Displaying publications 141 - 160 of 675 in total

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  1. Fulltext Metastatic Adenocarcinoma of the Lung Mimicking Spinal Tuberculosis
    Zamzuri, Z., Adham, S.Y., Shukrimi, A., Azril, M.A., Amran, R.
    International Medical Journal Malaysia, 2011;10(2):33-35.
    MyJurnal
    Clinically, it is sometimes diffi cult to distinguish an infection of the spine from a metastasis. Spinal tuberculosis is common according to its endemic region and adenocarcinoma of the lung is also rising in the incidence worldwide. Similar presentations, with unknown primary, clinical fi ndings and hematological investigations rarely conclude a true diagnosis. Radiologically, the hallmark of spinal infection is erosion of adjacent vertebral endplates and narrowing of the disc space with or without a paravertebral shadow. Metastasis typically does not involve the disc space with erosion of the adjacent vertebral endplates. It usually presents as a lytic/sclerotic lesion in the vertebral body or “winkle owl” sign. These distinguishing features of infection versus metastasis are not certainties. Biopsy is mandatory whenever in doubt or patient is not responded with provisional treatment. The author presents a case with so-called radiological features of spinal tuberculosis infection, which turns out to be a metastatic adenocarcinoma of the lung.
    Matched MeSH terms: Biopsy
  2. Fulltext Primary angiitis of the central nervous system with myelopathy as initial clinical presentation
    Cheng, Yin Tan, Lingam, Ganeshwara, Suhailah Abdullah, Ai, Huey Tan, Tai, Sharon Mei-Ling, Norlisah Ramli, et al.
    Neurology Asia, 2015;20(1):79-84.
    MyJurnal
    Primary angiitis of the central nervous system (PACNS) is a rare vasculitis restricted to the central nervous system without systemic involvement. Delay in diagnosis and treatment is common due to its non-specific symptoms and lack of non-invasive diagnostic tests. Myelopathy can occur in PACNS, during the clinical course of the illness, with or without cerebral symptoms. We describe here a 51 year-old ethnic Chinese woman who presented initially with paraparesis without cerebral symptoms. The diagnosis of PACNS was eventually made from brain biopsy when she subsequently developed cerebral involvement. Despite aggressive treatment, the patient developed progressive neurological deterioration and died. This patient demonstrates the rare occurrence of myelopathy as the sole initial presentation of PACNS.
    Matched MeSH terms: Biopsy
  3. Fulltext Comparison of immunohistochemical markers in core needle biopsy and excisional biopsy in breast carcinoma
    Alfatih, P., Munirah, M.I., Ainaen, M., Wenda, L., Sharifa Ezzat, W.P., Reena Rahayu, M.Z.
    Medicine & Health, 2015;10(1):10-16.
    MyJurnal
    Estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) immunohistochemistry are important markers in the management of patient with breast carcinoma. In this study, we determine the concordance rate of ER, PR and HER2 immunohistochemistry markers between core needle biopsy (CNB) and excisional biopsy (EB) of breast carcinoma in patients of Universiti Kebangsaan Malaysia Medical Centre (UKMMC) from January 2002 until December 2012. A total of 93 female patients with CNB and subsequent EB were included in this retrospective descriptive study. Immunohistochemistry is used to determine ER, PR and HER2. ER and PR was graded using Allred score (0 to 8) while HER2 was scored from 0 to 3+. The markers between these two biopsies were compared to determine the concordance rate. In ER and PR, 93 samples were compared. ER was concordant in 80 cases (86.0%) and 13 cases (14.0%) was discordant. PR was concordant in 82 cases (88.2%) and discordant in 11 cases (11.8%). In HER2, 87 samples were compared and 62 cases (71.3%) were concordant while 25 cases (28.7%) were discordant. Concordance between CNB and EB was high for ER and PR. However, concordance rate for HER2 immunohistochemistry was less consistent. Overall, immunohistochemical analyses of CNB reflect the tumour marker status of the excised specimen.
    Keywords: breast carcinoma, core needle biopsy, estrogen receptor, progesterone receptor, HER2
    Matched MeSH terms: Biopsy
  4. Fulltext Debulking biopsy of a huge intraoral mass avoiding tracheostomy
    Roselinda Abdul Rahman, Irfan Mohamad, Rohaizam Jaafar
    Archives of Orofacial Sciences, 2015;10(2):65-68.
