peer review speech rubric

Mastering Peer Evaluation with Effective Rubrics

Shreya verma.

Aug 1, 2023 • 5min read

Peer evaluation has emerged as a powerful process for fostering collaborative learning and providing valuable feedback to students. However, the process of peer evaluation can sometimes be ambiguous and subjective, leading to inconsistent outcomes. That's where rubrics come into play – these structured scoring guides bring clarity and objectivity to the peer evaluation process.

What are rubrics?

Rubrics are used to define the expectations of a particular assignment, providing clear guidelines for assessing different levels of effectiveness in meeting those expectations. 

Instructors should consider using rubrics when conducting peer evaluation for the following reasons:

• Increase Transparency and Consistency in Grading: Rubrics promote transparency by outlining success criteria and ensuring consistent grading, fostering fairness in assessments.
• Increase the Efficiency of Grading: Rubrics streamline grading with predefined criteria, enabling quicker evaluations.
• Support Formative Assessment: Rubrics are useful for formative assessment, providing ongoing feedback for student improvement and progress over time.
• Enhance the Quality of Self- and Peer-Evaluation: Rubrics empower students as active learners, fostering deeper understanding and critical thinking through self-assessment and peer evaluation.
• Encourage Students to Think Critically: Rubrics link assignments to learning outcomes , stimulating critical thinking and encouraging students to reflect on their performance's alignment with intended outcomes.
• Reduce Student Concerns about Subjectivity or Arbitrariness in Grading: Rubrics offer a clear framework for evaluation, minimizing subjectivity and ensuring that assessments are based on specific criteria rather than subjective judgment.

Components of a Rubric

A rubric comprises several essential components that collectively define the evaluation criteria for a given module. Firstly, a clear task description is needed, outlining the expectations and requirements. This description serves as the foundation upon which students' work will be assessed. The scale helps in gauging performance levels by offering various ranges such as good-bad, always-never, or beginner-expert. Moreover, the rubric breaks down the evaluation into distinct dimensions , which are specific elements of expectations that together shape the overall assessment. These dimensions can encompass various aspects like timeliness, contribution, preparation, and more. Lastly, a rubric requires a definition of the dimensions , outlining the performance levels for each dimension and providing a clear understanding of the expectations at each level.

Types of Rubrics: Holistic vs Analytic

When it comes to assessing student performance, two common types of rubrics are employed: holistic and analytic . 

Holistic rubrics use rating scales that encompass multiple criteria, emphasizing what the learner can demonstrate or accomplish. These rubrics are easier to develop and use, providing consistent and reliable evaluations. However, they do not offer specific feedback for improvement and can be challenging to score accurately. 

In contrast, analytic rubrics use rating scales to evaluate separate criteria, usually presented in a grid format. Each criterion is associated with descriptive tags or numbers that define the required level of performance. Analytic rubrics provide detailed feedback on areas of strength and weakness, and each criterion can be weighted to reflect its relative importance. While they offer more comprehensive feedback, creating analytic rubrics can be more time-consuming, and maintaining consistency in scoring may pose a challenge. 

Holistic rubrics are preferable when grading work or measuring overall progress and general performance. On the other hand, analytic rubrics are more suitable for evaluating multiple areas or criteria separately, allowing for a more detailed assessment of proficiency in each area.

Rubrics in Formative vs Summative Assessments

When deciding between using a holistic or analytic rubric, several factors come into play. One crucial consideration is the purpose of the rubric and how it aligns with the assessment goals. 

For formative assessment , where the focus is on providing ongoing feedback and supporting student learning, a holistic rubric might be more suitable. It allows educators to assess progress comprehensively, giving students an overall understanding of their performance.

In contrast, for summative assessment , where the emphasis lies on making final evaluations, an analytic rubric could be more effective. It breaks down the evaluation into distinct criteria, offering specific feedback on each area of assessment, enabling a more detailed and precise evaluation.

Examples of Rubrics in Peer Evaluation for Team-based Learning

Analytic rubrics, like Koles' and Texas Tech's methods , evaluate individual criteria separately, providing detailed feedback on various aspects of performance. Additionally, UT Austin's method, which is useful for formative assessments, focuses on ongoing feedback to support student learning and growth throughout the evaluation process. In contrast, holistic rubrics, such as Michaelsen's and Finks' methods , create an overall assessment score, capturing a comprehensive view of a student's performance. For an overview of these methods, fill out the form here to gain access to our Peer Evaluation Methods guide.

All in all, rubrics empower both educators and students to engage in meaningful and effective evaluations. The thoughtful application of rubrics ensures fair and transparent evaluations, ultimately contributing to enhanced learning outcomes.

Free Download

Peer evaluation methods guide, join our newsletter community, recommended for you, the 5 benefits of peer evaluation in team-based learning.

Peer evaluation is an integral part of

5 Reasons Why Immediate Feedback is Important for Effective Learning

Educators are always searching for teaching

PBL vs TBL: What's the Difference?

Educators are always looking for effective

3 Benefits of e-Gallery Walk for Students

InteDashboard can be used to conduct an online

Pros and Cons of The 4 Peer Evaluation Methods for Team-Based Learning

If you have been following our blog, you

What is Team-based Learning?

Team-based learning began as a way to improve

7 Benefits of Switching from IF-AT Scratch-off Cards to Digital TRAT

In 2015, after I had left as CFO of an airline

4 Benefits of Team-based Learning for Students

Hate sitting through hours of boring lectures

Testimonials

Center for Teaching Innovation

Resource library.

• Teaching students to evaluate each other

Peer assessment

Peer assessment or peer review provides a structured learning process for students to critique and provide feedback to each other on their work. It helps students develop lifelong skills in assessing and providing feedback to others, and also equips them with skills to self-assess and improve their own work. 

If you are interested in facilitating a team member evaluation process for group projects, see the page on  Teaching students to evaluate each other .

Why use peer assessment? 

Peer assessment can: 

• Empower students to take responsibility for and manage their own learning. 
• Enable students to learn to assess and give others constructive feedback to develop lifelong assessment skills. 
• Enhance students' learning through knowledge diffusion and exchange of ideas. 
• Motivate students to engage with course material more deeply. 

Considerations for using peer assessment 

• Let students know the rationale for doing peer review. Explain the expectations and benefits of engaging in a peer review process. 
• Consider having students evaluate anonymous assignments for more objective feedback. 
• Be prepared to give feedback on students’ feedback to each other. Display some examples of feedback of varying quality and discuss which kind of feedback is useful and why. 
• Give clear directions and time limits for in-class peer review sessions and set defined deadlines for out-of-class peer review assignments. 
• Listen to group feedback discussions and provide guidance and input when necessary. 
• Student familiarity and ownership of criteria tend to enhance peer assessment validity, so involve students in a discussion of the criteria used. Consider involving students in developing an assessment rubric. 

Getting started with peer assessment 

• Identify assignments or activities for which students might benefit from peer feedback. 
• Consider breaking a larger assignment into smaller pieces and incorporating peer assessment opportunities at each stage. For example, assignment outline, first draft, second draft, etc. 
• Design guidelines or   rubrics   with clearly defined tasks for the reviewer. 
• Introduce rubrics through learning exercises to ensure students have the ability to apply the rubric effectively. 
• Determine whether peer review activities will be conducted as in-class or out-of-class assignments. For out-of-class assignments, peer assessments can be facilitated through Canvas using tools such as FeedbackFruits peer review and group member evaluation , Canvas peer review assignment , or Turnitin . See the Comparison of peer evaluation tools to learn more and/or set up a consultation by contacting CTI ." 
• Help students learn to carry out peer assessment by modeling appropriate, constructive criticism and descriptive feedback through your own comments on student work and well-constructed rubrics. 
• Incorporate small feedback groups where written comments on assignments can be explained and discussed with the receiver. 

40 Peer Review

Learning Objectives

• Identify benefits to collaborative work.
• Examine cultural considerations for offering feedback.
• Use a systematic process for offering feedback.
• Use language constructive language to offer feedback.
• Use feedback to make edits to the speech outline.
• Use feedback to practice speech.

Collaborative work = Stronger Finished Product

The benefits of collaborative work are numerous. Peer review allows us to share our work and receive feedback that will help us to strengthen our final product. 

