Neolung

Lung pathology reports, from what you see and say.

Dictate the diagnosis in a line. Neolung fills the report from what you said, checks it against the guidelines, and leaves every decision to you.

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Not yet a medical device or for clinical use: used with invented cases until your organisation is approved.

A lung resection under the microscope, reported with Neolung

  1. 8:40, first case

    A lung resection. You put the slide on the stage. Drag to move it. Scroll to focus.

  2. Under the microscope the tissue tells you what it is almost at once. That part took you years to learn.

  3. So say it, the way you'd tell a colleague. Neolung fills the report from it.

  4. And checks it against RCPath, ICCR and TNM: what's missing, what contradicts. It never changes anything on its own.

  5. Then the lung around the tumour. Emphysema, fibrosis, early interstitial disease: what the patient lives with after the operation.

  6. Few pathologists have spent years on it. Neolung's report types ask for it, in the words of one who has.

  7. You review, decide and sign. Then paste it into the laboratory system, as you do today.

Non-mucinous adenocarcinoma, acinar seventy percent, papillary thirty. PL1. N0, R0.

Why Neolung exists

Very few pathologists specialise in the lung, fewer still in interstitial disease. Neolung is built to put what they know into every lung report.

  1. Expertise that doesn't retire. What a lung specialist looks for, in the tumour and in the lung around it, asked for in every report, wherever it's written.
  2. Checked before it's signed. Lung cancer is volume, and volume makes mistakes: a stage, a margin, a required item missing. Each report type checks for its own.
  3. Start from what you say. Laboratory systems ask for a report field by field. Neolung starts from your dictation.
  4. For the hospitals without a specialist. For every pathologist who reports a lung without a lung specialist down the corridor, and every trainee learning to.

Written with a specialist

Dr M. Ángeles Montero-Fernández

When I retire, there will be four of us left in the world.

Dr M. Ángeles Montero-Fernández Consultant thoracic histopathologist and Neolung's clinical lead, on how few pathologists specialise in interstitial lung disease, as she sees it.
years in histopathology
36
years in thoracic pathology: tumours, interstitial disease, transplants
22
thoracic centres, from Barcelona to Liverpool
4
  1. FellowshipMayo Clinic, ArizonaLung pathology
  2. 2004Vall d'Hebron University Hospital, BarcelonaThoracic pathologist: tumours, interstitial disease, transplantation
  3. 2012Royal Brompton Hospital, LondonConsultant thoracic histopathologist
  4. 2018Manchester University NHS Foundation TrustConsultant cardiothoracic histopathologist at a referral centre for interstitial lung disease and transplantation; Clinical Director for Cellular Pathology from 2020
  5. 2019British Thoracic Oncology GroupSteering committee
  6. 2024Liverpool Clinical LaboratoriesSenior consultant

Institutions are named as her career; they don't endorse Neolung.

Neolung for pathologists and for hospitals

For pathologists

Your eyes and your judgement. Not your typing.

You look, you decide, you say it. Neolung fills a specialist's template from it, checks it, and waits for your signature.

  • Say it once

    The diagnosis in a line, by voice or typed. The report is filled from what you said; anything you didn't say stays empty for you to add.

  • Checked before you sign

    What's missing and what contradicts, against RCPath, ICCR and TNM, each warning with its guideline.

  • The lung around the tumour

    Report types that ask for the background lung and interstitial disease, in a specialist's words.

Fourteen report types, in a specialist's words

From a lung resection to a transplant biopsy. Choose one to see what it asks for, what it checks, and how you'd dictate it. Each is in review by our clinical lead before it's used with patient data.

Lung cancer

Lung resection (primary carcinoma)

Resection for primary lung carcinoma, written as the clinical lead reports it.

sections
6
fields
37
checks
12

The AI may suggest from photos: Histological type, Predominant pattern.

Written against: UICC TNM Classification of Malignant Tumours, 9th edition: lung; RCPath dataset for histopathological reporting of lung cancer; ICCR dataset: lung cancer, resection.

Dictate it like this

Right upper lobe resection. Non-mucinous adenocarcinoma, papillary 75%, lepidic 25%, 17 mm. PL0, away from the stapled line. Margins and hilar nodes clear. Stations 11R, 4R, 2R and 7 clear. Background lung unremarkable. pT1b N0 R0.

