MyMedR

A foetus in the abdomen of a boy

Lal M

Med J Malaya, 1971 Jun;25(4):307-10.

PMID: 4261309

Matched MeSH terms: Diagnosis, Differential

Torsion of the testes: a review of 24 cases

Juat WT, Hin OT, Somasundaram K

Med J Malaysia, 1977 Dec;32(2):168-71.

PMID: 614487

Matched MeSH terms: Diagnosis, Differential

Fulltext Lymphoma presenting as gynaecomastia

Mahmood S, Sabih Z, Sabih D

Biomed Imaging Interv J, 2011 Apr;7(2):e10.

PMID: 22287984 DOI: 10.2349/biij.7.2.e10

Breast lymphoma is an uncommon neoplasm affecting the breast and is extremely rare in males. While gynaecomastia is common and in most cases benign, it can sometimes result from significant pathology and the physician should keep in mind the possible diseases that can lead to gynaecomastia. This paper reports a case of lymphoma presenting as unilateral gynaecomastia. The paper discusses the differential diagnosis and emphasises the points that should raise the suspicion of pathology.Mammography, high resolution ultrasound and biopsy findings are discussed and literature survey is presented.

Matched MeSH terms: Diagnosis, Differential

Primary follicular lymphoma of the pancreas: A rare tumour mimicking pancreatic carcinoma

Sallapan S, Abu Bakar NZ, Jarmin R, Masir N, Mohammed F

Malays J Pathol, 2018 Dec;40(3):359-371.

PMID: 30580370

INTRODUCTION: Primary pancreatic lymphomas are extremely rare. Clinically, primary pancreatic lymphoma mimics symptoms of carcinoma of the pancreatic head. Clinical and radiological features may overlap with other pancreatic conditions such as carcinoma, neuroendocrine tumours and autoimmune pancreatitis.

CASE REPORT: We report a case of a 75-year-old man who presented with symptoms of obstructive jaundice. Ultrasonography and computed tomography (CT) showed an ill-defined lobulated soft tissue lesion at the head/uncinate process of the pancreas measuring 4.5 x 4.9 x 5.8 cm. The patient underwent pancreaticoduodenectomy for suspected pancreatic head/uncinate process carcinoma. Histopathology and immunohistochemical assessment of the pancreatic lesion established the diagnosis of a low-grade follicular lymphoma.

DISCUSSION: Clinical and imaging features of primary pancreatic lymphoma may often overlap with pancreatic carcinoma. There is a value of obtaining preoperative tissue diagnosis such as tissue biopsy and fine needle aspiration (FNA) cytology with or without flow cytometry to make an accurate diagnosis of non-Hodgkin lymphoma and alleviate the need of more radical surgery in pancreatic lymphoma.

Matched MeSH terms: Diagnosis, Differential

Ulcerated bleeding palisaded encapsulated neuroma of the tongue

Dhanuka S, Rodrigues G, Carnello S

Malays J Pathol, 2019 Aug;41(2):229-232.

PMID: 31427561

INTRODUCTION: Palisaded encapsulated neuroma (PEN) is a benign lesion of Schwann cells and its occurrence in the oral mucosa especially the tongue is very rare.

CASE REPORT: This article describes a case of a 41-year-old male, a chronic smoker with an actively bleeding, ulcerated, solitary, firm lesion on the lateral border of the tongue which had bled thrice before. A differential diagnosis of pyogenic granuloma, haemangioma, fibroma, nerve sheath tumour, salivary gland tumour and malignancy was made and surgically excised. Histopathology of the excised specimen revealed a well-circumscribed lesion with spindle-shaped cells arranged in interlacing fascicles and with the help of immunohistochemical markers confirmed it to be a PEN.

DISCUSSION: To our knowledge, this is the first description of an ulcerated PEN presented with an active bleed.

Matched MeSH terms: Diagnosis, Differential

Swelling on the Upper Lip: A Diagnostic Challenge

Tegginamani AS, Hs V, Wanjari SG, Dubey G

J Coll Physicians Surg Pak, 2019 Aug;29(8):796.

PMID: 31358112 DOI: 10.29271/jcpsp.2019.08.796

Matched MeSH terms: Diagnosis, Differential

Discussion of leprosy

Journal of the Malaya Branch of the British Medical Association, 1941;5:110-2.

Matched MeSH terms: Diagnosis, Differential

Biliary cystadenoma: A rare occurrence

Peh KH, Eugene Chan BT

Med J Malaysia, 2020 05;75(3):307-308.

