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AMNESIA

id string	question string	answer string	patient_note string	article_title string	PMID string	category string	short_reason string
3686641-2_factual_1	What were the key peripheral blood counts on admission?	Pancytopenia with WBC 1.61 Gpt/l, hemoglobin 9.5 g/dl, and platelets 71 Gpt/l.	A collaborating rehabilitation center referred a 58-year old woman having suffered from a massive stroke of the left hemisphere with consecutive right hemiplegia and aphasia. In the past medical history, the husband reported heavy smoking, arterial hypertension, hyperlipoproteinemia, diabetes and overweight of his wife...	Rapid induction of complete molecular remission by sequential therapy with LDAC and sorafenib in FLT3-ITD-positive patients unfit for intensive treatment: two cases and review of the literature	23759001	Cancer	Title discusses FLT3-ITD-positive patients and induction of molecular remission with LDAC and sorafenib, indicating cancer treatment.
3686641-2_factual_2	What pallitative treatment regimen was initiated and its dosing schedule?	LDAC 20 mg BID for 10 days, followed by sorafenib 400 mg BID from day 11 to day 28.	A collaborating rehabilitation center referred a 58-year old woman having suffered from a massive stroke of the left hemisphere with consecutive right hemiplegia and aphasia. In the past medical history, the husband reported heavy smoking, arterial hypertension, hyperlipoproteinemia, diabetes and overweight of his wife...	Rapid induction of complete molecular remission by sequential therapy with LDAC and sorafenib in FLT3-ITD-positive patients unfit for intensive treatment: two cases and review of the literature	23759001	Cancer	Title discusses FLT3-ITD-positive patients and induction of molecular remission with LDAC and sorafenib, indicating cancer treatment.
3686641-2_factual_3	What were the treatment outcomes regarding remission and relapse?	Peripheral blood counts normalized 6 weeks after treatment initiation; bone marrow showed CR by cytomorphology and complete molecular remission by PCR, with relapse-free survival >290 days.	A collaborating rehabilitation center referred a 58-year old woman having suffered from a massive stroke of the left hemisphere with consecutive right hemiplegia and aphasia. In the past medical history, the husband reported heavy smoking, arterial hypertension, hyperlipoproteinemia, diabetes and overweight of his wife...	Rapid induction of complete molecular remission by sequential therapy with LDAC and sorafenib in FLT3-ITD-positive patients unfit for intensive treatment: two cases and review of the literature	23759001	Cancer	Title discusses FLT3-ITD-positive patients and induction of molecular remission with LDAC and sorafenib, indicating cancer treatment.
3686641-2_reasoning_1	How did the presenting pancytopenia influence initial management decisions?	The profound anemia and thrombocytopenia with low WBC created infection and bleeding risks, prompting RBC transfusion and selection of palliative chemotherapy; the subsequent neutropenic fever during cycle 1 illustrates infection risk associated with leukopenia and guided antibiotic therapy.	A collaborating rehabilitation center referred a 58-year old woman having suffered from a massive stroke of the left hemisphere with consecutive right hemiplegia and aphasia. In the past medical history, the husband reported heavy smoking, arterial hypertension, hyperlipoproteinemia, diabetes and overweight of his wife...	Rapid induction of complete molecular remission by sequential therapy with LDAC and sorafenib in FLT3-ITD-positive patients unfit for intensive treatment: two cases and review of the literature	23759001	Cancer	Title discusses FLT3-ITD-positive patients and induction of molecular remission with LDAC and sorafenib, indicating cancer treatment.
3686641-2_reasoning_2	What is the rationale for adding sorafenib after LDAC in this patient?	FLT3-ITD mutation identified by PCR provides a targetable pathway in AML; therefore, after initial cytoreduction with LDAC, sorafenib was added to improve disease control and promote molecular remission.	A collaborating rehabilitation center referred a 58-year old woman having suffered from a massive stroke of the left hemisphere with consecutive right hemiplegia and aphasia. In the past medical history, the husband reported heavy smoking, arterial hypertension, hyperlipoproteinemia, diabetes and overweight of his wife...	Rapid induction of complete molecular remission by sequential therapy with LDAC and sorafenib in FLT3-ITD-positive patients unfit for intensive treatment: two cases and review of the literature	23759001	Cancer	Title discusses FLT3-ITD-positive patients and induction of molecular remission with LDAC and sorafenib, indicating cancer treatment.
3686641-2_reasoning_3	How do the cycle-2 responses relate to the overall outcome and relapse-free status?	Cycle-2 responses showed normalization of counts and attainment of complete remission with molecular remission, which corresponded to relapse-free survival of over 290 days, indicating durable disease control under outpatient therapy.	A collaborating rehabilitation center referred a 58-year old woman having suffered from a massive stroke of the left hemisphere with consecutive right hemiplegia and aphasia. In the past medical history, the husband reported heavy smoking, arterial hypertension, hyperlipoproteinemia, diabetes and overweight of his wife...	Rapid induction of complete molecular remission by sequential therapy with LDAC and sorafenib in FLT3-ITD-positive patients unfit for intensive treatment: two cases and review of the literature	23759001	Cancer	Title discusses FLT3-ITD-positive patients and induction of molecular remission with LDAC and sorafenib, indicating cancer treatment.
