ABSTRACT
Objective To differentiate between pulmonary mucosa-associated lymphoid tissue lymphoma (MALT) and adenocarcinoma by radiomics, and then evaluate the diagnostic value of this novel approach. Methods We retrospectively analyzed CT images of pulmonary MALT lymphoma (n=16) and invasive pulmonary adenocarcinoma (n=41) and all these cases were confirmed by pathology in the Second Affiliated Hospital of Zhejiang University School of Medicine from June 2012 to June 2017. After we delineated the lesions as region of interest (ROI), sixty-one radiomics features were extracted from each individual's CT images by Radcloud 1.0. All cases in each group were randomly divided into training set (70％cases) and testing set(30％cases), with 7 features (Wilcoxon test) of which showed group differences and were used to train and validate a support vector machine (SVM) classifier. Results Seven of 61 radiomics features showed differences between the two groups, i.e. 10th percentile, mean, median, minimum, total energy, run length non uniformity, gray level non uniformity. Using these 7 features, the resulted SVM successfully differentiated two diseases. The SVM showed high performance with 90％precision, recall 0.89, F1-score 0.87, ROC 0.75. Conclusions Pulmonary MALT and adenocarcinoma differ in radiomics features and machine learning can utilize these features to differentiate between pulmonary MALT and adenocarcinoma. Combination of radiomics and machine learning is promising in the differential diagnosis of these two diseases.
ABSTRACT
Objective To investigate the feature,pathological diagnosis and differential diagnosis of blastic plasmacytoid dendritic cell neoplasm (BPDCN).Methods The clinical and histological findings,immunophenotype,treatment and prognosis of one case with BPDCN were evaluated with review of the relevant literature.Results The female patient with age of 32 years presented as cutaneous lesions.Pathologic findings showed skin and bone marrow were involved.Microscopically,the tumors were composed of diffuse blasts with small to medium size,scant cytoplasm,highly irregular nuclear contours,dispersed nuclear chromatin and faint indistinct nucleolus.Immunohistochemical characteristics of the tumors were the positive expression of CD4,CD56 and CD123,and negative expression of CD3,CD20,CD34,TdT,MPO.Conclusion BPDCN is a rare and highly aggressive hematopoietic neoplasm.Except for the skin,bone marrow and lymph node can also be involved.The differential diagnosis is necessary from other haematopoietic and lymphoid tumors.