Hodgkin Lymphoma Presenting as a Vulvar Mass in a Patient With Crohn Disease
Bibliographic record
Abstract
OBJECTIVE: A case of Hodgkin lymphoma of the vulva and perineum is presented along with a review of the literature. MATERIALS AND METHODS: Medical chart and clinical images were reviewed. RESULTS: A 45-year-old female patient with a longstanding history of Crohn disease presented with a large vulvar and perineal mass. Physical examination revealed a mass measuring approximately 20 x 20 cm involving primarily the labia majora, the labia minora, and the clitoris as well as the perineum. Incisional biopsy of the vulvar mass revealed histologic diagnosis and immunohistochemistry typical of classic Hodgkin lymphoma. Imaging revealed involvement of multiple lymph nodes as well as the liver. The patient was designated as having stage IV disseminated Hodgkin lymphoma, and chemotherapy with doxorubicin, bleomycin, vinblastine, and dacarbazine was instituted. A significant reduction of the size of the vulvar mass was observed following 8 cycles of chemotherapy. CONCLUSIONS.: Lymphoma of the vulva is rare with the majority being of the non-Hodgkin lymphoma type. The most common subtypes of vulvar lymphoma reported are diffuse large B-cell lymphoma and follicular lymphoma. Perianal Hodgkin lymphoma is also very rare but has been reported in association with human immunodeficiency virus infection, Epstein-Barr virus infection, and Crohn disease. This is only the second reported case of Hodgkin lymphoma of the vulva and the second case of Hodgkin lymphoma involving the perianal area in a female patient. There is currently no evidence that Crohn disease is associated with an increased risk of Hodgkin lymphoma.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
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".