  1. Specimen2 fields
  2. Tumour18 fields
  3. Margins2 fields
  4. Lymph nodes8 fields
  5. Non-neoplastic lung3 fields
  6. Pathological stage4 fields

Lung cancer

Lung resection, metastasis

Wedge or lobectomy for a metastasis (colorectal, ovarian, renal, sarcoma), written as the clinical lead reports it. For a primary lung carcinoma, use the lung resection.

sections
2
fields
15
checks
9

Written against: The clinical lead's own reports.

Dictate it like this

Right lower lobe wedge. Sections show an adenocarcinoma entirely consistent with a colorectal primary. Tumour is away from the visceral pleura and the stapled line. Background lung is unremarkable. Diagnosis: adenocarcinoma consistent with colorectal primary, completely resected.

  1. Microscopy9 fields
  2. Diagnosis6 fields

Lung cancer

Lung biopsy (small)

Needle core, bronchial or EBUS biopsy for suspected carcinoma, written as the clinical lead reports it.

sections
10
fields
61
checks
19

Written against: The clinical lead's own reports.

Dictate it like this

Lung biopsy, right upper lobe. Two needle core biopsies with extensive infiltration by a non-mucinous adenocarcinoma, acinar and lepidic patterns. Block for molecular tests A1, tumour 40%, no necrosis.

  1. Specimen3 fields
  2. EBUS sample A7 fields
  3. EBUS sample B7 fields
  4. EBUS sample C7 fields
  5. EBUS sample D7 fields
  6. EBUS sample E7 fields
  7. EBUS sample F7 fields
  8. Findings12 fields
  9. Molecular testing3 fields
  10. Comment1 fields

Other lung

Lung biopsy, non-neoplastic

Lung biopsy without a tumour: granulomas, amyloid, acute lung injury, organising pneumonia, hamartoma. For a carcinoma, carcinoid or metastasis, use the small lung biopsy.

sections
2
fields
15
checks
9

Written against: The clinical lead's own reports.

Dictate it like this

Lung biopsy, left lower lobe. The alveolar septa are thickened with neutrophils and eosinophils, with fibrin and focal organisation. No vasculitis, capillaritis or criteria of a specific infection. Diagnosis: acute lung injury with focal organising areas. Special stains to follow.

  1. Microscopy9 fields
  2. Diagnosis6 fields

Other lung

Lung resection, non-neoplastic

Lobectomy or wedge without a tumour: bronchiectasis, fibroelastosis, completion lobectomy, written as the clinical lead reports it.

sections
2
fields
15
checks
9

Written against: The clinical lead's own reports.

Dictate it like this

Right upper lobe. The sections show a bronchiectasis with a thick fibrotic capsule, extending to the pleura with adhesions. The bronchial and vascular resection margins and the lymph nodes are unremarkable. No malignancy seen. Diagnosis: bronchiectasis, fibrosis and inflammation.

  1. Microscopy9 fields
  2. Diagnosis6 fields

Interstitial lung disease

Interstitial lung disease biopsy

Surgical, cryo or transbronchial biopsy for interstitial lung disease, written as the clinical lead reports it, with radiological correlation.

sections
4
fields
22
checks
3

Written against: The clinical lead's own reports; ATS/ERS/JRS/ALAT clinical practice guideline: diagnosis of idiopathic pulmonary fibrosis.

Dictate it like this

Surgical biopsy, right upper, middle and lower lobes, parts A and B. Sections from the three lobes show similar features. Patchy subpleural fibrosis with organising pneumonia within severe emphysema. Constrictive bronchiolitis as a sign of small airways disease. No granuloma formation is seen. Diagnosis: constrictive bronchiolitis within severe emphysema. Comment: connective tissue disease and micro-aspiration should be excluded.

  1. Specimen2 fields
  2. Findings14 fields
  3. Radiological correlation3 fields
  4. Conclusion3 fields

Transplant

Lung transplant biopsy

Transbronchial biopsy after lung transplant, written as the clinical lead reports it, with ISHLT grades.

sections
4
fields
23
checks
5

Written against: The clinical lead's own reports; ISHLT revised working formulation for the grading of lung allograft rejection.

Dictate it like this

Transplant TBB, right lower and middle lobe. Eight pieces, bronchial wall and alveolar interstitium. Two bronchioles show lymphocytic inflammation. Perivascular lymphocytic cuffing in the alveolar parenchyma. Mild acute cellular rejection and lymphocytic bronchiolitis, A2 B1R C0. DSA recommended.

