SYSTEMIC LYMPHOMA MASQUERADING AS BIRDSHOT CHORIORETINOPATHY
Bibliographic record
Abstract
PURPOSE: To report a rare case of systemic lymphoma causing a birdshot-like chorioretinopathy in a histocompatibility leukocyte antigen-A29-negative patient. METHODS: A 58-year-old man presented with a 1-year history of blurry vision and intermittent floaters. He had evidence of bilateral choroidal birdshot-like lesions that appeared atrophic without any vitritis. He had a history of low-grade B-cell lymphoma and chronic myeloid leukemia, both of which were diagnosed >10 years before presentation and treated with chemotherapy. RESULTS: The differential diagnosis of these birdshot-like lesions included autoimmune, neoplastic, and infectious etiologies. Work-up revealed a negative histocompatibility leukocyte antigen-A29 and negative results for syphilis and tuberculosis. Magnetic resonance imaging revealed enhancement of the trigeminal and oculomotor nerve cisternal segments but no overt evidence of malignancy. Full-field electroretinogram and multifocal electroretinogram tests were within normal limits. Serial follow-up clinical examinations, retinal imaging, full-field electroretinogram, and multifocal electroretinogram demonstrated no disease progression. Two years after his initial consultation, he developed a paraspinal mass that was biopsied and found to be diffuse large B-cell lymphoma and was treated with chemotherapy. CONCLUSION: Clinicians should consider birdshot-like chorioretinopathy masquerade syndromes in patients who present with birdshot-like choroidal lesions with negative histocompatibility leukocyte antigen-A29, a history of lymphoma, or atypical characteristics. In this case, the authors suspect the patient's past low-grade B-cell lymphoma, and chemotherapy resulted in the chronic choroidal findings. It is unclear whether choroidal involvement predisposes a patient to high-grade transformation to diffuse large B-cell lymphoma. His ocular findings remained inactive throughout the treatment of his diffuse large B-cell lymphoma.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".