Increased pulmonary NECs
The area of bombesin-immunopositive NEBs in the alveolar ducts was divided by the area of the tissue section to obtain %NEB area. For subjects with more than one biopsy site (subjects 2 and 6-10), quantification of bombesin-immunopositive area was analyzed as the aggregate of all airways counted.
Statistical Analysis
Statistical analyses were performed using GraphPad Prism and InStat (GraphPad Software, Inc; San Diego, California). Data were compared with Mann-Whitney U test or Kruskal-Wallis with Dunn multiple comparisons test. Association between age and NEC indices was measured using Spearman correlation. A two-sided P < .05 was regarded as significant.
Results Viagra
Clinical, Radiographic, and Histologic Features of Study Subjects
Table 1 shows the overall demographic and clinical features of the study population. Prominent comorbidities were present in the other-diseases cohort as anticipated by the study design. Characteristic chest HRCT scans and histology from two subjects with NEHI are shown in Figure 1 compared with a patient with bronchiolitis obliterans (Figs 1A-F). Table 2 details the histologic findings in each patient. The initial pathologic interpretation of increased pulmonary NECs was based on the previously proposed criteria. In eight cases, either some airway inflammation or fibrosis was present, albeit involving a small proportion of airways (Fig 1E 1 . Four subjects with NEHI had long-standing tachypnea and retractions for which evaluation was ongoing but then experienced confirmed intercurrent viral infection prior to biopsy.
Extent and Anatomic Distribution of NECs
Biopsy specimens from the NEHI group, other-diseases group, and control group all had some bombesin-immunopositive cells and similar intensity of bombesin staining (Figs 2A-F). All subjects with NEHI had NECs in > 70% of bronchioles, although five of the 13 other-diseases subjects and five of the six control subjects also met this criterion. All subjects in the NEHI group and 50% of those in the other-diseases group also had at least one individual airway with > 10% NECs, suggesting that these histologic criteria alone are sensitive but not specific for the diagnosis of NEHI.
