Hyperplastic Gastric Polyposis Complicated by a High-Grade Sarcomatoid Malignancy
Bibliographic record
Abstract
1Departments of Medicine (Gastroenterology) and 2Pathology, University of British Columbia, Vancouver, British Columbia Correspondence: Dr Hugh J Freeman, University of British Columbia Hospital, 2211 Wesbrook Mall, Vancouver, British Columbia V6T 1W5. Telephone 604-822-7216, e-mail hugfree@shaw.ca Received for publication January 24, 2014. Accepted February 7, 2014 CASE PRESENTATION A 70-year-old Asian-born woman experienced intermittent melena and iron-deficiency anemia that was treated with long-term omeprazole and iron supplements. Previous studies in other hospitals in 2009 and 2010 revealed multiple hyperplastic gastric polyps in the gastric antrum and body, but no dysplasia. There was no known family history of gastric neoplasia or previous Helicobacter pylori infection. In 2012, she experienced an additional episode of melena. Gastroscopic evaluation confirmed the presence of multiple small and large gastric polyps, typical of hyperplastic polyps (1) (Figures 1A and 1B), some with focal erosions but no dysplasia, along with a superimposed large ulcerating and polypoid lesion in the gastric body consistent with a high-grade malignancy (Figures 2A and 2B). Routine immunostaining of these biopsies to exclude stromal tumours as well as tumours of smooth muscle and neural origin with CD-117, actin and S-100 were negative. Subtotal gastrectomy showed an anaplastic spindle and epithelioid neoplasm consistent with an undifferentiated high-grade sarcomatoid malignancy (sarcoma versus sarcomatoid carcinoma), but not a gastrointestinal stromal tumour (GIST), localized to the stomach without nodal or distant metastases. Extensive immunohistochemical staining for epithelial, neuroendocrine, hematopoietic and melanocyte differentiation on the resected gastric malignancy were negative. The following stains were all negative: CD117 and DOG1 for GIST; smooth muscle actin, desmin, caldesmon for leiomyosarcoma; S100, Melan A, HMB45 for malignant peripheral nerve sheath tumour, melanoma and PECOMA; CD31 and CD34 for angiosarcoma; synaptophysin, chromogranin and TTF1 for neuroendocrine differentiation; cytokeratins 7, 19, 20, Cam 5.2 and CDX-2 for epithelial differentiation; and CD45, CD20, CD3 and ALK1 for lymphoreticular origin.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 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".