Plasma cell neoplasm with plasmablastic morphology mimicking acute leukemia
Bibliographic record
Abstract
A 63-year-old woman presented with fatigue that increased over 2 months. The blood work showed a white blood cell count of 3.8 3 10 9 /L, hemoglobin of 8.8 g/dL, platelet count of 51 3 10 9 /L, and immunoglobulin G kappa paraproteins. There was no evidence of bone lytic lesions by imaging analysis. A bone marrow aspiration demonstrated diffuse infiltration of mononuclear cells, including the blast-like cells which showed dispersed chromatin, high nuclear-cytoplasmic ratio, and the nucleus concentrically placed with no perinuclear hof (panels A and B; original magnification 3100; May-Grnwald-Giemsa stain). Immunohistochemistry on bone marrow biopsy (panel C; original magnification 340; hematoxylin and eosin stain) revealed sheets of abnormal cells that were positive for CD138 (panel E; original magnification 340; CD138 immunostain), MUM1, CD79b, CD117 (dim, partial), and cytoplasmic kappa and were negative for CD34 (panel D; original magnification 340; CD34 immunostain), TdT, MPO, CD33, CD68, CD56, lysozyme, and CD3. A deletion of chromosome 13q14 was detected by fluorescence in situ hybridization. Overall, the findings were consistent with a plasma cell myeloma with plasmablastic features.
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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 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".