Neuroendocrine cell hyperplasia of infancy: diagnosis with high-resolution CT.
OBJECTIVE
Neuroendocrine cell hyperplasia of infancy is a form of childhood interstitial lung disease originally reported as persistent tachypnea of infancy. Reports of small series of cases and anecdotal experience have suggested that this disorder may have a consistent CT pattern. The purpose of this study was to review the CT findings in children with neuroendocrine cell hyperplasia of infancy to determine the findings at high-resolution CT, the diagnostic accuracy of CT compared with biopsy, and interrater reliability.


METHODS
Images from 23 CT examinations of children with biopsy-proven neuroendocrine cell hyperplasia of infancy and six CT examinations of children with other childhood interstitial lung diseases were reviewed by two pediatric radiologists with special expertise in thoracic imaging. Identifying digital data were removed, and images were reviewed without clinical data. A CT assessment form was completed for each patient.


RESULTS
Ground-glass opacification was the most common finding in patients with neuroendocrine cell hyperplasia of infancy. The right middle lobe and lingula were most commonly involved. Air trapping with a mosaic pattern was the second most common finding. Interrater reliability was very good with a kappa value of 0.93. The sensitivity and specificity of CT in the diagnosis of neuroendocrine cell hyperplasia of infancy were at least 78% and 100%.


CONCLUSIONS
Neuroendocrine cell hyperplasia of infancy can have a characteristic appearance on high-resolution CT scans, the imaging findings being useful in differentiating neuroendocrine cell hyperplasia of infancy from other types of childhood interstitial lung disease. The appearance aids radiologists in suggesting a specific diagnosis but does not exclude this diagnosis; in 17-22% of cases, the readers in this study did not suggest the diagnosis of neuroendocrine cell hyperplasia of infancy when it was present.
Brody
Alan S
AS
Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., MLC 5031, Cincinnati, OH 45229, USA. alan.brody@cchmc.org
Guillerman
R Paul
RP
Hay
Thomas C
TC
Wagner
Brandie D
BD
Young
Lisa R
LR
Deutsch
Gail H
GH
Fan
Leland L
LL
Deterding
Robin R
RR
D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006965:Hyperplasia; D007223:Infant; D008168:Lung / Q000473:pathology*; D017563:Lung Diseases, Interstitial / Q000000981:diagnostic imaging*; D008297:Male; D009490:Neurosecretory Systems / Q000166:cytology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*