Zufallsbefund von Lymphangioleiomyomatose in gynäkologischen Operationspräparaten – eine Fallserie
Bibliographic record
Abstract
BACKGROUND: Lymphangioleiomyomatosis (LAM) is a rare, slow progressing, low-grade neoplasia that primarily effects young women. The disease is well known for its pulmonary involvement with cystic destruction, but extra-pulmonary disease may occur. LAM is associated with mutations in the TSC 1 or TSC 2 genes and may develop sporadically or in the context of hereditary disease tuberous sclerosis complex (TSC). Incident LAM may represent the sentinel finding of the disease. OBJECTIVE: Raising awareness for rare extrapulmonary LAM lesions in retroperitoneum and pelvic cavity. METHODS: Data-based research was performed for LAM in gynecological surgical specimens. H&E-stained slides were re-examined, and immunohistochemical stains were re-evaluated. Clinical data were retrieved for the presence pulmonary LAM or TSC. RESULTS: A total of 13 cases were identified. The age of the patients ranged from 32 to 77 years, and 8/13 were ≤ 55 years. Two women had a history of pulmonary LAM and TSC. Most women underwent surgery for gynecological malignancy. On histological examination, 10/13 patients presented LAM in 1 to 9 lymph nodes with a lesion size of 0.5 to 12.0 mm, mainly located subcapsular or in the nodal parenchyma. Three of the 13 women showed extranodal involvement of the retroperitoneum, myometrium, and the hilum of the ovary. Immunohistochemically LAM was positive for HMB45, desmin, and smooth muscle actin. CONCLUSION: LAM is a rare systemic disease that mainly involves the lungs. Nevertheless, extra-pulmonary manifestations may occur. It is important to report the incidental finding of even small foci of LAM within the pathology report. Incidental LAM may represent the sentinel lesion for pulmonary LAM and/or TSC.
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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 | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 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".