  Automatic karyotype analysis is often defined as a visual perception task
focused solely on chromosomal object-level modeling. This definition has led
most existing methods to overlook componential and holistic information,
significantly constraining model performance. Moreover, the lack of
interpretability in current technologies hinders clinical adoption. In this
paper, we introduce Tokensome, a novel vision-language model based on
chromosome tokenization for explainable and cognitive karyotyping. Tokensome
elevates the method from the conventional visual perception layer to the
cognitive decision-making layer. This elevation enables the integration of
domain knowledge and cognitive reasoning via knowledge graphs and LLMs,
markedly enhancing model's explainability and facilitating abnormality
detection.