    MyJurnal
    Managing a patient with a huge intraoral mass is always challenging. Manipulation or even a simple biopsy of the mass may lead to hemorrhage and further compromise the airway. An examination under anesthesia is not without risk. The method of securing the airway itself may become an issue if the mass is fully occupying the airway before intubation. Usually a tracheostomy is indicated. We share a gentleman presented with a huge intraoral mass occupying the oropharynx, which initially necessitates tracheostomy. We utilized the ultrasonic scalpel-assisted instrument to biopsy by debulking the tumour, thus avoiding the tracheostomy while waiting for the definitive treatment.
    Matched MeSH terms: Biopsy
  5. Fulltext The oral mucosa and Langerhans cells in smokers: Evidence for carcinogenesis
    Khoo SP, Lee, K.W.
    Ann Dent, 1995;2(1):-.
    MyJurnal
    A study was carried out to investigate whether smoking had any effect on the Langerhans cells in the oral mucosa, which might throw light onto the mechanism of malignant transformation of some keratotic lesions in the oral cavity. Thirty-two cases of keratotic lesions from biopsy specimens of smokers and non-smokers were studied. Langerhans cells were identified by immuno cytochemical staining for 5100 proteins and their densities quantified. Smokers were associated with a significant reduction in the Langerhans cell population compared to non-smokers. The mean values of Langellans cell density in light smokers and heavy smokers were 2 2 2 28.64/mm and 33.421mm respectively compared to 66.51/mm in non- smokers. There was a dose-response relation between the number of cigarettes smoked daily and the effect on cell counts. These findings of a local immunological effect of smoking on oral epithelium may explain the means by which cigarette smoking contributes to the development of oral cancer.
    Matched MeSH terms: Biopsy
  6. 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: Biopsy, Fine-Needle
  7. Intradermal Naevi of External Auditory Canal: Unusual location with a unique presentation
    Yatiee SL, Mohd Khairi MD, Md Salzihan MS, Ikmal HB
    Med J Malaysia, 2018 04;73(2):121-122.
    PMID: 29703880 MyJurnal
    The incidence of intradermal nevus in the external auditory canal is uncommon. We herein are describing a case of 60-year-old lady who presented with foreign body sensation in the right external ear canal (EAC) with mild discomfort and ear bleed during ear picking. Otoscopic examination revealed hyperpigmented mass on the floor of the outer two third of EAC. Complete excisional biopsy of the mass resulted in histopathology findings of intradermal nevus. Despite the fact that the disease is not alarming, the possibilities of benign melanocytic nevi transformation into malignant lesions such as melanoma need to be ruled out.
    Matched MeSH terms: Biopsy
  8. Fulltext Accuracy of fine needle aspiration cytology in solitary or dominant nodular goitre: a single centre study
    Rohaizak, M., Aman Fuad, Y., Naqiyah, I., Saladina, J.J., Shahrun Niza, A.S.
    International Medical Journal Malaysia, 2017;16(2):85-88.
    MyJurnal
    Background: Thyroid swelling or goitre is a common condition, either asymptomatic or symptomatic. The
    diagnosis is usually established by ultrasound or fine needle aspiration cytology (FNAC) as a gold standard.
    The sensitivity of the test is inversely related to increasing size of the nodule. The objective of this study is
    to evaluate the accuracy of FNAC especially in cases of large goitre.

    Material and methods: This is a
    retrospective study on patients who underwent thyroidectomy between January 2000 to December 2007 for
    solitary or dominant nodular goitre. The analysis was made only on those patients with complete data on
    FNAC and histology.

    Result: There were 235 patients, but only 161 patients were analysed after excluding
    the suspicious and inadequate sample. The patients’ mean age was 42.1 year old (21 to 60). The size of the
    thyroid nodule ranged from 2.1 to 5.0 cm (mean = 3.9 cm). The overall sensitivity was 67.4% and the overall
    accuracy was 86.3%. The accuracy of FNAC according to the sizes above and below the value were as
    follows; 2 cm (72.2% vs. 88.1%); 3 cm (88.0% vs. 87.4%) ; 4 cm (86.6% vs. 84.4%) ; 5 cm (87.3% vs. 78.8%).