  1. Specimen5 fields
  2. Findings7 fields
  3. Rejection grades4 fields
  4. Conclusion7 fields

Transplant

Lung explant

Native lungs removed at transplant, written as the clinical lead reports them.

sections
3
fields
19
checks
3

Written against: The clinical lead's own reports; ATS/ERS/JRS/ALAT clinical practice guideline: diagnosis of idiopathic pulmonary fibrosis.

Dictate it like this

Bilateral lung transplantation. Sections from both lungs show diffuse and severe emphysema. Patchy acute lung injury and organising pneumonia are noted. There is no evidence of malignancy. Diagnosis: diffuse severe emphysema consistent with the clinical diagnosis of alpha-1 antitrypsin deficiency.

  1. Specimen1 fields
  2. Findings15 fields
  3. Conclusion3 fields

Pleura

Pleural biopsy

Pleural biopsy, benign or malignant, written as the clinical lead reports it.

sections
2
fields
17
checks
9

Written against: The clinical lead's own reports.

Dictate it like this

A and B. Sections show superficial pieces of pleura with marked mesothelial hyperplasia and lymphocytic inflammation. There is no granuloma formation or evidence of malignancy seen. Diagnosis: A and B, pleural biopsy, reactive mesothelial hyperplasia. Special stains to follow.

  1. Microscopy9 fields
  2. Diagnosis8 fields

Pleura

Pneumothorax resection

Bullectomy, apical wedge or pleurectomy for pneumothorax, written as the clinical lead reports it.

sections
2
fields
15
checks
9

Written against: The clinical lead's own reports.

Dictate it like this

Sections from the lung show mild pleural fibrosis and subpleural bullae. No granuloma formation or malignancy seen. The sections from the pleura show mesothelial hyperplasia and mild fibrosis. The overall features are those of recurrent pneumothorax.

  1. Microscopy9 fields
  2. Diagnosis6 fields

Pleura

Lung abscess and empyema

Lung abscess, empyema or decortication, written as the clinical lead reports it.

sections
2
fields
15
checks
9

Written against: The clinical lead's own reports.

Dictate it like this

A and B. Sections show a fibrinoid and organising pleuritis, with a fibrotic wall, superficial fibrin, granulation tissue and abundant mixed inflammation. There is no granuloma formation or malignancy seen. Diagnosis: A and B, abscess and pleural debris, fibrinoid and organising pleuritis and features consistent with empyema. Special stains in hand.

  1. Microscopy9 fields
  2. Diagnosis6 fields

Consultation

Referral opinion

An opinion on a case sent by a colleague, written as the clinical lead writes her letters.

sections
1
fields
12
checks
0

Written against: The clinical lead's own reports.

Dictate it like this

Thank you for sending me this interesting case. I agree with you that the features are those of a congenital pulmonary airway malformation, type 1. In the slides I have gone through the lesions are completely resected, however I would also advise follow up.

  1. Letter12 fields

Cytology

Respiratory cytology

Bronchial washings, bronchoalveolar lavage or brushings, written as the clinical lead reports them.

sections
2
fields
15
checks
9

Written against: The clinical lead's own reports.

Dictate it like this

The slides show a hypercellular cytology with abundant bronchial cells and alveolar macrophages within a background of neutrophils. There is no granuloma formation or evidence of malignancy seen. Diagnosis: bronchial washings, acute inflammation. Comment: infection should be excluded in the first instance.

  1. Microscopy9 fields
  2. Diagnosis6 fields

Cytology

Pleural fluid cytology

Pleural fluid or effusion, smears and clot, written as the clinical lead reports it.

sections
2
fields
15
checks
9

Written against: The clinical lead's own reports.

Dictate it like this

The section from the blood clot shows abundant small lymphocytes and occasional mesothelial cells within a haematic background. There is no granuloma formation or evidence of malignancy seen. Diagnosis: pleural fluid, lymphocytic effusion.

  1. Microscopy9 fields
  2. Diagnosis6 fields

For trainees: every warning says why

Open a warning to see the guideline behind it. The same two the worked case raises, as Neolung writes them.

MissingVascular resection margin is required.
ContradictionStated pT1c is lower than the size and pleural invasion support (at least pT2a).
  • UICC TNM Classification of Malignant Tumours, 9th edition: lung9th edition

A second opinion, inside the case

Ask a pathologist at another centre from inside the case, and keep their answer with it.

