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Diffuse idiopathic neuroendocrine cell hyperplasia as a rare cause of chronic cough
  1. Paula Inês Pedro1,
  2. Dolores Canário1,
  3. Miguel Lopes1 and
  4. Ana Oliveira2
  1. 1 Pulmonology, Hospital Garcia de Orta EPE, Almada, Portugal
  2. 2 Pathology, Hospital Garcia de Orta EPE, Almada, Portugal
  1. Correspondence to Dr Paula Inês Pedro, paulaines.gpedro{at}


A 39-year-old Caucasian woman, who has never smoked, presented a 16-year-duration chronic dry cough. She was prescribed by her general physician with corticosteroid and long-acting β-agonist inhalers assuming it was asthma, with mild symptomatic improvement. When cough got more persistent and associated with exertional dyspnoea and wheezing, a chest CT scan was performed, which showed multiple bilateral micronodular formations and diffuse mosaic lung pattern with air trapping. She was sent to our Respiratory Department and performed a bronchoalveolar lavage and cryobiopsy that were inconclusive. She underwent surgical lung biopsy with pathology revealing multiple foci of neuroendocrine cell hyperplasia and tumourlets associated with constrictive bronchiolitis, a histological pattern suggestive of diffuse idiopathic neuroendocrine cell hyperplasia (DIPNECH). DIPNECH is a rare and preinvasive disease. Presenting symptoms can be cough and breathlessness. At the time of writing, the patient is on octreotide with symptomatic improvement.

  • respiratory cancer
  • pathology
  • radiology
  • interstitial lung disease

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  • Contributors All the authors of this article have directly participated in the planning, execution and analysis of this case report. PIP was involved in patient’s follow-up consult, bibliographic research and manuscript writing. DC and ML were involved in patient’s follow-up consult and manuscript review. AO performed the histopathology analysis, contributed to the diagnosis of the disease and manuscript review. All authors read and approved the final version submitted.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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