Year: 2026
Type: article
Study design: Observational Study
Abstract: Objective: Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) is a rare condition for which the diagnostic role of transbronchial lung cryobiopsy (TBLC) remains incompletely investigated. This study compared histological samples obtained by transbronchial lung cryobiopsy (TBLC) with those obtained by surgical lung biopsy (SLB). Methods: This is an observational retrospective study enrolling adult patients with final diagnosis of DIPNECH histologically proved by TBLC and/or SLB, from 2011 to 2025. Clinical data, pulmonary function tests, BAL findings, CT features, and histology were compared between groups. Results: Fourteen women with a final biopsy-proven diagnosis of DIPNECH were included: 8 diagnosed by TBLC and 6 by SLB. Median age was 64 years (IQR 59-67). Pulmonary function tests showed airflow obstruction and air trapping, with median FEV1 71.4% predicted (IQR 49.8-90.0), FEV1/FVC 0.67 (IQR 0.57-0.75), and RV/TLC 47.3% (IQR 42.4-53.5). Clinical and radiological features were similar across groups. BAL showed lymphocytosis in 6/9 patients (67%). Histology showed a nonsignificant trend toward more frequent detection of constrictive bronchiolitis in SLB specimens than in TBLC specimens (66% vs 13%; p = 0.09), whereas no significant differences were observed for the other histological features. In the TBLC group, pneumothorax occurred in two cases, neither requiring drainage. Conclusion: The study suggests that TBLC can represent a valid diagnostic alternative to SLB for DIPNECH, capturing key histological features, though apparently less sensitive for constrictive bronchiolitis. Moreover, a lymphocytic BAL pattern may be observed in DIPNECH and, if confirmed in larger cohorts, could support the diagnostic workup.
Source: Pathologica
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7222881147