  1. You askFrom the case, to a pathologist at another organisation.
  2. They read that caseOnly that one, and they can't change it.
  3. Their opinion stays with itSigned by them, kept with the case, apart from your report.
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For hospitals

The same datasets, for every pathologist who reports.

The required items asked for every time, whoever writes the report. And a supplier that writes down how it protects your data and your patients, gaps included.

No integration project

Nothing to install on the laboratory system, no interface to build.

  1. In the browserYour pathologists sign in from a browser. Nothing to install.
  2. Dictated, checked, signedIn Neolung, with every version kept.
  3. Pasted into your laboratory systemAs reports are today. Nothing else changes.

What your governance team will ask

Choose a question. The full answers, and what isn't finished yet, are in the Trust center.

In London, encrypted
  • The application, its database and its file stores run in London. Sign-in is handled by Auth0, in the EU.
  • Each photo is encrypted (AES-256-GCM) before it leaves the server: the store only ever holds encrypted data.
  • Exports are encrypted too, and deleted after seven days.
Your organisation, and no one else
  • Every organisation is kept apart from every other.
  • Staff who don't report, such as management or IT, administer the team and see no cases.
  • A pathologist asked for a second opinion reads that one case, and can't change it.
A consultant, with permission
  • Each member reports as a consultant or a trainee, or doesn't report.
  • Signing is a separate permission that an administrator grants, only to a consultant. Nobody can grant it to themselves.
Never in place
  • Each signature makes a version that can't be changed, not even by the application's own database account.
  • An amendment carries its reason; a supplementary report is added alongside, never over.
  • Every action is recorded.
Only what you allow, under your contract
  • Off until your organisation turns it on, with its own provider and key, which Neolung keeps encrypted. For invented cases only, Neolung may lend its own demo account.
  • Nothing you report trains anyone else's model. No free text from other cases goes into a request: only past choices, such as a pattern picked, from your own organisation.
  • With patient data, only in the report types the clinical lead has approved, at the version in use.
Drafts and photos you remove, after seven days
  • A deleted draft, or a photo removed from a draft, is erased seven days later, and from backups 30 days after that.
  • A photo that is part of a signed version is never deleted.
Not yet, and we say so
  • Neolung is not yet a registered medical device. Until a hospital approves it for patient data, it's used with invented cases.
  • Clinical safety (DCB0129): a risk management plan and a hazard log are written, in draft; the safety case isn't issued yet.
  • DTAC evidence and a data processing agreement are drafted for your review.

How a department starts

A few steps for an administrator, then one decision that belongs to your governance.

  1. Create your organisationFind your hospital in the NHS directory by its ODS code.
  2. Verify your email domainOne DNS record, and colleagues who sign in with it are pointed to you.
  3. Invite your teamSet each role, and grant signing to consultants.
  4. Add your AI, if you want itYour organisation's own provider and key.
  5. Patient data, when you're readyOnce your governance approves, Neolung turns it on for your organisation.
Set up your department Read the Trust center

The AI inside Neolung

It helps. It doesn't decide.

  1. Neolung's AI: Turns what you dictate into the report's fields. Only what you said, never what it guesses.

    You: Review every field, and change any of them.

  2. Neolung's AI: Describes what it sees in a photo of the slide, beside the report. In some report types it may suggest a field's value, which you accept or dismiss.

    You: Decide what goes into the report.

  3. Neolung's AI: Doesn't stage, and doesn't check. The checks are fixed rules, written out and tested.

    You: State the pT and pN, see each warning with the guideline behind it, and settle it.

  4. Neolung's AI: Never signs, and never changes anything on its own.

    You: Sign. Only a consultant with permission to sign can.

Off until your organisation turns it on, with its own provider (or, for invented cases only, Neolung's demo account). Nothing you report trains anyone else's model.

One case, start to finish

  1. YouDictate the case as you'd tell a colleague, straight after the microscope.
  2. Neolung's AIPuts what you said into the report's fields. Only what you said: the vascular margin wasn't, so it stays empty.
  3. Neolung's AIReads the photo of the slide and describes it beside the report. It may suggest the histological type or the predominant pattern, never more.
  4. Neolung's rulesCheck the case against the guidelines. Fixed rules, not the AI, and nothing changed on its own.
  5. YouSettle each warning. Here: say the vascular margin, and restate the pT.
  6. YouReview the report, written in the template's words, and sign it. Then paste it into the laboratory system.

Try it with an invented case.

Start as a pathologist Set up your department Sign in