Keloidal and Other Collagen Patterns in Atypical Fibroxanthomas
Bibliographic record
Abstract
Collagen deposition is observed in several cutaneous neoplasms and its derivation is variable. It can represent (1) a mesenchymal component of a biphasic tumor, (2) a desmoplastic host response to a neoplasm, or (3) a product of the tumor cells. The result is that collagenous (desmoplastic) variants of many cutaneous neoplasms are well recognized. In regard to atypical fibroxanthoma (AFX), conventional wisdom holds that intratumoral collagen is not commonly observed, apart from the rare sclerotic subtype of the neoplasm. This has not been our experience. The relatively frequent observation of keloidal collagen in AFXs and the dearth of information in the literature about this phenomenon prompted us to investigate the matter. All cases of AFX diagnosed at our institution within a 10-year period (1999-2008) were reviewed. The group included 64 males and 27 females with a mean age of 75 years. The majority of the cases (92%) were located on the head or neck. The conventional pleomorphic subtype of the tumor was encountered most frequently (67%). In 17 of the 91 cases (19%), prominent intratumoral keloidal collagen was present. This morphological observation poses interesting questions: (1) Is the collagen part of a host response to the neoplasm or is it a product of the tumor cells? (2) If the latter, does it cast light on the controversial histogenesis of AFX? (3) Does it signify an involutional stage of the tumor and imply a favorable prognosis? (4) Is it related to the "sclerotic" variant of the tumor? We discuss the above quandaries and emphasize the need to register this variant of AFX amongst other morphological subtypes of the tumor. The goal is to facilitate accuracy in diagnosis and to promote further investigation.
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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) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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".