Solitary Hepatic Nodule Adjacent to the Right Portal Vein
Bibliographic record
Abstract
BACKGROUND: Hepatic lesions have been described in Alagille syndrome (ALGS) in isolated case reports, and most of these have been reported to be hepatocellular carcinoma. OBJECTIVES: The aim of the present study was to determine the frequency, imaging, and histopathologic characteristics of hepatic lesions in children with ALGS. METHODS: Available abdominal imaging of children with ALGS was retrospectively reviewed to note the presence of any focal liver lesion, its location, and imaging characteristics. Other findings including signs of portal hypertension, portal lymph nodes, and splenic and renal abnormalities were also noted. Findings were correlated with pathology in available cases and with clinical follow-up. RESULTS: Of 55 children with clinically and/or genetically confirmed ALGS followed in the liver clinic, 39 (19 boys, 20 girls; mean age 8.9 years) with imaging available on picture archival and communication system were included in the study. Focal hepatic lesions were seen in 12 of the 39 (30%) children, solitary in 11 and multiple in 1. Ten of these children had a large nodule adjacent to the right portal vein. The median diameter of the lesions was 8.1 cm (range 5.6-9.8 cm). Magnetic resonance imaging features and pathology in available cases were suggestive of a regenerative nodule. α-fetoprotein levels were normal in all except 1 child who had mild elevation. CONCLUSIONS: Combining our series and previous case reports, the presence of a large nodule adjacent to the right portal vein appears to be a common finding in ALGS. The typical location, normal α-fetoprotein levels, and magnetic resonance imaging features with vessels coursing through the lesion can reliably differentiate this benign nodule from hepatocellular carcinoma.
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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) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 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".