Primary Malignant Neuroendocrine Tumour of Pleura: First Case Report

Leveraging non-lattice subgraphs for suggestion of new concepts for SNOMED CT

Missing hierarchical is-a relations and missing concepts are common quality issues in biomedical ontologies. Non-lattice subgraphs have been extensively studied for automatically identifying missing is-a relations in biomedical ontologies like SNOMED CT. However, little is known about non-lattice subgraphs' capability to uncover new or missing concepts in biomedical ontologies. In this work, we investigate a lexical-based intersection approach based on non-lattice subgraphs to identify potential missing concepts in SNOMED CT. We first construct lexical features of concepts using their fully specified names. Then we generate hierarchically unrelated concept pairs in non-lattice subgraphs as the candidates to derive new concepts. For each candidate pair of concepts, we conduct an order-preserving intersection based on the two concepts' lexical features, with the intersection result serving as the potential new concept name suggested. We further perform automatic validation through terminologies in the Unified Medical Language System (UMLS) and literature in PubMed. Applying this approach to the March 2021 release of SNOMED CT US Edition, we obtained 7,702 potential missing concepts, among which 1,288 were validated through UMLS and 1,309 were validated through PubMed. The results showed that non-lattice subgraphs have the potential to facilitate suggestion of new concepts for SNOMED CT.

Histomorphological and Immunohistochemical Analysis of Pleural Neoplasms

BACKGROUND & OBJECTIVE

Primary pleural neoplasms are rare entities compared with the pleural involvement by metastatic carcinoma.The current study aimed at investigating the complete spectrum of pleural neoplasms and differentiating between them with the aid of immunohistochemistry (IHC).

METHODS

Consecutive pleural biopsy specimens positive for a neoplasm, both primary and metastatic, were included in the study. Diagnosis or a differential diagnosis was suggested on histopathology confirmed by a panel of IHC markers such ascytokeratin(AE1/AE3), epithelial membrane antigen (EMA),vimentin, calretinin, CD34, CD99, SMA,bcl2, S100, CK7,CK20,TTF1,GCDFP, HMB45, LCA, synapto-physin, chromogranin, and naspsin.

RESULTS

A total of 35 cases of pleural neoplasms included 15 (42.9%) primary pleural neoplasms and 20 (57.1%) metastatic carcinoma. Synovial sarcoma, malignant mesothelioma (MM), and solitary fibrous tumor (SFT) accounted for 14.2%,11.4%, and 8.5% of metastatic cases, respectively. Epithelioid sarcoma(ES), neuroendocrine carcinoma, and inflammatory myofibroblastic tumor were less common, each contributing to 2.9% of pleural neoplasms. Among the 20 cases of metastatic carcinoma, 13 were from the lung and 7 from the breast. Lung neoplasms metastasizing to the pleura were adenocarcinoma (n=12) and atypical carcinoid (n=1).

CONCLUSION

Analysis of histopathological pattern along with a panel of appropriate IHC markers distinguished the rare entities of pleural neoplasms essential to determine the prognosis and treatment modality.