Gastrointestinal: Solitary Peutz‐Jeghers‐type hamartoma of the colon
Bibliographic record
Abstract
A 50-year-old Japanese man had colonoscopy as a screening test for colorectal cancer. A pedunculated polyp, approximately 18 mm in diameter, was noted in the sigmoid colon. At chromoendoscopy, the polyp was lobulated with grooves as shown in Figure 1. The polyp was removed by loop diathermy and, histologically, was composed of branching bundles of smooth muscle fibers covered by elongated crypts without dysplasia (Figure 2). The diagnosis was that of a solitary Peutz-Jeghers-type hamartoma of the colon. Four years previously, he had been treated by distal gastrectomy for an early gastric cancer. Colonoscopy was performed at that time but no polyps or other lesions were found. Furthermore, there were no cutaneous manifestations of Peutz-Jeghers syndrome and no abnormalities were detected in the small bowel on a follow-through examination. Non-neoplastic polyps of the colon can be categorized as hyperplasias, inflammatory polyps, hamartomas, heterotopias and miscellaneous lesions. The most frequent non-neoplastic polyp is a hyperplastic polyp, sometimes called a metaplastic polyp. Another significant group are various inflammatory and postinflammatory polyps including an entity of uncertain etiology called an inflammatory fibroid polyp. Hamartomatous polyps contain a disorganised but mature mixture of specialized cells that normally reside in the colon. Examples include the Peutz-Jegher polyp, juvenile polyp, Cowden's disease polyp, ganglioneuroma and Cronkhite-Canada polyp. Solitary Peutz-Jeghers-type polyps have been described previously but appear to be rare. Although the pathogenesis of these polyps remains unclear, there is no evidence that patients with solitary polyps form part of the Peutz-Jeghers syndrome. At endoscopy, Peutz-Jegher-type polyps can have a similar appearance to juvenile polyps and inflammatory fibroid polyps. Histologically, Peutz-Jeghers-type polyps consist of normal colonic glands and lamina propria that is arranged into lobules by branching bands of smooth muscle. In contrast, juvenile polyps have an expanded, edematous and inflamed lamina propria that contains distorted glands, many showing cystic dilatation. For inflammatory fibroid polyps, the major feature is vascularized fibrous tissue that is infiltrated by a variety of chronic inflammatory cells, sometimes with prominent eosinophils.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.001 |
| Insufficient payload (model declined to judge) | 0.007 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".