Objective: To investigate the clinical features and the reason of misdiagnosis of consolidative primary pulmonary lymphoma. Methods: Retrospective study was conducted for three cases with consolidative primary pulmona...Objective: To investigate the clinical features and the reason of misdiagnosis of consolidative primary pulmonary lymphoma. Methods: Retrospective study was conducted for three cases with consolidative primary pulmonary lymphoma(PPL). The relevant literatures of primary pulmonary lymphoma in recent years were also reviewed. Results: All patients had been misdiagnosed for a long time due to the non-specific clinical features. Conclusion: Consolidative PPL is difficult to diagnose and is misdiagnosed frequently in clinic. Definitive diagnosis of PPL requires an adequate biopsy specimen. The most important prognostic factor is the histology.展开更多
Background:Pneumonia-like primary pulmonary lymphoma(PPL)was commonly misdiagnosed as infectious pneumonia,leading to delayed treatment.The purpose of this study was to establish a computed tomography(CT)-based radiom...Background:Pneumonia-like primary pulmonary lymphoma(PPL)was commonly misdiagnosed as infectious pneumonia,leading to delayed treatment.The purpose of this study was to establish a computed tomography(CT)-based radiomics model to differentiate pneumonia-like PPL from infectious pneumonia.Methods:In this retrospective study,79 patients with pneumonia-like PPL and 176 patients with infectious pneumonia from 12 medical centers were enrolled.Patients from center 1 to center 7 were assigned to the training or validation cohort,and the remaining patients from other centers were used as the external test cohort.Radiomics features were extracted from CT images.A three-step procedure was applied for radiomics feature selection and radiomics signature building,including the inter-and intra-class correlation coefficients(ICCs),a one-way analysis of variance(ANOVA),and least absolute shrinkage and selection operator(LASSO).Univariate and multivariate analyses were used to identify the significant clinicoradiological variables and construct a clinical factor model.Two radiologists reviewed the CT images for the external test set.Performance of the radiomics model,clinical factor model,and each radiologist were assessed by receiver operating characteristic,and area under the curve(AUC)was compared.Results:A total of 144 patients(44 with pneumonia-like PPL and 100 infectious pneumonia)were in the training cohort,38 patients(12 with pneumonia-like PPL and 26 infectious pneumonia)were in the validation cohort,and 73 patients(23 with pneumonia-like PPL and 50 infectious pneumonia)were in the external test cohort.Twenty-three radiomics features were selected to build the radiomics model,which yielded AUCs of 0.95(95%confidence interval[CI]:0.94-0.99),0.93(95%CI:0.85-0.98),and 0.94(95%CI:0.87-0.99)in the training,validation,and external test cohort,respectively.The AUCs for the two readers and clinical factor model were 0.74(95%CI:0.63-0.83),0.72(95%CI:0.62-0.82),and 0.73(95%CI:0.62-0.84)in the external test cohort,respectively.The radiomics model outperformed both the readers’interpretation and clinical factor model(P<0.05).Conclusions:The CT-based radiomics model may provide an effective and non-invasive tool to differentiate pneumonia-like PPL from infectious pneumonia,which might provide assistance for clinicians in tailoring precise therapy.展开更多
文摘Objective: To investigate the clinical features and the reason of misdiagnosis of consolidative primary pulmonary lymphoma. Methods: Retrospective study was conducted for three cases with consolidative primary pulmonary lymphoma(PPL). The relevant literatures of primary pulmonary lymphoma in recent years were also reviewed. Results: All patients had been misdiagnosed for a long time due to the non-specific clinical features. Conclusion: Consolidative PPL is difficult to diagnose and is misdiagnosed frequently in clinic. Definitive diagnosis of PPL requires an adequate biopsy specimen. The most important prognostic factor is the histology.
基金National Natural Science Foundation of China(Nos.81871354 and 81571672)Academic Promotion Program of Shandong First Medical University(No.2019QL023)
文摘Background:Pneumonia-like primary pulmonary lymphoma(PPL)was commonly misdiagnosed as infectious pneumonia,leading to delayed treatment.The purpose of this study was to establish a computed tomography(CT)-based radiomics model to differentiate pneumonia-like PPL from infectious pneumonia.Methods:In this retrospective study,79 patients with pneumonia-like PPL and 176 patients with infectious pneumonia from 12 medical centers were enrolled.Patients from center 1 to center 7 were assigned to the training or validation cohort,and the remaining patients from other centers were used as the external test cohort.Radiomics features were extracted from CT images.A three-step procedure was applied for radiomics feature selection and radiomics signature building,including the inter-and intra-class correlation coefficients(ICCs),a one-way analysis of variance(ANOVA),and least absolute shrinkage and selection operator(LASSO).Univariate and multivariate analyses were used to identify the significant clinicoradiological variables and construct a clinical factor model.Two radiologists reviewed the CT images for the external test set.Performance of the radiomics model,clinical factor model,and each radiologist were assessed by receiver operating characteristic,and area under the curve(AUC)was compared.Results:A total of 144 patients(44 with pneumonia-like PPL and 100 infectious pneumonia)were in the training cohort,38 patients(12 with pneumonia-like PPL and 26 infectious pneumonia)were in the validation cohort,and 73 patients(23 with pneumonia-like PPL and 50 infectious pneumonia)were in the external test cohort.Twenty-three radiomics features were selected to build the radiomics model,which yielded AUCs of 0.95(95%confidence interval[CI]:0.94-0.99),0.93(95%CI:0.85-0.98),and 0.94(95%CI:0.87-0.99)in the training,validation,and external test cohort,respectively.The AUCs for the two readers and clinical factor model were 0.74(95%CI:0.63-0.83),0.72(95%CI:0.62-0.82),and 0.73(95%CI:0.62-0.84)in the external test cohort,respectively.The radiomics model outperformed both the readers’interpretation and clinical factor model(P<0.05).Conclusions:The CT-based radiomics model may provide an effective and non-invasive tool to differentiate pneumonia-like PPL from infectious pneumonia,which might provide assistance for clinicians in tailoring precise therapy.