Important benefits for your speech development are:

• Learning from one another: Learning is collaborative. We can learn just as much from one another as we can from course materials. We have different experiences and interpret course concepts in different ways. Peer review allows us to share these ideas.
• Clarified goals:  When offering review and editing suggestions, we are forced to focus on the assignment goals. This focus allows us to catch things they may have otherwise missed.
• Strengthen speechwriting skills: The process provides opportunities for us to identify and articulate weaknesses in a peer’s outline. When doing this, we are learning at a deeper level and can use our own feedback to strengthen our outlines.
• Idea Clarification:   As students explain ideas to classmates, they can identify where content development may be lacking. This provides opportunities to strengthen the outline content for audience clarification.
• Minimizes Procrastination: Often students will wait until the last minute to prepare their speech outline. The peer review process forces students to prepare in enough time to work through edits and revisions which are necessary for effective speech development.
• Builds Confidence: Public speaking is a nerve-wracking event for many of us. Having others validate our work and provide suggestions for improvement helps us to build confidence that our final product is strong!

Engaging in Peer Review

The peer-review process can be an exceptional tool if you engage in it effectively. Below are tips…

• Read/Listen first: Read through the entire outline or watch the entire speech before offering comments. Once you get a good idea of the content then you can go back through it and give feedback.
• Ask questions: Clarifying questions can provide you with information about your partner’s thought process so you can give more effective feedback. Also, questions can provide your partner with an opportunity to think through how they can better explain concepts or ideas in their speech. Questions are a great learning tool.
• Use the course materials: Use the readings, assignment descriptions, and rubrics to structure your feedback. This will help you focus on useful feedback. Look for both format and content issues. Both of these will be necessary for a successful outline or speech delivery.
• Mix criticism and praise: Knowing our strengths and our weaknesses are equally important for our speech development. Offer feedback on what you think they did well and what you think they need to improve.
• Describe what you are reading or hearing and your understanding of the content (paraphrase and clarify, “this is what I am hearing…”).
• Evaluate the outline or speech based on the rubric, assignment sheet, or class material.
• Suggest steps for improvement.
• Write out your thoughts: Even if you are talking through your feedback, offering written feedback will be more helpful when your partner is revising the work.

Effective approaches to offering feedback

• Use phrases such as, “From what I understand, in this section you are…”, “It seems to me that the focus of this section is…”, “I am not sure I understand the main point here. It seems to me that…”
• Ask questions when you are uncertain about something. “What is the purpose of this section? ” or “Why is it important to your paper? ” or “How do these points connect? or “What do you mean by…?”
• Be specific about content, speech parts, format, etc. The more specific you are, the more helpful you are. “In this section, it appears…” or “This comment is…” or “I am not certain how this support connects….”
• Remember to praise strengths. “Your use of language is great” or “You have strong introduction elements.”

Techniques of Constructive Criticism

The goal of constructive criticism is to improve the behavior or the behavioral results of a person, while consciously avoiding personal attacks and blaming. This kind of criticism is carefully framed in language acceptable to the target person, often acknowledging that the critics themselves could be wrong.

Insulting and hostile language is avoided, and phrases used are like “I feel…” and “It’s my understanding that…” and so on. Constructive critics try to stand in the shoes of the person being criticized and consider what things would look like from their perspective.

Effective criticism should be:

• Positively intended, and appropriately motivated: you are not only sending back messages about how you are receiving the other’s message but about how you feel about the other person and your relationship with him/her. Keeping this in mind will help you to construct effective critiques.
• Specific: allowing the individual to know exactly what behavior is to be considered.
• Objective, so that the recipient not only gets the message but is willing to do something about it. If your criticism is objective, it is much harder to resist.
• Constructive, consciously avoiding personal attacks and blaming, insulting language, and hostile language are avoided. Avoiding evaluative language—such as “you are wrong” or “that idea was stupid”—reduces the need for the receiver to respond defensively.

As the name suggests, the consistent and central notion is that the criticism must have the aim of constructing, scaffolding, or improving a situation, a goal that is usually subverted by the use of hostile language or personal attacks.

Effective criticism can change what people think and do; thus, criticism is the birthplace of change. Effective criticism can also be liberating. It can fight ideas that keep people down with ideas that unlock new opportunities, while consciously avoiding personal attacks and blaming.

Cultural Groups Approach Criticism with Different Styles

A culture is a system of attitudes, beliefs, and behaviors that form distinctive ways of life. Different cultural groups have different ways of communicating both verbally and non-verbally. While globalization and media have moderated many of the traditional differences for younger audiences, it is wise to consider five important areas where cultural differences could play a role when giving and receiving criticism:

• Verbal style in low and high context cultures
• Instrumental versus affective message responsibility
• Collectivism and individualism in cultures
• “Face”
• Eye contact

Verbal Style in Low and High Context Cultures

In low context cultures such as in the United States and Germany, there is an expectation that people will say what is on their mind directly; they will not “beat around the bush.” In high context cultures, such as in Japan and China, people are more likely to use indirect speech, hints, and subtle suggestions to convey meaning.

Responsibility for Effectively Conveying a Message

Is the speaker responsible for conveying a message, or the audience? The  instrumental  style of speaking is sender-orientated; the burden is on the speaker to make him or herself understood. The  affective  style is receiver-orientated and places more responsibility on the listener. With this style, the listener must pay attention to verbal, nonverbal, and relationship clues in order to understand the message. Chinese, Japanese, and many Native American cultures are affective cultures, whereas the American culture is more instrumental. Think about sitting in your college classroom listening to a lecturer. If you do not understand the material, where does the responsibility lie? In the United States, students believe that it is up to the professor to communicate the material to the students. However, when posing this question to a group of Chinese students, you may encounter a different sense of responsibility. Listeners who were raised in a more affective environment respond with “no, it’s not you; it is our job to try harder.” These kinds of students accept responsibility as listeners who work to understand the speaker.

Collectivism and Individualism

Are the speaker and listeners from collectivist or individualistic cultures? When a person or culture has a collective orientation they place the needs and interests of the group above individual desires or motivations. In contrast, cultures with individualistic orientations view the self as most important. Each person is viewed as responsible for his or her own success or failure in life. When you provide feedback or criticism if you are from an individualistic culture, you may speak directly to one individual and that individual will be responsible. However, if you are speaking with someone from a culture which is more collectivist, your feedback may be viewed as shared by all the members of the same group, who may assume responsibility for the actions of each other.

Face  is usually thought of as a sense of self-worth, especially in the eyes of others. Research with Chinese university students showed that they view a loss of face as a failure to measure up to one’s sense of self-esteem or what is expected by others. In more individualistic cultures, speakers and listeners are concerned with maintaining their own face and not so much focused on that of others. However, in an intercultural situation involving collectivist cultures, the speaker should not only be concerned with maintaining his or her own face, but also that of the listeners.

Receiving Feedback

You will receive feedback from a peer to revise your speech content and delivery. Accepting any criticism at all, even effective and potentially helpful criticism, can be difficult. Ideally, effective criticism is positive, specific, objective, and constructive. There is an art to being truly effective with criticism; a critic can have good intentions but poor delivery, for example, “I don’t know why my girlfriend keeps getting mad when I tell her to stop eating so many french fries; I’m just concerned about her weight!” For criticism to be truly effective, it must have the goal of improving a situation, without using hostile language or involving personal attacks.

Receiving criticism is a listening skill that is valuable in many situations throughout life: at school, at home, and in the workplace. Since it is not always easy to do, here are three things that will help to receive effective criticism gracefully:

• Accept that you are not perfect . If you begin every task thinking that nothing will ever go wrong, you are fooling yourself. You will make mistakes. The important thing is to learn from mistakes .
• Be open-minded to the fact that others may see something that you do not . Even if you do not agree with the criticism, others may be seeing something that you are not even aware of. If they say that you are negative or overbearing, and you do not feel that you are, well, you might be and are just not able to see it. Allow for the fact that others may be right, and use that possibility to look within yourself.
• Seek clarity about aspects of a critique that you are not sure of.  If you do not understand the criticism, you are doomed to repeat the same mistakes. Take notes and ask questions.

