When Lymphoma Strikes the Pancreas: A Rare Presentation of Systemic Anaplastic Lymphoma Kinase-Negative Anaplastic Large Cell Lymphoma in a Human Immunodeficiency Virus-Positive Patient
Bibliographic record
Abstract
Anaplastic lymphoma kinase (ALK)-negative anaplastic large cell lymphoma (ALCL) is an uncommon subtype of non-Hodgkin lymphoma, with pancreatic involvement being exceedingly rare and documented in only a handful of case reports. We present a unique case of a 31-year-old human immunodeficiency virus (HIV)-positive male with multisite ALK-negative ALCL, who initially presented with a buttock ulcer, leading to a suspicion of primary cutaneous ALCL or lymphomatoid papulosis. However, the discovery of multiple extracutaneous sites, including an atypical pancreatic head involvement, confirmed the diagnosis of systemic ALK-negative ALCL with cutaneous manifestation. The patient received six cycles of brentuximab vedotin + cyclophosphamide-doxorubicin-prednisone (BV + CHP) treatment, achieving a substantial reduction in the size of the pancreatic head mass and no detectable fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET) scan. This case underscores the diagnostic challenges of ALK-negative ALCL in HIV-positive patients with extranodal presentations and demonstrates the potential effectiveness of targeted therapeutic strategies for such cases.
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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 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| 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".