6206852-1_factual_1	What cardiac conduction abnormality did the patient develop and how was it managed?	He developed a complete atrioventricular block and underwent pacemaker implantation; coronary angiography showed no significant stenosis.	We present the case of a 77-year-old ambulatory man with hypertension, sarcoidosis, complete atrioventricular block status post-pacemaker implantation, chronic kidney disease due to FSGS, and right facial nerve paralysis, who presented with sporadic gait and right face numbness. He was diagnosed with sarcoidosis by bio...	Intravascular lymphoma forming massive aortic tumors complicated with sarcoidosis and focal segmental glomerulosclerosis: a case report and literature review	30373554	Cancer	Title indicates intravascular lymphoma with massive aortic tumors, which is a cancer diagnosis.
6206852-1_factual_2	Describe the left leg thrombotic events including the depth and the arterial emboli pathology.	The patient developed a left femoral vein deep venous thrombosis (41 mm) with edema; later there was acute occlusion of the left femoral and superficial femoral arteries requiring emergent thrombectomy; the arterial emboli surface contained large atypical lymphoid cells that were CD20+ and CD79a+, but CD3−.	We present the case of a 77-year-old ambulatory man with hypertension, sarcoidosis, complete atrioventricular block status post-pacemaker implantation, chronic kidney disease due to FSGS, and right facial nerve paralysis, who presented with sporadic gait and right face numbness. He was diagnosed with sarcoidosis by bio...	Intravascular lymphoma forming massive aortic tumors complicated with sarcoidosis and focal segmental glomerulosclerosis: a case report and literature review	30373554	Cancer	Title indicates intravascular lymphoma with massive aortic tumors, which is a cancer diagnosis.
6206852-1_factual_3	What were the lymphoproliferative findings and the ultimate outcome?	CT showed enlarged bilateral axillary and inguinal lymph nodes up to 30 mm, and bone marrow biopsy revealed infiltration by CD79a-positive large atypical lymphoid cells; the patient died from sudden respiratory and cardiac arrest during hospitalization after sepsis.	We present the case of a 77-year-old ambulatory man with hypertension, sarcoidosis, complete atrioventricular block status post-pacemaker implantation, chronic kidney disease due to FSGS, and right facial nerve paralysis, who presented with sporadic gait and right face numbness. He was diagnosed with sarcoidosis by bio...	Intravascular lymphoma forming massive aortic tumors complicated with sarcoidosis and focal segmental glomerulosclerosis: a case report and literature review	30373554	Cancer	Title indicates intravascular lymphoma with massive aortic tumors, which is a cancer diagnosis.
6206852-1_reasoning_1	What data collectively support a lymphoma diagnosis beyond the thrombotic events?	Elevated soluble IL-2 receptor and LDH levels, along with bone marrow infiltration by CD79a-positive large atypical lymphoid cells and imaging-detected lymphadenopathy, point to a lymphoproliferative process and are consistent with intravascular large B-cell lymphoma.	We present the case of a 77-year-old ambulatory man with hypertension, sarcoidosis, complete atrioventricular block status post-pacemaker implantation, chronic kidney disease due to FSGS, and right facial nerve paralysis, who presented with sporadic gait and right face numbness. He was diagnosed with sarcoidosis by bio...	Intravascular lymphoma forming massive aortic tumors complicated with sarcoidosis and focal segmental glomerulosclerosis: a case report and literature review	30373554	Cancer	Title indicates intravascular lymphoma with massive aortic tumors, which is a cancer diagnosis.
6206852-1_reasoning_2	Why might immobilization alone fail to explain the patient’s thrombosis pattern in the context of a lymphoma?	Although reduced mobility predisposed to DVT, the concurrent finding of lymphoma cells within thrombi and a biochemical profile of lymphoproliferation suggests an underlying lymphoma-driven hypercoagulable state contributing to both venous thrombosis and arterial emboli.	We present the case of a 77-year-old ambulatory man with hypertension, sarcoidosis, complete atrioventricular block status post-pacemaker implantation, chronic kidney disease due to FSGS, and right facial nerve paralysis, who presented with sporadic gait and right face numbness. He was diagnosed with sarcoidosis by bio...	Intravascular lymphoma forming massive aortic tumors complicated with sarcoidosis and focal segmental glomerulosclerosis: a case report and literature review	30373554	Cancer	Title indicates intravascular lymphoma with massive aortic tumors, which is a cancer diagnosis.
6206852-1_reasoning_3	How do the renal findings help distinguish sarcoid nephropathy from the patient’s primary kidney disease?	Renal biopsy showed no sarcoid involvement, instead revealing features of primary FSGS, which, along with stable abdominal lymphadenopathy and lack of systemic sarcoidosis signs, argues against sarcoid nephropathy and supports non-sarcoidal CKD.	We present the case of a 77-year-old ambulatory man with hypertension, sarcoidosis, complete atrioventricular block status post-pacemaker implantation, chronic kidney disease due to FSGS, and right facial nerve paralysis, who presented with sporadic gait and right face numbness. He was diagnosed with sarcoidosis by bio...	Intravascular lymphoma forming massive aortic tumors complicated with sarcoidosis and focal segmental glomerulosclerosis: a case report and literature review	30373554	Cancer	Title indicates intravascular lymphoma with massive aortic tumors, which is a cancer diagnosis.