Sometimes it is easier said than done, but receiving effective criticism offers opportunities to see things differently, improve performance, and learn from mistakes.

Key Takeaways

• Peer review strengthens our final product, offers us a deeper learning experience, and boosts our confidence in our final product.
• Using a systematic method helps us to offer helpful and useful feedback.
• Using language that communicates a desire to help can have a positive influence on the peer review process.

Cho, Kwangsu, Christian D. Schunn, and Davida Charney. “Commenting on Writing: Typology and Perceived Helpfulness of Comments from Novice Peer Reviewers and Subject Matter Experts.”  Written Communication  23.3 (2006): 260-294.

Eli Review. (2014, December 19). Describe-evaluate-suggest: Giving helpful feedback, with Bill Hart-Davidson [Video file]. Retrieved from https://www.youtube.com/watch?v=KzdBRRQhYv4

Graff, Nelson. “Approaching Authentic Peer Review.”  The English Journal  95.5 (2009): 81-89.

Nilson, Linda B. “Improving Student Peer Feedback.”  College Teaching  51.1 (2003): 34-38.

“Using Peer Review to Help Students Improve Writing.”    The Teaching Center .  Washington University in St. Louis. n.d. Web. 1 June 2014.

Public Speaking Copyright © by Dr. Layne Goodman; Amber Green, M.A.; and Various is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License , except where otherwise noted.

Share This Book

5 Questions For Creating a Peer-Review Rubric

November 20, 2018

Most instructors today use some form of a rubric to assess student writing or project-based-learning. Gone are the days of a professor writing a letter grade on the paper, and that being the only form of feedback the students receive. However, even when using a rubric, instructors may grade each rubric category in a holistic way, a result of their depth of knowledge of the topic and years of experience.

Learners, though, do not have the experience, knowledge, or ability to grade an essay or project in this kind of holistic way. For learners, the rubric needs to be a tool both for assessment and for learning. If they use a well-designed, objective peer-review rubric, learners can grade more like an experienced instructor, improve their critical analysis, and produce better finished products. In fact, research has shown that the reviewers improved the quality of their own work as a result of reviewing their peer’s work ( Wooley, et al., 2008 ).

Peer Rubric Distinctives

Unlike rubrics designed for instructor use, peer rubrics should be structured in a way to (1) assess a document, whether it be a writing assignment, video upload, presentation, podcast, or any type of project, and (2) help the reviewer learn how to think critically about the content of that document. For this reason, peer rubrics should be designed to teach students how to analyze the assignment in terms of specific, objective criteria and identify the quality of work at each level.

Using peer review often requires making changes to the rubric to transform it from an effective teacher rubric to an effective peer rubric . Using learner-friendly language, stating clear qualitative differences between rubric levels, and assessing one aspect of an assignment at a time will help your rubric become better for peer review.

Whether you are transforming an instructor rubric into a peer rubric or creating a peer rubric from scratch, here are some questions to help guide the process.

Questions to ask to Create an Effective Peer-Review Rubric

1. do the commenting prompts encourage students to give constructive criticism that brings out strengths and weaknesses in the document.

Design your commenting prompt to elicit the type of feedback that you want your students to write and receive. Encourage students to identify both strengths and weaknesses and to provide suggestions for improvement. Focus students’ attention on any specific areas on which you want them to provide feedback. Students appreciate the peer review process more when they receive useful, specific feedback that they can apply to future assignments.

For example, this commenting prompt on the content of a video presentation is designed to have the reviewer tell the presenter what they learned and what is not yet clear.

Content Commenting Prompt: What was something new that you learned or a new insight that you had as a result of this presentation? What in the presentation could have been clearer or more fully developed to enhance the content of this presentation?

2. How much reviewing can my students handle and still provide thoughtful, accurate feedback?

Reviewing several long documents with numerous commenting and rating prompts can lead to reviewer fatigue, where the reviewer starts to comment and rate carelessly. We recommend having multiple rating prompts but only one commenting prompt for each dimension (aspect or criteria being evaluated). For example, if there is a Content dimension for a peer review of a presentation, the rubric may include the following rating prompts: Depth of Content, Argument Structure, and Quality of Sources Used. If you are encouraging students to provide detailed, constructive feedback in the commenting prompt, having a small number of commenting prompts allows for thoughtful responses on all of the documents a student reviews.

3. Do my students understand all of the words and terms used in the rubric?

Make sure that the rubric only includes words that you know your students know. Remember that your students may not be familiar with technical or academic language. Spend time defining or describing the rubric terminology in class. It is easy to assume that all students will understand the language or know the difference between “competent” and “satisfactory,” but unless you have defined it in class, students’ interpretation may vary.

4. Does the rubric have clear, objective differences between each rating level?

While an instructor can quickly identify the difference between “poor” and “fair” work or “progressing” and “mastering” a skill, learners need more guidance as to what each of these levels means. For that reason, avoid using only one-word descriptors for your ratings and instead include a short description for each rating level.

In your description, use objective language that can be quantified or measured by a learner in the class. Identify what distinguishes one level from another in the assignment and use words of frequency, amount, quality, or proficiency to describe each level. Provide examples if you think there will be any confusion.

Here are some useful words in creating distinct dimension levels:

• Frequency : never, rarely, sometimes, often, always
• Amount : less than 2, 3-4, 5-6, 7+; no more than 50%, over half
• Quality : poorly, well, thoroughly; satisfactory, exemplar
• Proficiency : developing, emerging, mastery, expert
• Actions : lacks X; includes X; includes and develops X; includes, develops, and analyzes X

5. Does this rubric scaffold student learning as well as allow for accurate peer review?

It is important to meet learners where they are in their understanding of concepts in your course. Your rubrics for peer assessment should include all the information a student needs to assess that particular assignment and not assume that students have outside knowledge of that concept or skill. This may mean that you remove or rework concepts such as grammatical accuracy, depth of analysis, or ability to synthesize material from the peer review rubric until students have had greater exposure to it. Or, you may choose to focus on one quantifiable aspect of that concept (appropriate use of verb tenses, number of sources used, etc.) rather than asking students to assess that dimension in a holistic way.

Wooley, R., et al. “The effects of feedback elaboration on the giver of feedback.” 30th Annual Meeting of the Cognitive Science Society. Vol. 5. 2008.

Peer Review Rubric

• Available Topics
• Top Documents
• Recently Updated
• Internal KB

Peer Feedback Rubric

(Source: UW-Madison BioCore ) Another way you will work in groups or pairs is through peer review, an opportunity for you to give and receive peer feedback on your papers before you turn them in to be graded by your TA. Writing is a form of communication; a peer can tell you whether or not your paper makes sense. It is to your advantage to take your responsibility to review a peer’s paper seriously . We find that the review process benefits the reviewer and the author because it gives you practice evaluating a paper by applying the same criteria your TA will use to evaluate your paper.

Note that you do not need to wait for us to assign a formal review to take advantage of the peer-review process. You can always get together with other students and act as reviewers for each other’s papers, even when it is not required as part of an assignment!

Peer review is a skill that takes practice. Use the following criteria when you are learning how to peer review. To help you become a more skilled peer reviewer, we will ask you to hand in your peer review comments to be evaluated by your TA. Your TA will use these same criteria to evaluate your peer review.

Encourage Better Peer Feedback with Our Guide to Feedback Rubrics

Giving and receiving peer feedback is a powerful learning tool. It enhances student engagement and performance , but only if done correctly. Feedback needs to be specific, organized, and actionable to work. Students need the skills to fully understand, analyze, and critique their peers’ work. The problem is that students aren’t teachers, so they don’t have years of experience leaving in-depth, qualitative feedback. A simple “good job” comment doesn’t lead to deeper learning for either the reviewer or the student who submitted the work. Feedback rubrics encourage better peer feedback by guiding students through the evaluation process. They act as the training wheels that keep students on track as they review their classmate’s work. As a result, both students benefit: the reviewer engages more deeply with the work, and the reviewee gets a more constructive critique of their work. We’re so passionate about peer reviews that we’ve put together a 60-page guide to building a feedback rubric. We’re sharing some of the highlights below, and you can download our ebook for an even more in-depth look at feedback rubrics. ‍

What Is a Peer Feedback Rubric?

