{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:32:20Z","timestamp":1789086740152,"version":"build-2803163510"},"reference-count":12,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,6,8]]},"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:p>Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia (DIPNECH) is a rare pulmonary disorder characterised by classic radiological findings and symptoms of obstructive lung disease. DIPNECH is considered a precursor to carcinoid tumours in the lungs. In this case, we describe a patient with years of unexplained dry cough presenting with 2\u2009weeks of progressive nausea and vomiting, and found to have massive hepatomegaly on examination. By CT-PE, she was diagnosed with DIPNECH, and abdominal MRI revealed metastatic carcinoid tumours. Despite its non-specific presentation, DIPNECH has characteristic radiological findings of mosaic attenuation with numerous pulmonary nodules. DIPNECH requires early identification and close surveillance to prevent progression to carcinoid tumours. Thus, it is critical for frontline providers to consider this diagnosis as part of their differential when other common causes of obstructive lung disease have been ruled out.<\/jats:p>","DOI":"10.1136\/bcr-2018-228536","type":"journal-article","created":{"date-parts":[[2019,6,25]],"date-time":"2019-06-25T08:40:13Z","timestamp":1561452013000},"page":"e228536","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia (DIPNECH) with liver metastases"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6941-9385","authenticated-orcid":false,"given":"Kristen","family":"Flint","sequence":"first","affiliation":[{"name":"Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengcheng","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3538-094X","authenticated-orcid":false,"given":"Tracey L","family":"Henry","sequence":"additional","affiliation":[{"name":"Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,6,24]]},"reference":[{"key":"2025082803355771000_12.6.e228536.1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01954-2015"},{"key":"2025082803355771000_12.6.e228536.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199210293271806"},{"key":"2025082803355771000_12.6.e228536.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinimag.2011.11.011"},{"key":"2025082803355771000_12.6.e228536.4","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201010-1685PP"},{"key":"2025082803355771000_12.6.e228536.5","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2006.063065"},{"key":"2025082803355771000_12.6.e228536.6","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1097\/PAS.0000000000001033","article-title":"Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia (DIPNECH) Syndrome and Carcinoid Tumors With\/Without NECH: A Clinicopathologic, Radiologic, and Immunomolecular Comparison Study","volume":"42","author":"Mengoli","year":"2018","journal-title":"Am J Surg Pathol"},{"key":"2025082803355771000_12.6.e228536.7","first-page":"318175","article-title":"A rare case of diffuse idiopathic pulmonary neuroendocrine cell hyperplasia","volume":"2015","author":"Ofikwu","year":"2015","journal-title":"Case Rep Surg"},{"key":"2025082803355771000_12.6.e228536.8","doi-asserted-by":"publisher","DOI":"10.1378\/chest.14-0711"},{"key":"2025082803355771000_12.6.e228536.9","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1007\/s00408-018-0149-z","article-title":"Management of diffuse idiopathic pulmonary neuroendocrine cell hyperplasia: review and a single center experience","volume":"196","author":"Myint","year":"2018","journal-title":"Lung"},{"key":"2025082803355771000_12.6.e228536.10","doi-asserted-by":"crossref","first-page":"2679","DOI":"10.1002\/ijc.30400","article-title":"The epidemiology of metastases in neuroendocrine tumors","volume":"139","author":"Riihim\u00e4ki","year":"2016","journal-title":"Int J Cancer"},{"key":"2025082803355771000_12.6.e228536.11","first-page":"e2525","article-title":"A rare case of diffuse idiopathic pulmonary neuroendocrine cell hyperplasia","volume":"10","author":"Anampa-Guzm\u00e1n","year":"2018","journal-title":"Cureus"},{"key":"2025082803355771000_12.6.e228536.12","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.26200"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-228536","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:36:04Z","timestamp":1756377364000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-228536"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6]]},"references-count":12,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2019,6,24]]},"published-print":{"date-parts":[[2019,6]]}},"alternative-id":["10.1136\/bcr-2018-228536"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-228536","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,6]]}}}