Autoimmune Pancreatitis Presenting as a Focal Pancreatic Mass Mimicking Pancreatic Cancer: A Case Report and Review of the Literature
Bibliographic record
Abstract
A 68-year-old female presented with a 2-week history of jaundice, generalized itching and weight loss in 2006. On physical examination, she was deeply jaundiced; however, other clinical examinations were completely unremarkable. Liver function tests (LFTs) were deranged: serum alkaline phosphatase 407 U/L (35 - 104), serum aspartate transaminase 57 U/L (0 - 31), serum alanine transaminase 184 U/L (0 - 37), and serum total bilirubin 4.3 mg/dL (0 - 1). Abdominal CT revealed a 4.8 cm × 3.5 cm mass in the pancreatic head. ERCP revealed a high-grade stricture in the distal CBD. An internal biliary stent was placed in to the CBD stricture. Patient’s symptoms relieved after biliary stenting. Serum CA 19-9 was elevated at 1,568 U/mL (0 - 37). Due to high suspicion for pancreatic cancer, patient underwent pylorus-sparing pancreaticoduodenectomy. Histopathology was benign and showed perilobular lymphoplasmacytic infiltrate, periductal fibrosis and phlebitis that was consistent with autoimmune pancreatitis. Patient was started on oral prednisone that was eventually replaced with azathioprine. Serum IgG4 was 53 mg/dL (1 - 291) after starting steroid treatment. doi: http://dx.doi.org/10.4021/jmc891w
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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) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.006 | 0.005 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.002 | 0.004 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
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".