A Hyperacute Presentation of Small Cell, Non‐Nodal Mantle Cell Lymphoma
Bibliographic record
Abstract
Mantle cell lymphoma (MCL) is an aggressive mature B‐cell non‐Hodgkin lymphoma. Patients often present with lymphadenopathy, early satiety, and B‐symptoms. Presentation with hyperleukocytosis is rare. The small cell, non‐nodal variant of MCL tends to be less aggressive, have lower mitotic rates, and mimics morphology of chronic lymphocytic leukemia (CLL). We present a 79‐year‐old woman admitted to hospital with generalized weakness, gait instability, and dyspnea; she was found to have a white count of 550 × 10 9 /L, hemoglobin of 30 g/L, and platelets of 49 × 10 9 /L. She had biochemical evidence of poor tissue perfusion. Peripheral blood smear demonstrated lymphocytosis with smudge cells. After aggressive red blood cell transfusion, she was managed as leukostasis with concurrent tumour lysis syndrome (TLS). She was administered intravenous fluids, rasburicase, allopurinol, and escalating doses of prednisone for lymphoreduction. Her mentation and biochemical evidence of shock improved. Although we initially had high suspicion for CLL, her flow cytometry raised concerns for MCL. Cytogenetics confirmed t (11; 14) rearrangement. This case is the first to discuss a severe, aggressive presentation of a small variant, leukemic non‐nodal MCL. We also review the role of steroids in leukostasis and concurrent warm autoimmune hemolytic anemia, in a centre where leukapheresis is unavailable.
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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 | 0.000 |
| 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".