Isolated Cardiac Involvement in Rosai-Dorfman-Destombes Disease Causing Obstructive Shock
Bibliographic record
Abstract
BACKGROUND: Rosai-Dorfman-Destombes disease (RDD) is a rare histiocytic disorder that classically presents with painless massive lymphadenopathy; however, extranodal disease can occur. CASE SUMMARY: A 63-year-old patient was incidentally found to have a soft tissue mass in the left atrium on computed tomography imaging during work-up for atrial flutter. After open surgery to obtain tissue diagnosis, the patient developed shock requiring venovenous extracorporeal membrane oxygenation support. The tissue biopsy revealed the diagnosis of RDD, and the patient received rituximab, which led to substantial clinical improvement. DISCUSSION: We report a case of isolated cardiac RDD resulting in severe cardiac obstruction. Cardiac RDD is very rare, and a histopathologic diagnosis is required. Expert clinicopathologic correlation is required for early recognition and diagnosis. TAKE-HOME MESSAGES: RDD is a rare neoplastic disease with heterogeneous presentations, including cardiac involvement. Treatment can range from surgery to systemic therapy, including immunomodulatory agents and targeted therapy for patients with a mitogen-activated protein kinase mutation.
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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) | 0.000 | 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".