PMID: 32467552

Biliary cystadenoma is a rare benign tumour with the potential to transform into malignant carcinoma of the biliary ductal system. There is difficulty in differentiating a benign one from a malignant biliary cystadenoma, and therefore these lesions should always be completely resected. We report a case of biliary cystadenoma which underwent a complete resection.

Matched MeSH terms: Diagnosis, Differential

A case of atypical imaging of Nasopharyngeal Carcinoma in an adolescent: A diagnostic challenge

Teo SW, Noorafidah MD, Laili SAL

Med J Malaysia, 2020 03;75(2):175-177.

PMID: 32281604

Nasopharyngeal mass in paediatric population is usually benign and malignant nasopharyngeal tumours such as carcinoma is rare. We report a case of nasopharyngeal carcinoma (NPC) in an adolescent with atypical imaging findings that mimicked a benign mass. This highlights the importance of a comprehensive review on the distinctive radiographic features of paediatric nasopharyngeal mass. We discuss the imaging features of NPC in the paediatric group, which differ from the elderly patients. By recognising these distinctive imaging features, it may help in diagnosing typical case. This case report serves as a reminder that NPC, despite being uncommon, should be considered in the differential diagnosis of a juvenile nasopharyngeal mass.

Matched MeSH terms: Diagnosis, Differential

Imaging bicipitoradial bursitis: a pictorial essay

Yap SH, Griffith JF, Lee RKL

Skeletal Radiol, 2019 Jan;48(1):5-10.

PMID: 29797016 DOI: 10.1007/s00256-018-2970-0

Although bicipitoradial bursitis is not commonly seen, when it does occur, it can frequently lead to diagnostic difficulty, mimicking either a soft-tissue tumor or infection. Lack of awareness of this uncommon entity can lead to unnecessary anxiety or tissue biopsy. This pictorial essay discusses the normal anatomy of the bicipitoradial bursa and the spectrum of imaging findings of bicipital bursitis.

Matched MeSH terms: Diagnosis, Differential

Nummular Eczema: An Updated Review

Leung AKC, Lam JM, Leong KF, Leung AAM, Wong AHC, Hon KL

Recent Pat Inflamm Allergy Drug Discov, 2020;14(2):146-155.

PMID: 32778043 DOI: 10.2174/1872213X14666200810152246

BACKGROUND: Nummular eczema may mimic diseases that present with annular configuration and the differential diagnosis is broad.

OBJECTIVE: This article aimed to provide an update on the evaluation, diagnosis, and treatment of nummular eczema.

METHODS: A PubMed search was performed in using the key terms "nummular eczema", "discoid eczema", OR "nummular dermatitis". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews. The search was restricted to English literature. The information retrieved from the above search was used in the compilation of the present article. Patents were searched using the key terms "nummular eczema", "discoid eczema", OR "nummular dermatitis" in www.google.com/patents and www.freepatentsonline.com.

RESULTS: Nummular eczema is characterized by sharply defined, oval or coin-shaped, erythematous, eczematous plaques. Typically, the size of the lesion varies from 1 to 10cm in diameter. The lesions are usually multiple and symmetrically distributed. Sites of predilection include the lower limbs followed by the upper limbs. The lesions are usually intensely pruritic. The diagnosis is mainly clinical based on the characteristic round to oval erythematous plaques in a patient with diffusely dry skin. Nummular eczema should be distinguished from other annular lesions. Dermoscopy can reveal additional features that can be valuable for correct diagnosis. Biopsy or laboratory tests are generally not necessary. However, a potassium hydroxide wet-mount examination of skin scrapings should be performed if tinea corporis is suspected. Because contact allergy is common with nummular eczema, patch testing should be considered in patients with chronic, recalcitrant nummular eczema. Avoidance of precipitating factors, optimal skin care, and high or ultra-high potency topical corticosteroids are the mainstay of therapy. Recent patents related to the management of nummular eczema are also discussed.

CONCLUSION: With proper treatment, nummular eczema can be cleared over a few weeks, although the course can be chronic and characterized by relapses and remissions. Moisturizing of the skin and avoidance of identifiable exacerbating factors, such as hot water baths and harsh soaps may reduce the frequency of recurrence. Diseases that present with annular lesions may mimic nummular eczema and the differential diagnosis is broad. As such, physicians must be familiar with this condition so that an accurate diagnosis can be made, and appropriate treatment initiated.

Matched MeSH terms: Diagnosis, Differential

Poliomyelitis in Malaysia - a case of underdiagnosis?

Hussain Imam Muhammad Ismail

Malaysian Journal of Child Health, 1992;4(1):23-26.