A peer feedback rubric is an assessment tool that students use to give their peers more comprehensive and constructive feedback on assignments. It consists of a series of open-ended questions that students answer as they review their peer’s work. Feedback rubrics overlap somewhat with grading rubrics, sometimes called matrix rubrics , but they are not the same. Matrix rubrics help you evaluate an assignment based on where an assignment falls on a continuum:

Matrix rubrics are useful for grading an assignment but they aren’t as useful for promoting individualized learning. Peer feedback rubrics might include scale questions, but they also employ open-ended questions that students must answer as they review their classmate’s assignment.

Writing their own answers requires original, critical thought, and promotes deeper learning. Because students learn both from receiving feedback and through the act of giving it. Here’s an example of a feedback rubric that incorporates different types of questions:

Rubrics are highly adaptable and can be used to facilitate feedback on almost any subject or assignment. Essay reviews are the most common, but your class could also use a rubric to peer review thesis statements before writing papers, to test code, or to review portfolios, videos or other artwork. ‍

Best Practices for Using a Peer Feedback Rubric

Many students aren’t familiar with the concept of peer feedback rubrics or even a structured peer-review process. So before you send them off with a classmate’s work and a rubric in hand, give them some background. Explain the purpose of feedback tools and the skills this exercise will help them develop . Consider including the class in the actual creation of the rubric. The more input they have, the better they will understand what top-notch work should look like. Introduce the concept of constructive criticism. Many students need to learn how to give feedback that is helpful without being hurtful. Talk to them about the goals of peer feedback, and show them examples of kind, specific, and actionable comments. Show them examples of great assignments and effective rubrics. If you have time, go through a mock assignment in class, and assess it together. Provide anonymity. Anonymity is another key part of a good peer-review process. Anonymity eases anxiety and promotes honesty. Studies show that students write better feedback when they know their identity will remain hidden. Anonymity also eliminates any personal bias that might arise from preexisting student relationships. ‍

Building Blocks of a Peer Feedback Rubric

Feedback rubrics consist of a series of questions that help students read, assess, and give feedback on their peers’ work. There is no one-size-fits-all formula for creating a rubric. Craft a series of questions that encourage students to assess the quality of the assignment and engage deeply with the content itself. These three types of questions are the building blocks of a feedback rubric:

Yes/No Questions

Yes/no questions are exactly what they sound like: a binary choice. The reviewer chooses between two options, with no other written follow-up. Yes/no questions are used to help gauge whether basic guidelines are being met. Stack a series of yes/no questions to create a checklist of elements students must fulfill to complete the assignment.

• Does the video have a beginning, a middle, and an end? Yes/No
• Did the writer correctly cite two independent research papers? Yes/No

Scale questions

Scale questions ask students to evaluate their classmate’s work by ranking it on a set scale. It’s similar to a matrix rubric, but there are no numerical values involved, just levels of mastery. Scale questions are useful for helping students understand expected learning outcomes from an assignment and for guiding them in their evaluation of the assignment’s quality. Example:

Text questions

Text questions are open-ended writing prompts that encourage reviewers to write long-form feedback about work they are reviewing.   While yes/no and scale questions help reviewers assess the quality of the assignment, text questions are essential for assessing the reviewer’s mastery over the material. Ask questions that encourage deeper analysis and complex criticism. Encourage reviewers to get specific in their answers by asking for examples, narrowing in on a specific element of the assignment, or encouraging reflection. Examples:

• What was the thesis statement of this essay? Was it persuasive, and, if not, how could it be strengthened? ‍
• How would you attempt to refute the argument presented in this essay? ‍ ‍

Prompts Should Benefit Reviewer and Reviewee

An effective peer-review experience benefits both the reviewer and the reviewee. The reviewer enhances their grasp of the course materials through thinking critically about the assignment. At the same time, the reviewee receives in-depth constructive criticism of their work. To facilitate these dual benefits, your rubric should include questions that encourage the reviewer to both engage in higher-order thinking and leave good quality feedback for the reviewee.

Prompts for higher-order thinking

Thinking analytically about the assignment helps the reviewer deepen their knowledge and understanding of the material. These questions help them write a better review, but, more importantly, they help reviewers learn during the process. Ask questions that encourage the following: Critical thinking : Require students to justify their feedback with coherent arguments.

Example: Find a section of the text where the argument could be stronger. Explain why it’s not strong enough, and propose a stronger argument. Self-reflection : Ask students to explicitly state what they have learned from the review process.

Example: What is something new you learned about this topic from reading this submission? ‍ New perspectives : Highlight different perspectives to help students think about how their peers see the world.

Example: Imagine you are a film critic. What would be your review of this film? ‍

Prompts for Effective Feedback

Effective feedback is kind, justified, specific, and constructive. Model this behavior both in class discussions around peer review and through the kind of questions you ask: Kind. Encourage reviewers to avoid stinging criticism in favor of feedback that is both encouraging and useful.

Example :   Name the aspect of your peer’s assignment that you feel is the strongest. Justified. Have reviewers explain the thinking behind their judgments.

Example: Explain your evaluation using language from the rubric. Specific and Constructive. Vague, general feedback isn’t useful. Ask questions that require the reviewer to call out specific textual examples.

Example: Find a paragraph in this essay that works well. Explain why.

Learn More About Feedback Rubrics with Our Free Guide

The success of your classroom’s peer-review process hinges on your student’s ability to give quality feedback. A well-developed peer feedback rubric will help reviewers leave responses that are more insightful, and more detailed. Once the review is complete and students have had a chance to review their feedback, give the reviewee a chance to respond to that feedback. It makes students feel heard and helps the reviewer improve their work. You may even want to create a second rubric to help students give feedback on the feedback. For more information on building great feedback rubrics, check out our free Guide to Creating Effective Feedback Rubrics . It has more tips and sample rubrics by academic subject, as well as information on converting a matrix rubric into a feedback rubric.

Join our newsletter to receive the latest updates on pedagogy and online teaching. ‍

Quick navigation

Talk to us the way you prefer, request a demo, get a quote, email sales.

Peer Review With a Rubric

Description, place in the hybrid sequence .

• Prepare for Class 
• ✔️In-Class 
• After Class 
• Listen to a presentation on a topic. 
• Revise documents in pairs to comply with [industry or discipline] principles. 
• Conduct peer review of revised document using a rubric. 
• Revise peer reviewed document based on a self-assessment and your partner’s feedback and submit to a Canvas Assignment. 

Questions from Terry Myers Zawacki, George Mason University  

Adapted from Dr. Stephanie Foster at CU Boulder  

• Students receive a faculty-provided rubric to assess a short paper.  
• Students conduct a review their own paper based on that rubric.  
• Students pair up and exchange drafts of their short paper. 
• What’s the writer’s main claim or focus?
• What two big questions do you have about the writer’s argument?
• What is the most interesting part of the draft?
• What part of the draft is clearest and/or most effective?
• What suggestions do you have for revising the unclear parts?
• Students then read, annotate, and provide answers to some questions above.  
• Students receive their paper's back after peer review and discuss their findings.  
• Students compare their self-assessment and their peer's assessment and determine changes to be made before submitting a draft to the instructor. 

Using Rubrics for Peer Review. (2021, March 18). Center for Teaching & Learning.

https://www.colorado.edu/center/teaching-learning/teaching-resources/assessment/assessing-student-learning/rubrics/using-rubrics-peer-review  

• Academic Calendar
• Accessibility
• Commencement
• Office of the President
• Student Parent Resources
• Admissions & Aid
• Student Success
• Campus Life
• Public Good
• MyCalStateLA
• Quick Links
• Faculty & Staff

Questions about FAFSA and CADAA?

Visit our Financial Aid and Scholarship Office for updated information, workshops and FAQs.

Earthquake Advisory

Campus closed until further notice

Mourtos, Nikos J

Site navigation, peer review rubric.

• Give to SJSU

Each team member will be evaluated and given a score 1 through 5 by his / her teammates in each of the seven criteria (see below) based on his / her participation and performance in the team. These scores will be averaged for each member. Individual project scores will be the average score converted into a percentage multiplied by the total number of points for the team.  For example, if the team score for this project is, 160 points, an individual with a peer review average score of 80% will receive 80 x 160 = 128 points). Team reports must include a peer evaluation form filled out by each member. Each peer evaluation form must be sealed in a separate envelope.

