Right ventricular mass: a rare presentation of cardiac sarcoidosis
Bibliographic record
Abstract
Illustrative images from a patient with a large right ventricular mass secondary to cardiac sarcoidosis primarily involving the right ventricle (RV). A 33-year-old male was referred for assessment after presenting with a 10-day history of dyspnoea on exertion with associated dizziness and was found to be in complete heart block with a ventricular escape rhythm. Endomyocardial biopsy demonstrated non-caseating granulomata suggestive of sarcoidosis. Advanced imaging modalities including 18FDG PET and MRI imaging demonstrated not only the extent of cardiac involvement but additionally, active cardiac and non-cardiac active inflammation. This is the first case to demonstrate an RV tissue mass due to extensive sarcoid involvement with corroborating evidence on 18FDG PET and MRI imaging. Panel A: Transthoracic Echocardiogram with an apical four-chamber view showing marked right ventricular free wall and apical thickening. Panel B: Cardiac MRI (4CH Fiesta gated) demonstrating an ovoid mass-like area of soft tissue thickening involving the mid RV-free wall measuring 5 × 1.7 cm. Panel C: 18FDG PET scan using the cardiac sarcoidosis protocol demonstrating a high degree of uptake within the mass lesion and adjacent right ventricular wall. Left ventricular involvement was most prominent in the interventricular septum with mild FDG uptake within the anterolateral wall. Panel D: Transoesophageal echocardiogram with midoesophageal four-chamber view at 0° (post 6 months of steroid treatment) demonstrating significant lessening in the degree of thickening at RV apex. Funding to pay the Open Access publication charges for this article was provided by Dr Gerald Wisenberg. Supplementary material is available at European Heart Journal online.
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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) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.004 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 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".