Gastric Inflammatory Fibroid Polyp: A Rare Incidental Finding on Endoscopy
Bibliographic record
Abstract
A 73-year-old man presented for upper endoscopy due to right upper quadrant pain that was subsequently diagnosed as myofascial pain. Incidentally, endoscopy demonstrated a 3-cm antral submucosal tumour with a sub-centimeter satellite nodule (Figure 1A and B). The patient subsequently had endoscopic ultrasound + fine needle aspiration that demonstrated a hypoechoic lesion arising from the muscularis mucosa. Fine needle aspiration was non-diagnostic. Considering that the lesion met size criteria, a plan for resection was made. Given the unknown pathology, the lesion was excised via endoscopic submucosal dissection to ensure an R0 resection. Final pathology demonstrated an inflammatory fibroid polyp (Figure 1D–F). Inflammatory fibroid polyps are rare gastric lesions that makeup ~0.1% of encountered gastric polyps (1). These are usually incidental findings on upper endoscopy. However, they can result in bleeding, gastric outlet obstruction, epigastric pain or recurrent nausea, and vomiting (2,3). Although rare, IFPs should be included in the differential for gastric submucosal tumours. Endoscopic and histologic views of inflammatory fibroid polyp. (A) Distant view demonstrating a Paris 1sp lesion in the antrum. (B) Closer view showing normal overlying antral mucosa. (C) Final endoscopic submucosal dissection defect with the gross specimen (top left insert). (D) At low power, there is a cellular proliferation filling the submucosa and extending into the basal portion of the mucosa. (E) On high power, cytologically bland spindle cells mixed with small blood vessels and eosinophil-rich mixed inflammation are seen. (F) The stromal cells are positive for CD34 by immunohistochemistry. CD117 and DOG-1 are negative. Robert Bechara is a consultant for Olympus.
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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 | 0.008 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.004 | 0.002 |
| Science and technology studies | 0.002 | 0.003 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.009 | 0.004 |
| Insufficient payload (model declined to judge) | 0.004 | 0.002 |
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".