Peer Evaluation Form

Please write below and in the back of this form one (minimum) or more paragraphs about the work of each member of your team, including your own.  These narratives should amplify the ratings you gave in the table, by (a) identifying the strengths and weaknesses of each individual and (b) suggesting ways in which his / her work can be more effective. Also, evaluate the team as a whole.  Feel free to attach additional pages.

SJSU Links and Resources

Information for.

• Current Students
• Faculty and Staff
• Future Students
• Researchers
• Engineering
• Graduate Studies
• Health and Human Sciences
• Humanities and the Arts
• Professional Education
• Social Sciences

Quick Links

• Budget Central
• Careers and Jobs
• Emergency Food & Housing
• Faculty & Staff
• Freedom of Speech
• King Library
• Land Acknowledgement
• Parenting Students
• Parking and Maps
• Annual Security Report [pdf]
• Contact Form
• Doing Business with SJSU
• File a Complaint
• Report a Title IX Complaint

San José State University One Washington Square, San José, CA 95192

408-924-1000

• Rating Count
• Price (Ascending)
• Price (Descending)
• Most Recent

Peer review presentation rubric

Resource type.

Presentation & Partner Peer Review Rubric

Presentation Kid-Friendly Peer Review Rubric

Peer Review Rubric for Student Presentations

Presentation - Peer Review Rubric

Peer Review Presentation Grading Criteria Rubrics

Writing Rubrics (3), Homework, Groups, Behavior and Presentation : BUNDLE

Peer Review Feedback Form for Student Presentations

Presentation /Public Speaking Rubric , Reflection, and Peer Review for High School

Presentation Peer Review Sheet

Peer Review / Grading for Class Presentations (BILINGUAL)

Peer Review Packet: Presentation , Notes, & Classroom Forms

Debate Script & Presentation RUBRIC

Peer Review for Presentation Black White

Peer Review “Make It Meaningful” Bundle: Help Writers Learn from Each Other!

Teacher For A Day An End of the Year Review Activity

Conflicts of the Cold War Group Presentations

Winter Holiday Research Project ( Presentation Template) BILINGUAL

Winter Holiday Research Project - Graphic organizer and presentation planning

Book Talk Presentaton Student Rubrics and Peer Review Handouts

Experimental Design and Peer Review Mini Posters

Inquiry Lab Report Writing Instructions and Rubric

Spanish Verb Conjugation Photo-shoot Includes Assignment, Rubric and Examples

Scientific Peer Review : Slides & Activity

Writing Commentary Peer Review Rubric

• We're hiring
• Help & FAQ
• Privacy policy
• Student privacy
• Terms of service
• Tell us what you think

An official website of the United States government

Here's how you know

Official websites use .gov A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS A lock ( ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.

•   Facebook
•   Twitter
•   Linkedin
•   Digg
•   Reddit
•   Pinterest
•   Email

Latest Earthquakes |    Chat Share Social Media  

What is the FSP policy for presentation materials and posters used in poster sessions? [165]

Presentation materials and poster sessions presented once and not left for conference dissemination or posted on a public website do not require peer review; however, the Science Center Director has discretion to require peer review. Poster session/presentation materials requiring Bureau approval must be tracked and approval documented in the IPDS. [Read more]

Presentation materials and poster sessions for scientific meetings, conferences, and hearings that are presented once and not left for conference dissemination or posted on a public website do not require peer review. If these products are left for conference dissemination or are posted on a public website, whether they do or do not contain new interpretive material, the need for their peer review is at the discretion of the Science Center Director. Presenters are cautioned that it is inappropriate to display sensitive, confidential, or proprietary information in these materials and they must consult with their supervisors and other managers before presenting any materials that potentially contain such information. Additionally, all poster session/presentation materials requiring Bureau approval must be tracked and approval documented in the IPDS. Refer to a  diagram showing approval for poster session/presentation materials , as well as  SM 205.18  and  SM 502.3  for more information. Note: If the poster session/presentation materials have been disseminated (made available to the public in any way) without author permission or knowledge and without Bureau approval, then an after-the-fact approval (and peer review as appropriate) must be done to confirm the record. The timing of the process should be made clear by adding applicable comments in the IPDS. Managers or supervisors may request changes to or require removal of the poster session/presentation materials from dissemination if an after-the-fact review and approval shows that such actions are warranted. For additional guidance, refer to the  FSP training module  on the requirements for posters and presentation materials.  Policy references and other guidance on virtual presentations and poster sessions  are also available.

• Case report
• Open access
• Published: 31 July 2024

Lymphomatosis cerebri caused by adult T cell leukemia/lymphoma: a differential diagnosis for depression: a case report

• Satoshi Inaba 1 , 2 ,
• Masataka Kudo 1 , 3 ,
• Hironori Kamano 4 ,
• Yoshihiro Ohishi 5 ,
• Junichi Kiyasu 6 &
• Takashi Watari 7 , 8  

Journal of Medical Case Reports volume  18 , Article number:  348 ( 2024 ) Cite this article

2 Altmetric

Metrics details

Primary central nervous system lymphoma is rare, and primary central nervous system T cell lymphoma is relatively uncommon, contributing to < 5% of all cases. Lymphomatosis cerebri, a rare subtype of primary central nervous system lymphoma, is characterized by extensive white-matter lesions on magnetic resonance imaging and nonspecific symptoms, such as cognitive decline and depression. Reports of lymphomatosis cerebri in adult T cell leukemia/lymphoma are limited.

Case presentation

A 49-year-old Japanese man gradually developed insomnia, anorexia, and weight loss over a 2-month period following work-related promotion. Initially diagnosed with depression, his condition rapidly deteriorated with cognitive decline and motor dysfunction. Despite various treatments, his symptoms persisted within a month. Upon admission, the presence of neurological abnormalities suggestive of a central nervous system disorder raised suspicion of a cerebral lesion. Diagnostic tests revealed extensive brain lesions on imaging and the presence of atypical lymphocytes (flower cells) in the cerebrospinal fluid. The patient was diagnosed with lymphomatosis cerebri due to adult T cell leukemia/lymphoma, a rare presentation in the literature. Due to irreversible brainstem damage and poor neurological prognosis, aggressive treatment was not initiated, and the patient died, with an autopsy confirming the diagnosis.

Lymphomatosis cerebri with adult T cell leukemia/lymphoma is very rare. It is crucial to promptly consider lymphomatosis cerebri as a differential diagnosis, particularly in cases of rapid cognitive decline and poor treatment response. Recognition of lymphomatosis cerebri as an important differential diagnosis for cognitive decline, and depression is necessary for timely intervention and management. Further research is required to better understand this unique and rare presentation in adult T cell leukemia/lymphoma.

Peer Review reports

Primary central nervous system (CNS) lymphoma is a rare condition, accounting for 0.45 per 100,000 population [ 1 ]. Diffuse large B cell lymphoma accounts for most primary CNS lymphomas, whereas primary CNS T cell lymphoma is relatively uncommon, accounting for 2% of all primary CNS lymphomas [ 2 ]. Primary CNS lymphomas are generally characterized by clinical and neuroimaging findings consistent with those of single or multiple intracranial mass lesions. However, lymphomatosis cerebri (LC) is a rare subtype of primary CNS lymphoma, presenting with extensive white-matter lesions on magnetic resonance imaging (MRI) [ 3 ] and nonspecific symptoms, such as cognitive decline and depression [ 4 , 5 ]. Given the nonspecific clinical and neuroimaging characteristics, the diagnosis of LC often presents a considerable challenge, requiring careful consideration of various potential causes. CNS infections, inflammatory conditions, toxic insults, and metabolic disorders can imitate the radiological features observed in LC [ 5 , 6 ], leading to a delayed and incorrect diagnosis. The median overall survival in untreated patients was 1.97 months, while in patients receiving methotrexate-based therapies, it was 13.8 months. Particularly, given that the initiation of therapeutic measures during a favorable Karnofsky performance status is positively correlated with a favorable prognosis, early diagnosis and prompt intervention are deemed pivotal [ 4 ]. In previous LC reports, the proportion of T cell type is 8.9%, and none of them was caused by human T cell leukemia virus type 1 (HTLV-1) [ 7 , 8 , 9 , 10 ]. Herein, we present the case of LC associated with adult T cell leukemia/lymphoma, aiming to contribute toward expediting the diagnostic process in such scenarios.