9048571-1_factual_1	What did the initial X-ray of the left shoulder show?	A comminuted fracture of the proximal humerus with degenerative changes.	A 64-year-old man who came to our emergency department complaining of left shoulder pain. He had mild left shoulder trauma due to accidental falling from the standing position while walking 3 h ago. His past medical history included atrial fibrillation treated with aspirin enteric-coated tablets (Bayer SPA), metoprolol...	Intramedullary nailing for pathological fractures of the proximal humerus caused by multiple myeloma: A case report and review of literature	35611188	Cancer	Title specifies multiple myeloma causing pathological fractures; multiple myeloma is a malignancy.
9048571-1_factual_2	What hematology/immunochemistry findings were reported?	Anemia was present; multifocal plasmacytoid cell aggregation with immunochemistry showing CD38+, kappa+, and lambda+ expression, along with MPO+ and CD61+ markers.	A 64-year-old man who came to our emergency department complaining of left shoulder pain. He had mild left shoulder trauma due to accidental falling from the standing position while walking 3 h ago. His past medical history included atrial fibrillation treated with aspirin enteric-coated tablets (Bayer SPA), metoprolol...	Intramedullary nailing for pathological fractures of the proximal humerus caused by multiple myeloma: A case report and review of literature	35611188	Cancer	Title specifies multiple myeloma causing pathological fractures; multiple myeloma is a malignancy.
9048571-1_factual_3	What chronic medications was the patient taking for atrial fibrillation?	Aspirin enteric-coated tablets and metoprolol succinate.	A 64-year-old man who came to our emergency department complaining of left shoulder pain. He had mild left shoulder trauma due to accidental falling from the standing position while walking 3 h ago. His past medical history included atrial fibrillation treated with aspirin enteric-coated tablets (Bayer SPA), metoprolol...	Intramedullary nailing for pathological fractures of the proximal humerus caused by multiple myeloma: A case report and review of literature	35611188	Cancer	Title specifies multiple myeloma causing pathological fractures; multiple myeloma is a malignancy.
9048571-1_reasoning_1	How do the hematology/immunochemistry results contribute to hypothesizing a plasma cell dyscrasia?	Multifocal plasmacytoid cells with CD38+ expression and light-chain positivity (kappa and lambda) indicate clonal plasma cell proliferation. When paired with anemia, this pattern is characteristic of plasma cell disorders such as multiple myeloma, helping to differentiate it from non-clonal bone injury.	A 64-year-old man who came to our emergency department complaining of left shoulder pain. He had mild left shoulder trauma due to accidental falling from the standing position while walking 3 h ago. His past medical history included atrial fibrillation treated with aspirin enteric-coated tablets (Bayer SPA), metoprolol...	Intramedullary nailing for pathological fractures of the proximal humerus caused by multiple myeloma: A case report and review of literature	35611188	Cancer	Title specifies multiple myeloma causing pathological fractures; multiple myeloma is a malignancy.
9048571-1_reasoning_2	What is the significance of reduced bone density on CT/X-ray and focal uptake on the bone scan?	Widespread reduced bone density suggests diffuse bone involvement or osteolysis, while focal FDG uptake in ribs, L5, and proximal humerus signals metabolically active lesions. Together, these findings support a neoplastic bone process rather than localized trauma alone.	A 64-year-old man who came to our emergency department complaining of left shoulder pain. He had mild left shoulder trauma due to accidental falling from the standing position while walking 3 h ago. His past medical history included atrial fibrillation treated with aspirin enteric-coated tablets (Bayer SPA), metoprolol...	Intramedullary nailing for pathological fractures of the proximal humerus caused by multiple myeloma: A case report and review of literature	35611188	Cancer	Title specifies multiple myeloma causing pathological fractures; multiple myeloma is a malignancy.
9048571-1_reasoning_3	How do normal motor findings and absence of hypoesthesia influence the differential diagnosis in this shoulder injury?	Normal muscle tone and reflexes with no hypoesthesia reduce the likelihood of acute nerve injury from trauma and favor consideration of an underlying systemic process causing bone lesions and masses seen on imaging, rather than a purely peripheral nerve injury from the fall.	A 64-year-old man who came to our emergency department complaining of left shoulder pain. He had mild left shoulder trauma due to accidental falling from the standing position while walking 3 h ago. His past medical history included atrial fibrillation treated with aspirin enteric-coated tablets (Bayer SPA), metoprolol...	Intramedullary nailing for pathological fractures of the proximal humerus caused by multiple myeloma: A case report and review of literature	35611188	Cancer	Title specifies multiple myeloma causing pathological fractures; multiple myeloma is a malignancy.
10011851-1_factual_1	What were the patient’s symptoms on the third day of evaluation?	Dull global headache, recent memory deficits, tiredness, hypersomnolence, and irritability.	A 34-year-old male software engineer had gone to cast his vote in the election from his home on a bike. After casting the vote he walked back home as he could not remember where he parked his bike. On returning home, he complained of headache, tiredness, and drowsiness. On evaluation of the symptoms on the third day, t...	Abrupt Cognitive Decline in Thalamic Tumor—Case Report	36925492	Cancer	Title mentions a thalamic tumor causing abrupt cognitive decline, indicating cancer.
