Tumefactive Demyelinating Lesions
Bibliographic record
Abstract
A 40-year-old right-handed female presented with a threeweek history of abrupt onset, persistent right-sided sensory alteration.She described a sense of heaviness and numbness in the right face, arm, and part of her right leg.She also noted intermittent expressive speech difficulty.On examination, she was found to have a mild right-sided facial droop and impairment of all sensory modalities including light touch, pinprick, vibration, and proprioception throughout her right side.The remainder of her neurological exam was normal and speech was fluent.An MRI was obtained, which revealed a solitary 2.4 x 2.6 cm lesion in the deep left parietal lobe with minimal positive mass effect.The lesion had an incomplete periphery or rim of low signal intensity on T1-weighted images and high signal intensity on T2-weighted images.The lesion's central core had slightly greater signal intensity on T1-weighted images and relatively lesser signal intensity on T2-weighted images (Figures 1,2).There was a small focus of contrast enhancement at the superomedial aspect of the lesion (Figure 3).Diffusion-weighted imaging (DWI) showed increased diffusion at the periphery consistent with a probable cystic nature (Figure 4).No other lesions were identified.The MR angiography was normal.Differential diagnosis for the lesion included neoplastic, infectious, granulomatous, and demyelinating diseases.Two months following her initial MRI, the patient underwent stereotactic biopsy using an intra-operative MRI scanner.The baseline intra-operative MR images revealed a new lesion in the right posterior frontal white matter measuring 2.4 x 1.7 cm with patchy rim enhancement (Figure 5 and6), in addition to the known left parietal lesion.Since the new lesion was in the nondominant hemisphere and relatively superficial, a biopsy targeting this lesion was performed as it was felt to likely represent the same etiology.Pathology revealed sheets of macrophages intermixed with lymphocytes, plasma cells, and reactive astrocytes.In addition, there was perivascular lymphocytic inflammation with sharply defined foci of almost
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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) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| 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".