A 49-year-old Japanese man with no history of physical or mental illness gradually developed symptoms of insomnia, anorexia, and weight loss approximately 1 month after being promoted at work and after an offer to be transferred at work 3 months before visiting our hospital. One month prior to his visit, he consulted an internist with complaints of poor concentration and somnolence during the day and was suspected of having depression. He was subsequently referred to a psychiatrist who prescribed duloxetine 20 mg/day. However, his spontaneity rapidly declined, and he required assistance with toileting and walking. The following week, he had difficulty talking, was judged to be comatose, and was subsequently admitted to a psychiatric hospital. At the time of admission, the patient could barely transfer himself to a wheelchair or open his eyes, and he displayed poor voluntary body movements and eye pursuit. He rapidly became bedridden. Intranasal injections of vortioxetine (a selective serotonin reuptake inhibitor) 10 mg/day, aripiprazole 3 mg/day, lorazepam 2 mg/day, and mirtazapine 15 mg/day were administered; however, the patient’s condition persisted with a Japan Coma Scale score of 200 points (equivalent to approximately six points on the Glasgow Coma Scale score [ 11 ]). He was suspected of having malignant catatonia, and despite being treated with intramuscular injections of lorazepam 2 mg/day and diazepam 20 mg/day, his symptoms did not improve. After 3 weeks of psychiatric inpatient treatment, he was referred to our hospital to exclude organic disease.

At the time of admission, the patient had a Glasgow Coma Scale score of five points (E1V1M3) and presented the following vital signs: blood pressure, 153/106 mmHg; pulse rate, 106 beats per minute; respiratory rate, 21 breaths per minute; and oxygen saturation, 94% on room air. The general physical examination findings were normal. The neurological examination revealed the pupil size to be 3/3 mm, and light and eyelash reflexes to be absent bilaterally. The ocular position was predominantly left, and leftward horizontal nystagmus was observed in both eyes. Muscle tone was strong in the extremities, and tendon reflexes were enhanced, with right predominance in the upper body and left predominance in the lower body: brachioradialis +/+ , biceps ++ / + , triceps ++/+  , patellar +/++ , Achilles +/+ , ankle clonus −/+ , Babinski, Chaddock, Hoffman, and Trömner reflexes were absent, and there was a slight escape response to pain stimuli in all extremities.

Blood tests revealed a white blood cell count of 17,420/μL, with differential percentages as follows: neutrophils 86.6%, lymphocytes 7.3%, monocytes 3.4%, eosinophils 1.2%, and basophils 0.6%. Red blood cell parameters (hemoglobin 15.2 g/dL, hematocrit 50.5%) and platelet count (297,000/μL) were within normal ranges. Biochemical and immunological tests showed a C-reactive protein level of 1.67 mg/L, with other data within normal limits. The syphilis, antinuclear antibody, copper, and vitamin B1 test results were also normal. Computed tomography (CT) of the head revealed symmetrical extensive hypoabsorption areas in the brain parenchyma. Head MRI showed marked diffusion abnormalities in the bilateral entorhinal to cerebral peduncles on diffusion-weighted imaging (DWI) (Fig.  1 a). In addition, the extensive cerebral high-intensity lesion was observed on fluid-attenuated inversion recovery (FLAIR) imaging (Fig.  1 b). A mildly elevated cerebrospinal fluid (CSF) cell count of 70/mm 3 , with a protein level of 52 mg/dL and glucose level of 56 mg/dL, was observed, suggesting encephalitis, neurosyphilis, drug-induced encephalopathy, CNS lupus, and malignant lymphoma. Electroencephalography mostly revealed generalized 1–2 Hz high-amplitude delta waves, with no apparent epileptic waves. On the third day of hospitalization, a May–Giemsa stain was performed on the peripheral blood, revealing the presence of flower cells (Fig.  2 ). Subsequently, a cytopathological examination of CSF also revealed flower cells (Fig.  3 ). Flow cytometric analysis of CSF showed a predominance of T cells. The immunophenotypic profile indicated that 82.6% of the cells were CD2 + , 76.3% were CD3 + , 73.5% were CD5 + , and 74.7% were CD7 + . The analysis also revealed the presence of both CD4 and CD8 T cells, with 42.4% and 37.2% positivity, respectively, resulting in a CD4/CD8 ratio of 1.1. These findings align with the expected T cell predominance in cases of adult T cell leukemia/lymphoma. The patient was also positive for HTLV-1 antibody; therefore, we suspected HTLV-1-related primary CNS lymphoma. The route of HTLV-1 infection remained unknown as the patient’s mother had no history of testing, there were no records of blood transfusions, and both the patient’s sexual history and history of substance abuse were inaccessible due to communication barriers. In this patient, the human immunodeficiency virus antibody test was negative. In random skin biopsies, no clustering of atypical lymphocytes within blood vessels was observed. In bone marrow aspiration and trephine biopsy, normocellular marrow was noted, with approximately 10% of small lymphocytes being CD3 + /CD20 − , although atypia was limited.

Head magnetic resonance imaging on admission day. a With diffusion-weighted imaging. b With fluid-attenuated inversion recovery imaging

Flower cells (arrow) from the patient’s peripheral blood using a 100× objective lens

Flower cells (arrow) from the patient’s cerebrospinal fluid using a 100× objective lens

The clinical diagnosis of HTLV-1-associated primary CNS lymphoma was established based on high-level positivity for HTLV-1 antibody (≥ 8192 times), positive spinal fluid cytology (flower cells), and absence of any apparent primary disease on bone marrow and skin biopsies and systemic contrast-enhanced CT [ 12 ]. After consulting with a hematologist, we decided not to perform a brain biopsy or initiate aggressive treatment, including chemotherapy, as irreversible damage to the brainstem was suspected [ 13 , 14 ], and the neurological prognosis was deemed poor. The patient received palliative management while undergoing hydration via peripheral intravenous fluids. Although his consciousness was not restored, with the intervention of a palliative care team, including grief support for the family, he remained in a peaceful state accompanied by his family. Six weeks after admission to our hospital, the patient peacefully passed away. The pathological autopsy showed diffuse infiltration of T cell atypical lymphocyte-like cells into the brain tissue (Fig.  4 a), and immunohistochemical analysis revealed that the lymphocytes were positive for CD3 (Fig.  4 b). Evaluation of other organs, including the liver, spleen, lungs, and bone marrow, revealed no histological evidence of infiltration. Based on these findings, we made a definite diagnosis of HTLV-1-related primary CNS lymphoma.

Atypical T cell lymphocyte-like cells identified entirely in the patient’s brain tissue from the pathological autopsy using a 400× objective lens. a Hematoxylin and eosin stain demonstrating diffuse infiltration of atypical lymphocyte-like cells. b Immunohistochemical staining for CD3 in brain tissue indicating positive staining in lymphocyte-like cells

Discussion and conclusions

We presented the case of a patient with relatively common LC along with depressive symptoms; however, the diagnosis was delayed due to anchoring bias and the patient’s work history before affliction. In general, primary CNS lymphoma due to adult T cell leukemia/lymphoma often presents as a mass [ 15 ]; however, LC, which is also a primary CNS lymphoma, does not present as a mass [ 4 ]. Currently, there is no established definition for diagnosing LC. However, studies have adhered to the description of gliomatosis cerebri in the criteria established by the 2007 World Health Organization classification of tumors of the CNS. These criteria include: (1) T2-weighted image/FLAIR abnormal hyperintensity present in at least three cerebral lobes or three anatomical regions of the CNS and (2) non-enhancing lesions or lesions without nodular or mass enhancement visible on initial MRI scans [ 7 , 16 ]. In addition, excluding the presence of concomitant systemic lymphoma or intravascular lymphoma is crucial. In the present case, the diagnosis of LC was confirmed using imaging and pathological findings.