10011851-1_factual_2	What treatment was started to minimize intracranial pressure?	Injection Mannitol and steroids were started to minimize intracranial pressure.	A 34-year-old male software engineer had gone to cast his vote in the election from his home on a bike. After casting the vote he walked back home as he could not remember where he parked his bike. On returning home, he complained of headache, tiredness, and drowsiness. On evaluation of the symptoms on the third day, t...	Abrupt Cognitive Decline in Thalamic Tumor—Case Report	36925492	Cancer	Title mentions a thalamic tumor causing abrupt cognitive decline, indicating cancer.
10011851-1_factual_3	What was the postoperative outcome by day 6?	Postoperatively the patient did not regain consciousness, required ventilatory support, developed brainstem coning, and died on the 6th day of admission.	A 34-year-old male software engineer had gone to cast his vote in the election from his home on a bike. After casting the vote he walked back home as he could not remember where he parked his bike. On returning home, he complained of headache, tiredness, and drowsiness. On evaluation of the symptoms on the third day, t...	Abrupt Cognitive Decline in Thalamic Tumor—Case Report	36925492	Cancer	Title mentions a thalamic tumor causing abrupt cognitive decline, indicating cancer.
10011851-1_reasoning_1	How do the initial symptoms and papilledema relate to the underlying diagnosis?	The headache, memory deficits, hypersomnolence, and irritability reflect raised intracranial pressure from a space-occupying brain lesion. Bilateral papilledema is a sign of sustained increased ICP. Together with the MRI-detected tumor, these findings support a diagnosis of mass effect from a brain tumor.	A 34-year-old male software engineer had gone to cast his vote in the election from his home on a bike. After casting the vote he walked back home as he could not remember where he parked his bike. On returning home, he complained of headache, tiredness, and drowsiness. On evaluation of the symptoms on the third day, t...	Abrupt Cognitive Decline in Thalamic Tumor—Case Report	36925492	Cancer	Title mentions a thalamic tumor causing abrupt cognitive decline, indicating cancer.
10011851-1_reasoning_2	Why was an emergency ventriculoperitoneal shunt performed, and what happened afterward?	Rising intracranial pressure with altered sensorium due to the tumor and edema prompted the VP shunt to relieve pressure. Afterward, the patient continued to deteriorate (GCS 3/15), developed signs of brainstem compression (coning), and ultimately died, indicating ongoing intracranial hypertension despite decompression...	A 34-year-old male software engineer had gone to cast his vote in the election from his home on a bike. After casting the vote he walked back home as he could not remember where he parked his bike. On returning home, he complained of headache, tiredness, and drowsiness. On evaluation of the symptoms on the third day, t...	Abrupt Cognitive Decline in Thalamic Tumor—Case Report	36925492	Cancer	Title mentions a thalamic tumor causing abrupt cognitive decline, indicating cancer.
10011851-1_reasoning_3	What does the clinical sequence from imaging to outcome illustrate about ICP management in large intracranial lesions?	It illustrates that although imaging-guided ICP management (mannitol, steroids, and surgical decompression) aims to prevent herniation, severe edema and mass effect can overwhelm these measures, leading to brain herniation and death despite intervention.	A 34-year-old male software engineer had gone to cast his vote in the election from his home on a bike. After casting the vote he walked back home as he could not remember where he parked his bike. On returning home, he complained of headache, tiredness, and drowsiness. On evaluation of the symptoms on the third day, t...	Abrupt Cognitive Decline in Thalamic Tumor—Case Report	36925492	Cancer	Title mentions a thalamic tumor causing abrupt cognitive decline, indicating cancer.
10061007-1_factual_1	What were the main presenting symptoms at referral?	Severe epigastric pain and a suspicion of interstitial lung disease on everolimus therapy.	A 37-year-old man treated for PanNEN gastrinoma with multiple liver metastases was referred to our Department of Endocrinology in May 2021 due to severe epigastric pain and a suspicion of interstitial lung disease on everolimus therapy. The patient’s medical history included Hashimoto’s disease, nephrolithiasis, and ch...	Severe ectopic Cushing syndrome in a transgender man with a metastatic gastrinoma and an adrenal tumor—A case report and review of the literature	37008936	Cancer	Title describes metastatic gastrinoma with ectopic Cushing syndrome and adrenal tumor, indicating an underlying malignancy.
10061007-1_factual_2	Which biomarkers were markedly elevated to confirm gastrinoma?	Gastrin levels and chromogranin A were markedly elevated.	A 37-year-old man treated for PanNEN gastrinoma with multiple liver metastases was referred to our Department of Endocrinology in May 2021 due to severe epigastric pain and a suspicion of interstitial lung disease on everolimus therapy. The patient’s medical history included Hashimoto’s disease, nephrolithiasis, and ch...	Severe ectopic Cushing syndrome in a transgender man with a metastatic gastrinoma and an adrenal tumor—A case report and review of the literature	37008936	Cancer	Title describes metastatic gastrinoma with ectopic Cushing syndrome and adrenal tumor, indicating an underlying malignancy.