MyJurnal

The last confirmed case of poliomyelitis in West Malaysia was in 1986', and over the past few years, we have condescendingly associated polio with other developing countries. Recently, 2 children with acute flaccid paralysis (AFP) were confirmed as cases of poliomyelitis due to a wild strain of the virus. This implies a failure of the immunisation programme to contain the spread of the wild virus (Hall). However, if we look at the WHO standard case definition of polio virus infection (appendix 1) it is possible that we could have missed a few cases over the last 6 years. At this juncture a brief clinical summary of the 2 cases and a discussion of the differential diagnosis may be useful. (Copied from article).

Matched MeSH terms: Diagnosis, Differential

Fulltext Isolated unilateral sixth cranial nerve palsy: A rare presentation of dengue fever

Mazliha M, Boo YL, Chin PW

Malays Fam Physician, 2016;11(1):25-26.

PMID: 28461846 MyJurnal

Dengue fever is a common mosquito-borne viral infection endemic in tropical and subtropical countries. Neurological manifestations in dengue infection are relatively uncommon, and include encephalitis, encephalopathy, neuromuscular disorders and neuro-ocular disorders. Cranial mononeuropathy is a rare manifestation of dengue infection. A 40-year-old man was diagnosed with isolated, unilateral sixth cranial nerve palsy complicating dengue infection. The patient was managed accordingly, and full ocular recovery was observed. This was the first reported case of isolated sixth cranial nerve palsy associated with dengue fever in Malaysia. It is important for clinicians to consider dengue as a differential diagnosis in patients presenting with fever and sixth cranial nerve palsy.

Matched MeSH terms: Diagnosis, Differential

Fulltext Oncocytic schneiderian papilloma: a rare sinonasal papilloma removed via endoscopic medial maxillectomy

Faizah, A.R., Mazita, A., Marina, M.B., Jeevanan, J., Isa, M.R.

Medicine & Health, 2010;5(1):55-59.

MyJurnal

There are three types of papilloma which arises from the Schneiderian membrane namely inverted, fungiform and oncocytic. Oncocytic papilloma is the rarest type and occurs predominantly in the older age group. Clinically, its behaviour is similar to inverted papilloma in having both local recurrence and associated malignancy. We report a rare case of oncocytic papilloma arising from the maxillary sinus, extending into the nasal cavity and nasopharynx, in a 78-year-old lady. Despite the longstanding history there was no evidence of associated malignancy in this lesion. An endoscopic medial maxillectomy was successfully utilized for approach and complete tumour excision. In conclusion, oncocytic papilloma should be considered as a differential diagnosis in patients presenting with unilateral polypoid nasal lesions especially in the elderly. In addition, endoscopic medial maxillectomy can provide an adequate approach for complete tumour removal.

Matched MeSH terms: Diagnosis, Differential

Fulltext Appraisal of weekly conducted clinical pathologic case conference (CPC)

Hassan S

Education in Medicine Journal, 2011;3(2):15-23.

MyJurnal

Background: The weekly held clinical pathologic case conference popularly known as CPC provides an effective and regular educational media of collaborative learning for inter-disciplinary exchange of knowledge among the faculty members of an institution. CPC has been routinely practiced for the last two decades in School of medical Sciences (SMS) at Universiti Sains Malaysia (USM). An hour session primarily involves a case presentation hiding the diagnosis followed by discussion on differential diagnosis and floor interaction on interesting clinical cases. It also gives an opportunity to new teaching staff in the institution to experience an in-house practice of presenting the clinical cases; witch can readily be reproduced as a case report for publication. An effort to follow the original format of CPC is comprehended as an essential outcome of this study to keep up the sanctity of CPC as a case method of learning medicine in future. Methodology: A questionnaire-based survey was recently conducted to evaluate the weekly held CPC in SMS. It was a cross sectional survey in which a questionnaire comprising of 23 items was administered to a targeted population of faculty members of School of Medical Sciences. The items in questionnaire were grouped into 5 clusters. All respondents were adequately briefed through a letter addressing the objectives and importance of survey and its appraisal aiming to revamp the CPC guided by the out-come of study. Questionnaires were administered to 240 academic staff, covering > 80% of the target population of 294 faculty members. 159 (66.2%) members of sample population completed the questionnaires. Total non-responses were 81 (33.7%) and item non-responses were 320 (8.7%) Result: All the items in questionnaire were found significant (p 0.016) except those two items related to, observing a difference in preparing for a case presentation verses a formal CPC presentation and its promotion (p 0.556 and 0.197 respectively). It was also established that the major respondents were unaware of the original format of CPC (p 0.003) in which a presenter select and prepares a case, which is discussed with participating faculty members for its differential diagnoses. 51.6% faculty members did not follow the formal CPC format (p 0.016) in their presentations. A lack of awareness about the format of CPC was shown by (61.0%) faculty members (p 0.003). Conclusion : It was concluded that emphasis to discuss the differential diagnosis by a competent discussant was lacking, as presenters did not follow the formal CPC format. It was critically observed that a number of presentations made in this weekly program deviate from the original format adapted by SMS in USM. However, the out-come appraisal of this survey was the pledge shown by the majority faculty members to adapt the guidelines as a reverence to the formal CPC format.

