QG, England
Caplin, M. E.
Baudin, E.
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Univ Paris 11, Inst Gustave Roussy, Dept Nucl Med Endocrine Canc & Intervent Radiol, Villejuif, FranceRoyal Free Hosp, Neuroendocrine Tumour Unit, London NW3 2QG, England
Baudin, E.
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Ferolla, P.
Filosso, P.
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Univ Turin, Dept Thorac Surg, Turin, ItalyRoyal Free Hosp, Neuroendocrine Tumour Unit, London NW3 2QG, England
Filosso, P.
Garcia-Yuste, M.
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机构:
Univ Clin Hosp, Dept Thorac Surg, Valladolid, SpainRoyal Free Hosp, Neuroendocrine Tumour Unit, London NW3 2QG, England
Garcia-Yuste, M.
Lim, E.
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Univ London Imperial Coll Sci Technol & Med, London, England
Royal Brompton Hosp, Acad Div Thorac Surg, London SW3 6LY, EnglandRoyal Free Hosp, Neuroendocrine Tumour Unit, London NW3 2QG, England
Lim, E.
Oberg, K.
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Univ Uppsala Hosp, Dept Med, Endocrine Oncol Unit, Uppsala, SwedenRoyal Free Hosp, Neuroendocrine Tumour Unit, London NW3 2QG, England
Oberg, K.
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Pelosi, G.
Perren, A.
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Univ Bern, Inst Pathol, Bern, SwitzerlandRoyal Free Hosp, Neuroendocrine Tumour Unit, London NW3 2QG, England
Perren, A.
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Rossi, R. E.
Travis, W. D.
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h-index: 0
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Mem Sloan Kettering Canc Ctr, Dept Pathol, New York, NY 10021 USARoyal Free Hosp, Neuroendocrine Tumour Unit, London NW3 2QG, England
机构:
Natl Jewish Hlth, Dept Med, Div Oncol, Denver, CO 80206 USANatl Jewish Hlth, Dept Med, Div Oncol, Denver, CO 80206 USA
Carr, Laurie L.
Chung, Jonathan H.
论文数: 0引用数: 0
h-index: 0
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Natl Jewish Hlth, Dept Med, Div Radiol, Denver, CO 80206 USANatl Jewish Hlth, Dept Med, Div Oncol, Denver, CO 80206 USA
Chung, Jonathan H.
Achcar, Rosane Duarte
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Natl Jewish Hlth, Dept Med, Div Pathol, Denver, CO 80206 USANatl Jewish Hlth, Dept Med, Div Oncol, Denver, CO 80206 USA
Achcar, Rosane Duarte
Lesic, Zoran
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h-index: 0
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St Anthony Hosp, Dept Med, Lakewood, CO USANatl Jewish Hlth, Dept Med, Div Oncol, Denver, CO 80206 USA
Lesic, Zoran
Rho, Ji Y.
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h-index: 0
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CHA Univ, CHA Bundang Med Ctr, Div Radiol, Seoul, South KoreaNatl Jewish Hlth, Dept Med, Div Oncol, Denver, CO 80206 USA
Rho, Ji Y.
Yagihashi, Kunihiro
论文数: 0引用数: 0
h-index: 0
机构:
Natl Jewish Hlth, Dept Med, Div Radiol, Denver, CO 80206 USA
St Marianna Univ, Sch Med, Dept Radiol, Kawasaki, Kanagawa, JapanNatl Jewish Hlth, Dept Med, Div Oncol, Denver, CO 80206 USA
Yagihashi, Kunihiro
Tate, Robert M.
论文数: 0引用数: 0
h-index: 0
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Natl Jewish Hlth, Dept Med, Div Pulm Crit Care & Sleep Med, Denver, CO 80206 USANatl Jewish Hlth, Dept Med, Div Oncol, Denver, CO 80206 USA
Tate, Robert M.
Swigris, Rey J.
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Natl Jewish Hlth, Dept Med, Div Pulm Crit Care & Sleep Med, Denver, CO 80206 USANatl Jewish Hlth, Dept Med, Div Oncol, Denver, CO 80206 USA
Swigris, Rey J.
Kern, Jeff Rey A.
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Natl Jewish Hlth, Dept Med, Div Oncol, Denver, CO 80206 USANatl Jewish Hlth, Dept Med, Div Oncol, Denver, CO 80206 USA
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Royal Liverpool Univ Hosp, Dept Pathol, Liverpool L69 3GA, Merseyside, EnglandRoyal Liverpool Univ Hosp, Dept Pathol, Liverpool L69 3GA, Merseyside, England
Gosney, John R.
Williams, Ian J.
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Royal Liverpool Univ Hosp, Dept Pathol, Liverpool L69 3GA, Merseyside, EnglandRoyal Liverpool Univ Hosp, Dept Pathol, Liverpool L69 3GA, Merseyside, England
Williams, Ian J.
Dodson, Andrew R.
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Royal Liverpool Univ Hosp, Dept Pathol, Liverpool L69 3GA, Merseyside, EnglandRoyal Liverpool Univ Hosp, Dept Pathol, Liverpool L69 3GA, Merseyside, England
Dodson, Andrew R.
Foster, Christopher S.
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h-index: 0
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Univ Liverpool, Liverpool L69 3BX, Merseyside, EnglandRoyal Liverpool Univ Hosp, Dept Pathol, Liverpool L69 3GA, Merseyside, England
机构:
Royal Free Hosp, Neuroendocrine Tumour Unit, London NW3 2QG, EnglandRoyal Free Hosp, Neuroendocrine Tumour Unit, London NW3 2QG, England
Caplin, M. E.