10061007-1_factual_3	What systemic therapies were started in February 2021 due to progression?	Somatostatin receptor ligand therapy with octreotide LAR, followed by oral everolimus.	A 37-year-old man treated for PanNEN gastrinoma with multiple liver metastases was referred to our Department of Endocrinology in May 2021 due to severe epigastric pain and a suspicion of interstitial lung disease on everolimus therapy. The patient’s medical history included Hashimoto’s disease, nephrolithiasis, and ch...	Severe ectopic Cushing syndrome in a transgender man with a metastatic gastrinoma and an adrenal tumor—A case report and review of the literature	37008936	Cancer	Title describes metastatic gastrinoma with ectopic Cushing syndrome and adrenal tumor, indicating an underlying malignancy.
10061007-1_reasoning_1	What is the pathophysiologic link between the PanNEN and the Cushing syndrome, and how was cortisol excess initially managed?	The ACTH-dependent Cushing syndrome was likely driven by ectopic ACTH or CRH secretion from the PanNEN. Cortisol excess was initially managed with metyrapone and pasireotide before surgical intervention.	A 37-year-old man treated for PanNEN gastrinoma with multiple liver metastases was referred to our Department of Endocrinology in May 2021 due to severe epigastric pain and a suspicion of interstitial lung disease on everolimus therapy. The patient’s medical history included Hashimoto’s disease, nephrolithiasis, and ch...	Severe ectopic Cushing syndrome in a transgender man with a metastatic gastrinoma and an adrenal tumor—A case report and review of the literature	37008936	Cancer	Title describes metastatic gastrinoma with ectopic Cushing syndrome and adrenal tumor, indicating an underlying malignancy.
10061007-1_reasoning_2	Why was only left adrenalectomy performed, and what intraoperative finding drove this choice?	During surgery, the liver was significantly enlarged, creating unfavorable intraoperative conditions for a bilateral adrenalectomy; consequently, only a left-sided adrenalectomy was performed.	A 37-year-old man treated for PanNEN gastrinoma with multiple liver metastases was referred to our Department of Endocrinology in May 2021 due to severe epigastric pain and a suspicion of interstitial lung disease on everolimus therapy. The patient’s medical history included Hashimoto’s disease, nephrolithiasis, and ch...	Severe ectopic Cushing syndrome in a transgender man with a metastatic gastrinoma and an adrenal tumor—A case report and review of the literature	37008936	Cancer	Title describes metastatic gastrinoma with ectopic Cushing syndrome and adrenal tumor, indicating an underlying malignancy.
10061007-1_reasoning_3	Why was temozolomide and capecitabine chosen, what was the observed initial response, and why was treatment discontinued?	Temozolomide and capecitabine were chosen due to progression of liver metastases with rising gastrin and chromogranin A after adrenal surgery. There was an initial decrease in metastases and gastrin, but treatment was discontinued after four courses because of recurrent severe pancytopenia requiring transfusions.	A 37-year-old man treated for PanNEN gastrinoma with multiple liver metastases was referred to our Department of Endocrinology in May 2021 due to severe epigastric pain and a suspicion of interstitial lung disease on everolimus therapy. The patient’s medical history included Hashimoto’s disease, nephrolithiasis, and ch...	Severe ectopic Cushing syndrome in a transgender man with a metastatic gastrinoma and an adrenal tumor—A case report and review of the literature	37008936	Cancer	Title describes metastatic gastrinoma with ectopic Cushing syndrome and adrenal tumor, indicating an underlying malignancy.
10081889-1_factual_1	What was the renal function distribution on the nuclear medicine scan?	Right kidney function was 33% and left kidney function was 67%.	A 37-year-old male with a medical history of nephrolithiasis, latent tuberculosis, and a 20+ pack-year smoking history initially presented in February 2021 with complaints of hematuria, right flank pain, and new onset clot passage. A renal and bladder ultrasound was then done which showed numerous irregular cysts in th...	Concurrent Xanthogranulomatous Pyelonephritis and Upper Urinary Tract Transitional Cell Carcinoma	37035839	Cancer	Title includes 'Upper Urinary Tract Transitional Cell Carcinoma' indicating cancer.
10081889-1_factual_2	What treatment was initially recommended given preserved left kidney function?	A simple right nephrectomy was recommended because the left kidney function was preserved, but the patient initially declined the operation.	A 37-year-old male with a medical history of nephrolithiasis, latent tuberculosis, and a 20+ pack-year smoking history initially presented in February 2021 with complaints of hematuria, right flank pain, and new onset clot passage. A renal and bladder ultrasound was then done which showed numerous irregular cysts in th...	Concurrent Xanthogranulomatous Pyelonephritis and Upper Urinary Tract Transitional Cell Carcinoma	37035839	Cancer	Title includes 'Upper Urinary Tract Transitional Cell Carcinoma' indicating cancer.
10081889-1_factual_3	What did the nephrectomy pathology show?	Urothelial carcinoma with squamous differentiation in a background of XGP; margins were negative for invasive carcinoma and there was no evidence of regional lymph node metastasis.	A 37-year-old male with a medical history of nephrolithiasis, latent tuberculosis, and a 20+ pack-year smoking history initially presented in February 2021 with complaints of hematuria, right flank pain, and new onset clot passage. A renal and bladder ultrasound was then done which showed numerous irregular cysts in th...	Concurrent Xanthogranulomatous Pyelonephritis and Upper Urinary Tract Transitional Cell Carcinoma	37035839	Cancer	Title includes 'Upper Urinary Tract Transitional Cell Carcinoma' indicating cancer.
