Intraductal Papillary Neoplasm of the Bile Duct Arising From a Background of Autoimmune Hepatitis: A Case Report
Bibliographic record
Abstract
Intraductal papillary neoplasm of the bile duct (IPNB) is a rare cystic tumor of the liver defined separately from hepatic mucinous cystic neoplasm. Development of liver cancer in patients with autoimmune hepatitis (AIH) is also sporadic, and such cases reported previously have been hepatocellular carcinoma. Here we report a 50-year-old man with IPNB complicated by AIH who underwent a successful extended left hepatectomy. Histopathology and immunohistochemical staining of the resected tumor revealed that it was a pancreatobiliary-type IPNB expressing both MUC5AC and MUC6, accompanied by carcinoma in situ expressing p53, Ki-67 and CA19-9. The histopathology of the background liver was compatible with that of AIH showing interface hepatitis with accompanying plasma cell infiltration. The patient has remained free of cancer recurrence for 12 years following the hepatectomy, and liver dysfunction caused by AIH has been controllable by steroid administration. This is the first report of pancreatobiliary-type IPNB associated with AIH. doi: http://dx.doi.org/10.4021/jmc1439w
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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 | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.004 | 0.002 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.005 | 0.003 |
| 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".