Primary Anaplastic Large Cell Lymphoma of the Lung in a Child
Bibliographic record
Abstract
Anaplastic large cell lymphoma [ALCL] is a rare disease in children accounting for 10-15% of all childhood non-Hodgkin lymphomas. Primary ALCL characteristically involves the lymph node/skin and is a rare malignancy in the lung accounting for only 0.3% of primary lung neoplasms. A case of primary ALCL of the lung in a 5-year old boy is discussed detailing pathology, and diagnostic pitfalls. A 5-year-old boy was admitted with a 2-month history of persistent upper respiratory symptoms, fever and 'pneumonitis.' A fiberoptic endoscopy revealed the presence of whitish lesion in the right bronchus that was biopsied and initially reported as Ewing sarcoma of the lung. A repeat bronchoscopic evaluation with biopsy was undertaken. Histopathologic examination showed the presence of a “blue cell tumor” with sheets of monomorphic cells with scant cytoplasm, vesicular nuclei with irregular chromatin, and inconspicuous nucleoli. Initial panel of immunohistochemical markers showed these cells to be negative to CD45, CD3, CD20, S100, Synaptophysin, CGA, CD56, and Pankeratin with positive expression of CD99. The correct diagnosis of ALCL, null phenotype was arrived at by the finding of strong expression of CD30 which led to the confirmatory third panel of stains- EMA and ALK-1 being strongly expressed. Clinical and radiologic staging revealed no evidence of extrathoracic disease and the child was started on combination-chemotherapy. A rare case of ACLC in a 5-year old child with its first clinical presentation as a lung mass is discussed. Accurate diagnosis of this unusual entity could only be established with the use of immunohistochemistry with demonstration of co-expression of CD30, EMA and Alk-1. In conclusion, although a rare tumor of the lung, ACLC should be considered in the differential diagnosis of “unusual lung neoplasms” even with a negative 'initial' lymphoma panel of T and B-cell markers.
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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 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| 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".