10081889-1_reasoning_1	What finding in the nephrectomy specimen changed the diagnostic and treatment trajectory?	The specimen showed urothelial carcinoma with squamous differentiation in a background of XGP, indicating malignant transformation beyond inflammatory XGP and shifting management toward oncologic treatment.	A 37-year-old male with a medical history of nephrolithiasis, latent tuberculosis, and a 20+ pack-year smoking history initially presented in February 2021 with complaints of hematuria, right flank pain, and new onset clot passage. A renal and bladder ultrasound was then done which showed numerous irregular cysts in th...	Concurrent Xanthogranulomatous Pyelonephritis and Upper Urinary Tract Transitional Cell Carcinoma	37035839	Cancer	Title includes 'Upper Urinary Tract Transitional Cell Carcinoma' indicating cancer.
10081889-1_reasoning_2	What evidence indicated liver metastasis and how did that change management?	CT identified multiple new hepatic hypodensities, and CT-guided liver biopsy confirmed metastatic urothelial carcinoma, leading to systemic chemotherapy with GC and subsequent maintenance therapy.	A 37-year-old male with a medical history of nephrolithiasis, latent tuberculosis, and a 20+ pack-year smoking history initially presented in February 2021 with complaints of hematuria, right flank pain, and new onset clot passage. A renal and bladder ultrasound was then done which showed numerous irregular cysts in th...	Concurrent Xanthogranulomatous Pyelonephritis and Upper Urinary Tract Transitional Cell Carcinoma	37035839	Cancer	Title includes 'Upper Urinary Tract Transitional Cell Carcinoma' indicating cancer.
10081889-1_reasoning_3	What was the overall outcome despite chemotherapy?	Despite initial chemotherapy with GC and avelumab maintenance, the disease progressed rapidly and the patient was transitioned to hospice, ultimately passing away from the disease.	A 37-year-old male with a medical history of nephrolithiasis, latent tuberculosis, and a 20+ pack-year smoking history initially presented in February 2021 with complaints of hematuria, right flank pain, and new onset clot passage. A renal and bladder ultrasound was then done which showed numerous irregular cysts in th...	Concurrent Xanthogranulomatous Pyelonephritis and Upper Urinary Tract Transitional Cell Carcinoma	37035839	Cancer	Title includes 'Upper Urinary Tract Transitional Cell Carcinoma' indicating cancer.
10200038-1_factual_1	When did pembrolizumab treatment begin and what was its purpose?	Pembrolizumab treatment began in October 2019 to prevent the need for cystectomy.	A 75-year-old male was diagnosed with non-muscle invasive carcinoma in-situ of the bladder in August 2018. Over the next year, he was treated with and failed two rounds of bacillus Calmette-Guérin (BCG) therapy. In October 2019, he started pembrolizumab treatment to prevent the need for a cystectomy. Over the next few ...	Therapy-Related Acute Promyelocytic Leukemia Developed During Pembrolizumab Therapy	37220434	Cancer	Title indicates acute promyelocytic leukemia occurring during pembrolizumab therapy, which is a cancer diagnosis.
10200038-1_factual_2	Which autoimmune side effects occurred with pembrolizumab, and how were they managed?	Adrenal insufficiency, hypophysitis, hypothyroidism, hepatitis, and arthritis occurred, managed by temporarily discontinuing pembrolizumab or providing hormonal replacement therapy.	A 75-year-old male was diagnosed with non-muscle invasive carcinoma in-situ of the bladder in August 2018. Over the next year, he was treated with and failed two rounds of bacillus Calmette-Guérin (BCG) therapy. In October 2019, he started pembrolizumab treatment to prevent the need for a cystectomy. Over the next few ...	Therapy-Related Acute Promyelocytic Leukemia Developed During Pembrolizumab Therapy	37220434	Cancer	Title indicates acute promyelocytic leukemia occurring during pembrolizumab therapy, which is a cancer diagnosis.
10200038-1_factual_3	What were the fall 2022 hematologic findings and initial management steps?	Severe neutropenia (ANC 0.34 x 10^6/uL) and moderate thrombocytopenia (platelets 58 x 10^3/uL) were noted; pembrolizumab was stopped and steroids, pegfilgrastim, and two IVIG doses were given.	A 75-year-old male was diagnosed with non-muscle invasive carcinoma in-situ of the bladder in August 2018. Over the next year, he was treated with and failed two rounds of bacillus Calmette-Guérin (BCG) therapy. In October 2019, he started pembrolizumab treatment to prevent the need for a cystectomy. Over the next few ...	Therapy-Related Acute Promyelocytic Leukemia Developed During Pembrolizumab Therapy	37220434	Cancer	Title indicates acute promyelocytic leukemia occurring during pembrolizumab therapy, which is a cancer diagnosis.
10200038-1_reasoning_1	Why is DIC clinically relevant in this patient, and how does it relate to the APL diagnosis?	APL is frequently associated with disseminated intravascular coagulation (DIC). The patient presented with moderate DIC and severe thrombocytopenia at diagnosis, which aligns with APL and guided induction therapy.	A 75-year-old male was diagnosed with non-muscle invasive carcinoma in-situ of the bladder in August 2018. Over the next year, he was treated with and failed two rounds of bacillus Calmette-Guérin (BCG) therapy. In October 2019, he started pembrolizumab treatment to prevent the need for a cystectomy. Over the next few ...	Therapy-Related Acute Promyelocytic Leukemia Developed During Pembrolizumab Therapy	37220434	Cancer	Title indicates acute promyelocytic leukemia occurring during pembrolizumab therapy, which is a cancer diagnosis.