Symptoms of primary CNS lymphoma associated with adult T cell leukemia/lymphoma typically commonly observed include muscle weakness, altered mental state, paresthesia, headache, and urinary incontinence [ 17 ]. In contrast, cognitive deterioration and gait disturbances, as presented in the current case, are typical symptoms of LC and are less prevalent in primary CNS lymphoma with adult T cell leukemia/lymphoma [ 4 ]. Some patients present with depression as the main symptom [ 5 ], and the present patient’s clinical course was typical for LC. Two previous case reports of LC-like appearance on MRI due to adult T cell leukemia/lymphoma were identified [ 18 , 19 ]. Table 1 presents the features of all three cases, including the present one. One case depicted the progression of lethargy, anorexia, and unsteadiness within approximately 1 month, while the other case illustrated the progression of headaches, mild dysarthria, and gait disturbances within approximately 2 months, mirroring the symptoms observed in the present case. These symptoms closely resemble those of LC [ 4 ]. Moreover, the diagnostic criteria for LC were satisfied based on the MR images [ 7 , 16 ], and it is possible that these cases were LC. The case of “Taguchi, Sonobe, Yamato, Takeuchi, Ookawa, Kodama, Ohtsuki, and Miyoshi [ 19 ]” cannot be classified as a primary CNS lymphoma correctly, as T cells were also identified in the kidney and skin. In both cases, CSF analysis revealed almost normal cell counts, and a diagnosis of adult T cell leukemia/lymphoma was established through a brain biopsy. To date, no instances have been reported where a diagnosis was made subsequent to the detection of elevated cell counts in the CSF, as observed in the present case. In cases exhibiting indications of CSF involvement, the performance of CSF cytology can aid in establishing a definitive tissue diagnosis [ 12 ]. A comparison of MRI images of these cases showed brainstem involvement only in the present case.

In the present case, the CSF analysis performed on admission to the hospital revealed the presence of flower cells, which were a pivotal determinant in the diagnosis of LC. Notably, the diagnosis of LC through CSF cytology is rare. Although the incidence of abnormal CSF results in patients with LC is substantial, with a 14.3–85.7% ratio of abnormal-to-normal results, the presence of atypical lymphocytes has only been reported in a single case [ 7 ]. However, the presence of flower cells in the peripheral blood of individuals with adult T cell leukemia/lymphoma cells involves the CNS and can also be detected in the CSF, making the detection of flower cells in the CSF highly specific and aiding in narrowing down the diagnosis [ 20 ]. In the present case, the widespread progression of the CNS lesion at the time of admission might have led to the detection of flower cells in the CSF.

The diagnosis of LC was not made until approximately 3 months after symptom onset when the patient gradually developed impaired consciousness and gait disturbance and developed confusion. The importance of investigating organic causes in rapidly progressing psychiatric symptoms and dementia is often emphasized [ 21 ]. Therefore, it must be said that there was a diagnostic delay in this case. However, even in a 2016 systematic review, the median time from onset to diagnosis of LC is 4.5 months [ 4 ]. Generally, LC may be difficult to diagnose. This period may be shortened if LC is also added to the differential disease list at the onset of depressive symptoms and rapid progression of impaired consciousness and gait.

Furthermore, confusion developed rapidly, but the treatment for catatonia with generalized muscle tension was continued, which delayed diagnosis. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, diagnostic criteria for catatonia, three or more of the following symptoms are required: stupor, waxy flexibility, catalepsy, mutism, posturing, negativism, stereotypes, mannerisms, grimacing, agitation, echopraxia, and echolalia [ 22 ]. The patient met these criteria. Additionally, patients with catatonia and acute autonomic instability often require early therapeutic intervention with benzodiazepines or other drugs due to the increased risk of complications and death [ 23 ]. Therefore, prompt therapeutic intervention was necessary as the condition rapidly deteriorated, and a poor response to the administered treatment should have prompted the consideration of alternative diagnoses. However, the patient’s history of depressive symptoms following work-related changes likely anchored the diagnosis [ 24 ], making the consideration of alternative diagnoses difficult.

The most common lesions on MRI in LC are located in the deep and periventricular white matter, with the white matter areas of the frontal, parietal, occipital, and temporal lobes being the areas affected mainly [ 7 ]. This patient presented characteristic markedly symmetrical diffusion abnormalities in the bilateral internal capsule on DWI (Fig.  1 ). A previous case report of primary CNS lymphomas by natural killer/T cells demonstrated similar DWI findings, but the underlying cause was not determined, as no pathological autopsy was performed [ 25 ]. In the present case, a pathological autopsy was performed, which only showed diffuse atypical lymphocytic infiltration and lytic necrosis throughout the brain tissue. The cause of the characteristic imaging findings confined to the internal capsule in our patient is unknown. Since approximately 6 weeks had elapsed between MRI and autopsy, the lesion might have initially progressed along the pyramidal tract.

Additionally, upon admission, the case exhibited highly distinctive vital signs, as both systolic and diastolic blood pressure levels were elevated. Previous observational studies have revealed a consistent correlation between concurrent diastolic and systolic blood pressure levels and the presence of white matter lesions [ 26 ]. While a causal relationship between these lesions and elevated blood pressure remains uncertain, it is plausible that they might underlie hypertension in this particular case, given the absence of other contributing factors.

We believe that in instances of rapid progression of depression and cognitive decline, especially when the patient presents with a poor response to pharmacotherapy, head CT or MRI should be performed to exclude the possibility of LC prior to making a diagnosis of depression, even in patients with a typical history of depression. Further, we believe that LC needs to be further recognized as an important differential diagnosis for cognitive decline and depression.

Availability of data and materials

Data for this article are available upon request. Please contact the corresponding author for inquiries.

Abbreviations

Central nervous system

• Lymphomatosis cerebri

Human T cell leukemia virus type 1

Cerebrospinal fluid

Magnetic resonance imaging

Ostrom QT, Price M, Neff C, Cioffi G, Waite KA, Kruchko C, et al . CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2015–2019. Neuro Oncol. 2022;24(Suppl 5):v1–95. https://doi.org/10.1093/neuonc/noac202 .

Article   CAS   PubMed   PubMed Central   Google Scholar  

Ferreri AJ, Blay JY, Reni M, Pasini F, Spina M, Ambrosetti A, et al . Prognostic scoring system for primary CNS lymphomas: the International Extranodal Lymphoma Study Group experience. J Clin Oncol. 2003;21:266–72. https://doi.org/10.1200/JCO.2003.09.139 .

Article   PubMed   Google Scholar  

Bakshi R, Mazziotta JC, Mischel PS, Jahan R, Seligson DB, Vinters HV. Lymphomatosis cerebri presenting as a rapidly progressive dementia: clinical, neuroimaging and pathologic findings. Dement Geriatr Cogn Disord. 1999;10:152–7. https://doi.org/10.1159/000017116 .

Article   CAS   PubMed   Google Scholar  

Izquierdo C, Velasco R, Vidal N, Sánchez JJ, Argyriou AA, Besora S, et al . Lymphomatosis cerebri: a rare form of primary central nervous system lymphoma. Analysis of 7 cases and systematic review of the literature. Neuro Oncol. 2016;18:707–15. https://doi.org/10.1093/neuonc/nov197 .

Kitai R, Hashimoto N, Yamate K, Ikawa M, Yoneda M, Nakajima T, et al . Lymphomatosis cerebri: clinical characteristics, neuroimaging, and pathological findings. Brain Tumor Pathol. 2012;29:47–53. https://doi.org/10.1007/s10014-011-0064-y .

Lewerenz J, Ding XQ, Matschke J, Schnabel C, Emami P, von Borczyskowski D, et al . Dementia and leukoencephalopathy due to lymphomatosis cerebri. BMJ Case Rep. 2009;2009:bcr0820080752. https://doi.org/10.1136/bcr.08.2008.0752 .

Article   Google Scholar  

Li L, Rong JH, Feng J. Neuroradiological features of lymphomatosis cerebri: a systematic review of the English literature with a new case report. Oncol Lett. 2018;16:1463–74. https://doi.org/10.3892/ol.2018.8839 .