Matched MeSH terms: Diagnosis, Differential

Fulltext Granular cells in a benign parotid gland tumour: an attempt to understand its probable histogenesis

George, T., Zain, R.B., Abraham, M.T.

Ann Dent, 2011;18(1):30-35.

MyJurnal

Tumours that occur in the oral cavity may contain granular cells as a component of their pathology. A more common granular cell lesion occurring in the head and neck region is the granular cell tumour (GCT) that usually arises in the tongue or the buccal mucosa. Granular cell tumours are very rare in the parotid gland with only 11 cases previously reported in the English literature. We report a case of a benign tumour involving the parotid gland of a young female patient. The case was diagnostically challenging due to the large proportion of granular cells masking the underlying pathology. Histopathological features and immunohistochemical analysis favoured a diagnosis of a benign GCT. The present report provides an insight into the differential diagnosis and attempts to characterise the granular cells with the use of the wellestablished immunohistochemical markers and conventional histopathological techniques.

Matched MeSH terms: Diagnosis, Differential

Fulltext Comorbid charles bonnet syndrome in tourette disorder: a case report

Renganathan, A. Kanni, Maniam, T.

ASEAN Journal of Psychiatry, 2009;10(2):194-198.

MyJurnal

Objective: This is a case report discussing about the Charles Bonnet Syndrome (CBS). CBS is a condition in which extremely vivid and well-formed visual hallucinations occur episodically with great profusion. They are typically experienced in clear consciousness, and
the insight is either retained or very quickly attained into the unreal nature of the phenomena. Method: We report a case of a 70 year-old Malaysian male who has been suffering from Tourette disorder for the past 40 years and was blind bilaterally. Results: He presented with episodic, nocturnal visual hallucinations. These occurred in clear
consciousness and the patient’s insight to these experiences was retained. There was no history of any other major psychiatric illness in this patient. Conclusion: This case illustrates a diagnosis of CBS with the differential diagnoses of epilepsy and other organic conditions.

Matched MeSH terms: Diagnosis, Differential

Fulltext Sublingual epidermoid cyst resembling sublingual ranula: a case report

Nee, Tan Shi, Roszalina Ramli, Athar, Primuharsa Putra Sabir Husin

Archives of Orofacial Sciences, 2015;10(1):46-51.

MyJurnal

Dermoid cysts are anatomic embryonic abnormalities that are rarely seen in the oral cavity. Histologically, they are further classified as epidermoid, dermoid or teratoid. We report a case in which an 18- year-old girl who developed an epidermoid cyst presenting as a large sublingual swelling occupying the entire floor of the mouth causing snoring and speech difficulty. We emphasized on the clinical steps in achieving an accurate diagnosis, possible differential diagnosis, necessary imaging techniques and management of epidermoid cyst.

Matched MeSH terms: Diagnosis, Differential

Rubber cast of stomach produced by latex ingestion

Yusof Said M, Goh Tin Kay

Med J Malaysia, 1973 Sep;28(1):52-4.

PMID: 4273787

Matched MeSH terms: Diagnosis, Differential

Fulltext Pilomatrixoma: a diagnostic pitfall on fine-needle aspiration cytology of benign ‘Neck Metastases’

Asha’ari ZA, Shiyuti MI, Abdullah K, Selimin A, Sathananthar KS

International Medical Journal Malaysia, 2014;13(2):63-66.

MyJurnal

Pilomatrixoma is a benign tumour that originates from the matrix of the hair root. This rare tumour is usually managed by the dermatologists. The commonest location of this tumour is in the head and neck region; hence, it can be encountered by any doctors with interest in this area. When presented in the neck, this hard tumour may pose a diagnostic challenge. A case report of pilomatrixoma misdiagnosed as a metastatic neck disease from fine-needle aspiration cytology is presented. The mistake in the diagnosis has led to a more aggressive and high morbidity surgery than necessary. It is important that head and neck doctors be aware of this condition and includes it in the differential diagnosis of hard masses presenting in the neck.

Matched MeSH terms: Diagnosis, Differential

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