Clinicopathological diagnosis of primary ocular amyloidosis
Bibliographic record
Abstract
Abstract Purpose: The pathogenesis of amyloidosis involves the deposition of misfolded protein, called amyloid, in various tissues. Amyloidosis can further be classified as primary, secondary, familial transthyretin amyloidosis (ATTR), and wild-type ATTR amyloidosis. Congo red staining that becomes apple green by dichroism under polarized light confirms the diagnosis. When it affects the eyes, amyloidosis can target all the ocular adnexal tissues, most commonly the eyelid, conjunctiva, and lacrimal gland. Amyloidosis of the conjunctiva manifests as a sessile salmon-patch irregularly shaped lesion favoring the bulbar conjunctiva. Orbital and eyelid amyloidosis is often clinically present as ptosis, proptosis, and diplopia. The aim of the study is to describe the clinicopathological features of periocular amyloidosis, and in particular conjunctival amyloidosis. Subjects and Methods: A total of 15 patients with ocular amyloidosis were studied at the MUHC McGill University Ocular Pathology and Translational Research Laboratory. Their demographic information and pathology reports were collected and analyzed. Results: Of 15 amyloidosis cases, 10 were primary (66.67%); 10 (66.67%) were conjunctival, 3 (20%) were in the eyelid, and 2 (13.33%) were lacrimal. Most patients were female with nine female cases and six male cases (ratio: 3:2). Of the cases where immunohistochemical information was available, all but two were diagnosed by Congo red special staining with Apple Green dichroism. Among conjunctival amyloidosis cases, 10 (100%) were primary, while all eyelid and lacrimal amyloidosis cases were secondary. Associated findings include fibrosis, chronic inflammation, and acanthosis. The clinical indication for the biopsy in 8 of the 15 cases (53.33%) was to rule out malignant processes, such as lymphoma, particularly for conjunctival lesions. Conclusions: Periocular amyloidosis can take on varied presentation, often mimicking other malignant pathologies including lymphoma. As such, the diagnosis requires clinicopathological correlation to be confirmed. The histopathological diagnosis is made with Congo red dichroism.
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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) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.005 | 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".