Article   PubMed   PubMed Central   Google Scholar  

Wanschitz J, Hainfellner JA, Simonitsch I, Schnizer M, Deisenhammer E, Terunuma H, et al . Non-HTLV-I associated pleomorphic T-cell lymphoma of the brain mimicking post-vaccinal acute inflammatory demyelination. Neuropathol Appl Neurobiol. 1997;23:43–9.

Clark AJ, Lee K, Broaddus WC, Martin MJ, Ghatak NR, Grossman CE, et al . Primary brain T-cell lymphoma of the lymphoblastic type presenting as altered mental status. Acta Neurochir (Wien). 2010;152:163–8. https://doi.org/10.1007/s00701-009-0433-z .

Sugino T, Mikami T, Akiyama Y, Wanibuchi M, Hasegawa T, Mikuni N. Primary central nervous system anaplastic large-cell lymphoma mimicking lymphomatosis cerebri. Brain Tumor Pathol. 2013;30:61–5. https://doi.org/10.1007/s10014-012-0094-0 .

Nakajima M, Okada Y, Sonoo T, Goto T. Development and validation of a novel method for converting the Japan coma scale to Glasgow Coma Scale. J Epidemiol. 2023;33:531–5. https://doi.org/10.2188/jea.JE20220147 .

Abrey LE, Batchelor TT, Ferreri AJ, Gospodarowicz M, Pulczynski EJ, Zucca E, et al . Report of an international workshop to standardize baseline evaluation and response criteria for primary CNS lymphoma. J Clin Oncol. 2005;23:5034–43. https://doi.org/10.1200/JCO.2005.13.524 .

Benghanem S, Mazeraud A, Azabou E, Chhor V, Shinotsuka CR, Claassen J, et al . Brainstem dysfunction in critically ill patients. Crit Care. 2020;24:5. https://doi.org/10.1186/s13054-019-2718-9 .

Nolan JP, Soar J, Cariou A, Cronberg T, Moulaert VRM, Deakin CD, et al . European resuscitation council and European society of intensive care medicine guidelines for post-resuscitation care 2015: section 5 of the European resuscitation council guidelines for resuscitation 2015-section 5. Resuscitation. 2015;95:202–22. https://doi.org/10.1016/j.resuscitation.2015.07.018 .

Lotan I, Khlebtovsky A, Inbar E, Strenov J, Djaldetti R, Steiner I. Primary brain T-cell lymphoma in an HTLV-1 serologically positive male. J Neurol Sci. 2012;314:163–5. https://doi.org/10.1016/j.jns.2011.10.024 .

Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Burger PC, Jouvet A, et al . The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol. 2007;114:97–109. https://doi.org/10.1007/s00401-007-0243-4 .

Teshima T, Akashi K, Shibuya T, Taniguchi S, Okamura T, Harada M, et al . Central nervous system involvement in adult T-cell leukemia/lymphoma. Cancer. 1990;65:327–32. https://doi.org/10.1002/1097-0142(19900115)65:2%3c327::aid-cncr2820650224%3e3.0.co;2-w .

Marshall AG, Pawson R, Thom M, Schulz TF, Scaravilli F, Rudge P. HTLV-I associated primary CNS T-cell lymphoma. J Neurol Sci. 1998;158:226–31. https://doi.org/10.1016/s0022-510x(98)00111-7 .

Taguchi H, Sonobe H, Yamato K, Takeuchi T, Ookawa K, Kodama H, et al . Central nervous system involvement of adult T-cell leukemia-lymphoma with multinucleated giant cells in the brain, skin, and kidney. Cancer. 1993;71:133–7. https://doi.org/10.1002/1097-0142(19930101)71:1%3c133::aid-cncr2820710121%3e3.0.co;2-g .

Dahmoush L, Hijazi Y, Barnes E, Stetler-Stevenson M, Abati A. Adult T-cell leukemia/lymphoma: a cytopathologic, immunocytochemical, and flow cytometric study. Cancer. 2002;96:110–6. https://doi.org/10.1002/cncr.10480 .

Geschwind MD, Shu H, Haman A, Sejvar JJ, Miller BL. Rapidly progressive dementia. Ann Neurol. 2008;64:97–108. https://doi.org/10.1002/ana.21430 .

Remberk B, Szostakiewicz Ł, Kałwa A, Bogucka-Bonikowska A, Borowska A, Racicka E. What exactly is catatonia in children and adolescents. Psychiatr Pol. 2020;54:759–75. https://doi.org/10.12740/PP/113013 .

Serra-Mestres J, Jaimes-Albornoz W. Recognizing catatonia in medically hospitalized older adults: why it matters. Geriatrics (Basel). 2018;3:37. https://doi.org/10.3390/geriatrics3030037 .

Koyama A, Ohtake Y, Yasuda K, Sakai K, Sakamoto R, Matsuoka H, et al . Avoiding diagnostic errors in psychosomatic medicine: a case series study. Biopsychosoc Med. 2018;12:4. https://doi.org/10.1186/s13030-018-0122-3 .

Takeuchi Y, Kaga T, Ieda M, Kojima Y, Ochiai J, Mabuchi C. Symmetrical lesions of the cerebral peduncles and internal capsules on MRI in a patient with extranodal NK/T cell lymphoma. Rinsho Shinkeigaku. 2017;57:778–81. https://doi.org/10.5692/clinicalneurol.cn-001076 .

Veldink JH, Scheltens P, Jonker C, Launer LJ. Progression of cerebral white matter hyperintensities on MRI is related to diastolic blood pressure. Neurology. 1998;51:319–20. https://doi.org/10.1212/wnl.51.1.319 .

Download references

Acknowledgements

We express our sincere gratitude to Doctor Masashi Ono from the Department of General Internal Medicine, Iizuka Hospital, Fukuoka, Japan, for caring for the patient. We also thank Doctor Koichi Ohshima from the Department of Pathology, Kurume University, Fukuoka, Japan, for the pathological diagnosis. Finally, we are also grateful to the Department of Pathology, Iizuka Hospital, for taking pictures of tissues and cells.

No financial support and/or financial incentive was received in the production of this manuscript.

Author information

Authors and affiliations.

Department of General Internal Medicine, Iizuka Hospital, 3-83 Yoshino-Machi, Iizuka, Fukuoka, 820-8505, Japan

Satoshi Inaba & Masataka Kudo

Department of General Internal Medicine, Fukuchiyama City Hospital, Kyoto, Japan

Satoshi Inaba

Department of Clinical Epidemiology, Kochi Medical School, Nankoku, Japan

Masataka Kudo

Department of Radiology, Iizuka Hospital, Fukuoka, Japan

Hironori Kamano

Department of Diagnostic Pathology, Iizuka Hospital, Fukuoka, Japan

Yoshihiro Ohishi

Department of Hematology, Iizuka Hospital, Fukuoka, Japan

Junichi Kiyasu

General Medicine Center, Shimane University Hospital, Shimane, Japan

Takashi Watari

Department of Medicine, University of Michigan Medical School, Ann Arbor, MI, USA

You can also search for this author in PubMed   Google Scholar

Contributions

SI: drafting the manuscript. MK: reviewing and editing the manuscript. HK: analysis and interpretation of data. YO: acquisition and analysis of data. JK: analysis and interpretation of data. TW: supervision.

Corresponding author

Correspondence to Masataka Kudo .

Ethics declarations

Ethics approval and consent to participate.

The institution does not require ethical approval for the publication of a single case report.

Consent for publication

Written informed consent was obtained from the patient’s next-of-kin for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.

Competing interests

The authors declare that there has been no conflict of interest in the development or publication of this manuscript.

Additional information

Publisher’s note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ . The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article.

Inaba, S., Kudo, M., Kamano, H. et al. Lymphomatosis cerebri caused by adult T cell leukemia/lymphoma: a differential diagnosis for depression: a case report. J Med Case Reports 18 , 348 (2024). https://doi.org/10.1186/s13256-024-04666-1

Download citation

Received : 06 March 2024

Accepted : 27 June 2024

Published : 31 July 2024

DOI : https://doi.org/10.1186/s13256-024-04666-1

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Adult T cell leukemia/lymphoma
• Central nervous system neoplasms
• Nervous system diseases

Journal of Medical Case Reports

ISSN: 1752-1947

• Submission enquiries: Access here and click Contact Us
• General enquiries: [email protected]