Clinical Image
Neuroendocrine cell hyperplasia of infancy diagnosed by imaging techniques
Hiperplasia neuroendocrina de la infancia: diagnóstico por imagen
Antonio Jesús Láinez Ramos-Bossini
, Ángela Ruiz de Arévalo, Juan Francisco Ferrer Soriano
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Servicio de Radiodiagnóstico, Hospital Universitario Virgen de las Nieves, Granada, Spain
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Comparativa inicial (A) y un año después (B). Áreas con patrón «en vidrio deslustrado» que afectan predominantemente al lóbulo medio y a la língula, mostrando el patrón de distribución típico de la hiperplasia de células neuroendocrinas de la infancia.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Antonio Jesús Láinez Ramos-Bossini, Ángela Ruiz de Arévalo, Juan Francisco Ferrer Soriano" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Antonio Jesús" "apellidos" => "Láinez Ramos-Bossini" ] 1 => array:2 [ "nombre" => "Ángela" "apellidos" => "Ruiz de Arévalo" ] 2 => array:2 [ "nombre" => "Juan Francisco" "apellidos" => "Ferrer Soriano" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1579212921002214" "doi" => "10.1016/j.arbr.2021.06.001" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212921002214?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S030028962030034X?idApp=UINPBA00003Z" "url" => "/03002896/0000005700000009/v1_202109020750/S030028962030034X/v1_202109020750/es/main.assets" ] ] "itemSiguiente" => array:18 [ "pii" => "S1579212921002615" "issn" => "15792129" "doi" => "10.1016/j.arbr.2020.01.017" "estado" => "S300" "fechaPublicacion" => "2021-09-01" "aid" => "2403" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2021;57:588" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => "Pulmonary Artery Aneurysm Partially Regressing With Medical Treatment in Behçet's Disease" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "588" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Aneurisma de la arteria pulmonar con regresión parcial tras tratamiento médico en la enfermedad de Behçet" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1041 "Ancho" => 750 "Tamanyo" => 167906 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">In presentation, coronal (A) and axial (C) MIP thorax CT angiography scans reveal aneurysms in the anterior (frame) and posterior (arrow) segmentary pulmonary arteries of the right upper lobe. 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Initial comparison (A) and 1 year later (B). Areas with a ground glass pattern affecting predominantly the middle lobe and the lingula, showing the typical distribution pattern of neuroendocrine hyperplasia of infancy.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 3-year-old pediatric patient was referred to our hospital with a history of recurrent respiratory infections and dry nocturnal cough following respiratory bronchiolitis at 5 months. On physical examination, she had mild tachypnea, subcostal and sternal retractions, and some bilateral crackling rales. A chest X-ray showed hyperinflation of both hemithoraxes and increased perihilar density (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Chest computed tomography (CT) scan was performed, showing areas of ground glass density in both lungs, more marked in the lingula and middle lobe (<a class="elsevierStyleCrossRefs" href="#fig0005">Figs. 1 and 2</a>). An acute respiratory process was assumed, and symptomatic treatment with follow-up was prescribed. In the following months, several studies (autoimmunity, cystic fibrosis, pulmonary scintigraphy) were performed and found to be normal, and several drugs (mucolytics, β2 agonists, corticosteroids, and antibiotic therapy) were administered, but only partial symptomatic relief was achieved. A year later, a new CT was performed that showed persistence of lung findings, at which time the patient was diagnosed with neuroendocrine hyperplasia of infancy (NEHI).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">NEHI is a type of interstitial lung disease that usually occurs before the age of 2, presenting with tachypnea, crackles, chest retractions, and hypoxemia<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a>. The appearance on CT is characterized by a mosaic attenuation pattern with patchy areas and ground glass density affecting 4 or more lobes, typically the lingula and middle lobe. In certain cases, consistent clinical signs and functional tests may permit diagnosis of NEHI without the need for a lung biopsy<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a>. The recommended treatment is supportive, with oxygen therapy and prevention measures<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Láinez Ramos-Bossini AJ, Ruiz de Arévalo Á, Ferrer Soriano JF. Hiperplasia neuroendocrina de la infancia: diagnóstico por imagen. Arch Bronconeumol. 2021;57:587.</p>" ] ] "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 467 "Ancho" => 950 "Tamanyo" => 49967 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Plain X-ray of the chest (A). Hyperinflation of both hemithoraxes and increased lung parenchyma density in the perihilar region. Chest CT, coronal reconstruction (B). Areas with a ground glass pattern affecting predominantly the middle lobe and the lingula, showing the typical distribution pattern of neuroendocrine hyperplasia of infancy.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 368 "Ancho" => 950 "Tamanyo" => 61483 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Chest CT, axial slice at the level of the lingula. Initial comparison (A) and 1 year later (B). Areas with a ground glass pattern affecting predominantly the middle lobe and the lingula, showing the typical distribution pattern of neuroendocrine hyperplasia of infancy.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Current update on interstitial lung disease of infancy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "P.G. Thacker" 1 => "S.O. Vargas" 2 => "M.P. Fishman" 3 => "A.M. Casey" 4 => "E.Y. Lee" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rcl.2016.05.012" "Revista" => array:6 [ "tituloSerie" => "Radiol Clin North Am" "fecha" => "2016" "volumen" => "54" "paginaInicial" => "1065" "paginaFinal" => "1076" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27719976" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia and neuroendocrine hyperplasia of infancy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "L.L. Carr" 1 => "J.A. Kern" 2 => "G.H. Deutsch" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ccm.2016.04.018" "Revista" => array:7 [ "tituloSerie" => "Clin Chest Med" "fecha" => "2016" "volumen" => "37" "paginaInicial" => "579" "paginaFinal" => "587" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27514602" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0091674915002729" "estado" => "S300" "issn" => "00916749" ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005700000009/v1_202109020614/S1579212921002214/v1_202109020614/en/main.assets" "Apartado" => array:4 [ "identificador" => "60604" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Clinical Images" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005700000009/v1_202109020614/S1579212921002214/v1_202109020614/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212921002214?idApp=UINPBA00003Z" ]
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