Baudin, E.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Paris 11, Inst Gustave Roussy, Dept Nucl Med Endocrine Canc & Intervent Radiol, Villejuif, FranceRoyal Free Hosp, Neuroendocrine Tumour Unit, London NW3 2QG, England
Baudin, E.
论文数: 引用数:
h-index:
机构:
Ferolla, P.
Filosso, P.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Turin, Dept Thorac Surg, Turin, ItalyRoyal Free Hosp, Neuroendocrine Tumour Unit, London NW3 2QG, England
Filosso, P.
Garcia-Yuste, M.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Clin Hosp, Dept Thorac Surg, Valladolid, SpainRoyal Free Hosp, Neuroendocrine Tumour Unit, London NW3 2QG, England
Garcia-Yuste, M.
Lim, E.
论文数: 0引用数: 0
h-index: 0
机构:
Univ London Imperial Coll Sci Technol & Med, London, England
Royal Brompton Hosp, Acad Div Thorac Surg, London SW3 6LY, EnglandRoyal Free Hosp, Neuroendocrine Tumour Unit, London NW3 2QG, England
Lim, E.
Oberg, K.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Uppsala Hosp, Dept Med, Endocrine Oncol Unit, Uppsala, SwedenRoyal Free Hosp, Neuroendocrine Tumour Unit, London NW3 2QG, England
Oberg, K.
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h-index:
机构:
Pelosi, G.
Perren, A.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Bern, Inst Pathol, Bern, SwitzerlandRoyal Free Hosp, Neuroendocrine Tumour Unit, London NW3 2QG, England
Perren, A.
论文数: 引用数:
h-index:
机构:
Rossi, R. E.
Travis, W. D.
论文数: 0引用数: 0
h-index: 0
机构:
Mem Sloan Kettering Canc Ctr, Dept Pathol, New York, NY 10021 USARoyal Free Hosp, Neuroendocrine Tumour Unit, London NW3 2QG, England
机构:
Natl Jewish Hlth, Dept Med, Div Oncol, Denver, CO 80206 USANatl Jewish Hlth, Dept Med, Div Oncol, Denver, CO 80206 USA
Carr, Laurie L.
Chung, Jonathan H.
论文数: 0引用数: 0
h-index: 0
机构:
Natl Jewish Hlth, Dept Med, Div Radiol, Denver, CO 80206 USANatl Jewish Hlth, Dept Med, Div Oncol, Denver, CO 80206 USA
Chung, Jonathan H.
Achcar, Rosane Duarte
论文数: 0引用数: 0
h-index: 0
机构:
Natl Jewish Hlth, Dept Med, Div Pathol, Denver, CO 80206 USANatl Jewish Hlth, Dept Med, Div Oncol, Denver, CO 80206 USA
Achcar, Rosane Duarte
Lesic, Zoran
论文数: 0引用数: 0
h-index: 0
机构:
St Anthony Hosp, Dept Med, Lakewood, CO USANatl Jewish Hlth, Dept Med, Div Oncol, Denver, CO 80206 USA
Lesic, Zoran
Rho, Ji Y.
论文数: 0引用数: 0
h-index: 0
机构:
CHA Univ, CHA Bundang Med Ctr, Div Radiol, Seoul, South KoreaNatl Jewish Hlth, Dept Med, Div Oncol, Denver, CO 80206 USA
Rho, Ji Y.
Yagihashi, Kunihiro
论文数: 0引用数: 0
h-index: 0
机构:
Natl Jewish Hlth, Dept Med, Div Radiol, Denver, CO 80206 USA
St Marianna Univ, Sch Med, Dept Radiol, Kawasaki, Kanagawa, JapanNatl Jewish Hlth, Dept Med, Div Oncol, Denver, CO 80206 USA
Yagihashi, Kunihiro
Tate, Robert M.
论文数: 0引用数: 0
h-index: 0
机构:
Natl Jewish Hlth, Dept Med, Div Pulm Crit Care & Sleep Med, Denver, CO 80206 USANatl Jewish Hlth, Dept Med, Div Oncol, Denver, CO 80206 USA
Tate, Robert M.
Swigris, Rey J.
论文数: 0引用数: 0
h-index: 0
机构:
Natl Jewish Hlth, Dept Med, Div Pulm Crit Care & Sleep Med, Denver, CO 80206 USANatl Jewish Hlth, Dept Med, Div Oncol, Denver, CO 80206 USA
Swigris, Rey J.
Kern, Jeff Rey A.
论文数: 0引用数: 0
h-index: 0
机构:
Natl Jewish Hlth, Dept Med, Div Oncol, Denver, CO 80206 USANatl Jewish Hlth, Dept Med, Div Oncol, Denver, CO 80206 USA
机构:
Royal Liverpool Univ Hosp, Dept Pathol, Liverpool L69 3GA, Merseyside, EnglandRoyal Liverpool Univ Hosp, Dept Pathol, Liverpool L69 3GA, Merseyside, England
Gosney, John R.
Williams, Ian J.
论文数: 0引用数: 0
h-index: 0
机构:
Royal Liverpool Univ Hosp, Dept Pathol, Liverpool L69 3GA, Merseyside, EnglandRoyal Liverpool Univ Hosp, Dept Pathol, Liverpool L69 3GA, Merseyside, England
Williams, Ian J.
Dodson, Andrew R.
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h-index: 0
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Royal Liverpool Univ Hosp, Dept Pathol, Liverpool L69 3GA, Merseyside, EnglandRoyal Liverpool Univ Hosp, Dept Pathol, Liverpool L69 3GA, Merseyside, England
Dodson, Andrew R.
Foster, Christopher S.
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h-index: 0
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Univ Liverpool, Liverpool L69 3BX, Merseyside, EnglandRoyal Liverpool Univ Hosp, Dept Pathol, Liverpool L69 3GA, Merseyside, England