10200038-1_reasoning_2	Why were ATRA and arsenic trioxide chosen for treatment, and how did steroids influence therapy during this period?	ATRA and arsenic trioxide are standard induction therapy for APL; steroids were used to manage autoimmune adrenal insufficiency and to mitigate differentiation syndrome, allowing continuation of APL-directed therapy.	A 75-year-old male was diagnosed with non-muscle invasive carcinoma in-situ of the bladder in August 2018. Over the next year, he was treated with and failed two rounds of bacillus Calmette-Guérin (BCG) therapy. In October 2019, he started pembrolizumab treatment to prevent the need for a cystectomy. Over the next few ...	Therapy-Related Acute Promyelocytic Leukemia Developed During Pembrolizumab Therapy	37220434	Cancer	Title indicates acute promyelocytic leukemia occurring during pembrolizumab therapy, which is a cancer diagnosis.
10200038-1_reasoning_3	What was the treatment outcome after induction and consolidation for APL, and what does this indicate about disease control?	Induction with ATRA and arsenic trioxide elicited a therapeutic response and resolved DIC. The patient then completed consolidation therapy as an outpatient and is in complete molecular remission.	A 75-year-old male was diagnosed with non-muscle invasive carcinoma in-situ of the bladder in August 2018. Over the next year, he was treated with and failed two rounds of bacillus Calmette-Guérin (BCG) therapy. In October 2019, he started pembrolizumab treatment to prevent the need for a cystectomy. Over the next few ...	Therapy-Related Acute Promyelocytic Leukemia Developed During Pembrolizumab Therapy	37220434	Cancer	Title indicates acute promyelocytic leukemia occurring during pembrolizumab therapy, which is a cancer diagnosis.
10276186-1_factual_1	What were the key findings on the pelvic examination?	A friable 3 x 4 cm mass was felt on the anterior lip of the cervix; the fornices were free and there was no inguinal lymphadenopathy.	A 35-year-old pre-menopausal woman presented with irregular vaginal bleeding for three months and white vaginal discharge for one week. She was the mother of two children with no family history of malignancies. On vaginal examination, a 3 x 4 cm growth was felt over the anterior lip of her cervix which was friable. Her...	Neuroendocrine Carcinoma of Cervix: A Case Series	37332440	Cancer	Title specifies neuroendocrine carcinoma of the cervix, which is a cancer.
10276186-1_factual_2	What did the imaging studies show about the cervical lesion?	Ultrasound showed a hypoechoic 3 x 3 cm lesion on the anterior cervical lip, and MRI showed a well-defined 3.8 x 2.5 cm mass in the cervix with suspicious minimal parametrial infiltration.	A 35-year-old pre-menopausal woman presented with irregular vaginal bleeding for three months and white vaginal discharge for one week. She was the mother of two children with no family history of malignancies. On vaginal examination, a 3 x 4 cm growth was felt over the anterior lip of her cervix which was friable. Her...	Neuroendocrine Carcinoma of Cervix: A Case Series	37332440	Cancer	Title specifies neuroendocrine carcinoma of the cervix, which is a cancer.
10276186-1_factual_3	What were the histopathological and immunohistochemical findings?	Histology suggested papillary adenocarcinoma with neuroendocrine features involving more than half the cervical stromal thickness; there was no lymphovascular, parametrial, uterine, or upper vaginal invasion, and immunohistochemistry showed strong chromogranin positivity, consistent with high-grade neuroendocrine cervi...	A 35-year-old pre-menopausal woman presented with irregular vaginal bleeding for three months and white vaginal discharge for one week. She was the mother of two children with no family history of malignancies. On vaginal examination, a 3 x 4 cm growth was felt over the anterior lip of her cervix which was friable. Her...	Neuroendocrine Carcinoma of Cervix: A Case Series	37332440	Cancer	Title specifies neuroendocrine carcinoma of the cervix, which is a cancer.
10276186-1_reasoning_1	Why was adjuvant chemoradiation considered despite absence of lymphovascular invasion or nodal metastasis on surgical pathology?	Because high-grade neuroendocrine cervical carcinomas have a high risk of occult micrometastatic disease even when LV invasion and nodal metastasis are not detected; thus systemic chemotherapy with radiotherapy is used to address potential hidden spread.	A 35-year-old pre-menopausal woman presented with irregular vaginal bleeding for three months and white vaginal discharge for one week. She was the mother of two children with no family history of malignancies. On vaginal examination, a 3 x 4 cm growth was felt over the anterior lip of her cervix which was friable. Her...	Neuroendocrine Carcinoma of Cervix: A Case Series	37332440	Cancer	Title specifies neuroendocrine carcinoma of the cervix, which is a cancer.
10276186-1_reasoning_2	How does chromogranin positivity on IHC influence interpretation of the tumor and its management plan?	Chromogranin positivity supports a neuroendocrine differentiation in a tumor described as papillary adenocarcinoma with neuroendocrine features, indicating a high-grade NECC; this drives the use of platinum-based chemotherapy regimens such as etoposide plus cisplatin along with radiotherapy.	A 35-year-old pre-menopausal woman presented with irregular vaginal bleeding for three months and white vaginal discharge for one week. She was the mother of two children with no family history of malignancies. On vaginal examination, a 3 x 4 cm growth was felt over the anterior lip of her cervix which was friable. Her...	Neuroendocrine Carcinoma of Cervix: A Case Series	37332440	Cancer	Title specifies neuroendocrine carcinoma of the cervix, which is a cancer.

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AMNESIA: A Large-Scale Medical Unlearning Benchmark Suite with Disease-Informed Analysis

AMNESIA is the first large-scale, open-source benchmark for machine unlearning in the medical domain. It is designed to evaluate methods that selectively remove the influence of specific patient data from trained medical language models while preserving the model's overall clinical knowledge and utility — a capability motivated by privacy regulations such as the GDPR "right to be forgotten."

The benchmark is built on de-identified clinical notes drawn from PubMed Central and paired with model-answerable question–answer items, organized into forget/retain partitions at multiple removal ratios and across disease categories.

Paper: AMNESIA: A Large-Scale Medical Unlearning Benchmark Suite with Disease-Informed Analysis
License: CC BY-NC-SA 4.0

Dataset structure

Each line of every .jsonl file is a single JSON record built from a de-identified patient note. A record contains:

a de-identified clinical patient note from PubMed Central,
factual questions testing direct recall from the note,
reasoning questions requiring multi-hop clinical inference,
gold-standard answers as verified references, and
a disease category label (one of the CDC-classified disease types).

Splits

The suite provides two kinds of partitioning, exposed here as loadable configurations:

Random (patient-level) partitioning. Patients are selected at random to form forget sets at 5%, 10%, 15%, 20%, and 25%; the remaining patients form the corresponding retain sets. hold_out contains held-out QA items that are never seen during training or unlearning, used to test generalization. rest holds the remaining data.

Disease-level partitioning. The same forget/retain ratios are applied within individual disease cohorts — Cancer, Cardiovascular, and Infectious/Immune Diseases — enabling disease-informed analysis. (Note that the Cardiovascular cohort provides the 5/10/15% ratios, while Cancer and Infectious/Immune provide additional higher ratios, reflecting cohort sizes.)

The forget sets are nested: each forget_X is a subset of the next larger forget_(X+5), which makes evaluations across removal ratios directly comparable and reproducible.

Usage

from datasets import load_dataset

# Random patient-level splits
ds = load_dataset("dsaeedeh/AMNESIA", "random", split="forget_10")

# Disease-level splits
cancer = load_dataset("dsaeedeh/AMNESIA", "cancer", split="forget_10")
cvd    = load_dataset("dsaeedeh/AMNESIA", "cardiovascular", split="retain_5")

You can also stream individual files directly:

ds = load_dataset("json", data_files="hold_out_with_category.jsonl")

Citation

If you use AMNESIA, please cite:

@article{davoudi2026amnesia,
  title   = {AMNESIA: A Large-Scale Medical Unlearning Benchmark Suite with Disease-Informed Analysis},
  author  = {Davoudi, Saeedeh and Iranmanesh, Reihaneh and Frieder, Ophir and Goharian, Nazli},
  journal = {arXiv preprint arXiv:2605.30599},
  year    = {2026}
}

License

Released under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) license. Non-commercial use only, with attribution and share-alike.

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Paper for dsaeedeh/AMNESIA

AMNESIA: A Large Scale Medical Unlearning Benchmark Suite with Disease-Informed Analysis

Paper • 2605.30599 • Published May 28