    This was most obvious in the sensitivity of the FNA which also showed reducing trend as the nodules
    increased in size.

    Conclusion: FNAC is an essential diagnostic tool in the management of nodular goitre.
    Our study showed that the accuracy of FNAC decreased as the size of the nodule getting bigger. Cautious
    approach should be taken in the management of large goitre and decision should not be based only on the
    result of FNAC.
    Matched MeSH terms: Biopsy, Fine-Needle
  9. Fulltext Perianal Mucinous Adenocarcinoma Diagnosed by Histological Study of Anorectal Abscess with Fistula
    Jee SL, Amin-Tai H, Fathi NQ, Jabar MF
    ACG Case Rep J, 2018;5:e21.
    PMID: 29577055 DOI: 10.14309/crj.2018.21
    Perianal mucinous adenocarcinoma (PMA) is an oncologic rarity that poses a diagnostic and therapeutic dilemma for treating clinicians because there are few reported cases and an absence of definitive guidelines. We report a patient who had been treated with local surgery for recurrent perianal abscess with fistula for 3 years. Biopsy of the indurated tissue overlying his surgical scars revealed PMA. Neoadjuvant concurrent chemoradiotherapy followed by abdominoperineal resection was planned to address the locally advanced disease and ongoing sepsis. Our case is unique in that the fistula preceded carcinoma by only 3 years instead of the typical 10 years.
    Matched MeSH terms: Biopsy
  10. Fulltext Clinical and histopathological relevance of helicobacter pylori BabA2 genotype
    Tariq Elhashim, M. Imad Mustafa Mahmud, Nasser Amjad, Norra Harun, Imad M. Alani
    International Medical Journal Malaysia, 2016;15(2):43-49.
    MyJurnal
    Introduction: H. pylori BabA is an outer membrane protein that mediates bacterial adherence to the gastric
    epithelium, triggers several pathways during the course of infection, and thus contributes to the disease
    development. Considering the variability in the presence of BabA coding gene (babA2) among H. pylori
    clinical strains, the aim of this study was to assess the relationship between the genotype status of H. pylori
    babA2 and the severity of clinical and histopathological outcomes. Methods: Gastric mucosal biopsy
    specimens were collected from 30 CLO test-positive patients, 16 with gastritis and 14 with peptic ulcer
    disease. Polymerase chain reaction was carried out to detect the presence of H. pylori-specific glmM gene
    and BabA coding gene (babA2). Histopathological examination was performed to evaluate the severity of H.
    pylori-associated gastric disease according to the Updated Sydney Classification System. Results: The glmM
    and babA2 genes were present in 100% and 86.7% of the tested H. pylori strains, respectively. Although
    higher degrees of inflammatory activity and H. pylori density were noted in babA2-positive biopsy
    specimens, there was no statistically significant association between babA2 genotype status and the severity
    of gastric disease. Conclusion: The babA2 genotype status of H. pylori may not be considered as a sole
    marker for determining the infection outcomes.
    Matched MeSH terms: Biopsy
  11. Fulltext Carcinoma Ex Pleomorphic Adenoma Presented as a Gigantic Tumor: Treatment and Diagnostic Challenges
    Maruthamuthu T, Saniasiaya J, Mohamad I, Nadarajah S, Lazim NM, Wan Abdul Rahman WF
    Oman Med J, 2018 Jul;33(4):342-345.
    PMID: 30038735 DOI: 10.5001/omj.2018.62
    Parotid gland surgery can be challenging due to intricate relationship between the gland and facial nerve. Besides complete removal of the lesion, the main focus of surgery is centered on the facial nerve. Surgery can be technically demanding especially when the tumor is large or involves the deep lobe. We report a patient with a 30-year history of gigantic parotid mass, which initial fine-needle aspiration cytology reported as pleomorphic adenoma. The tumor, weighing 1.3 kg, was successfully resected with facial nerve preservation. Histopathological examination of the excised mass confirmed as carcinoma ex pleomorphic adenoma (CaExPA) of adenocarcinoma, not otherwise specified type. We describe the specific surgical and reconstruction techniques for successful removal of large parotid tumors with facial nerve preservation. To our knowledge, this is the heaviest CaExPA of the parotid gland in South-East Asian region.
    Matched MeSH terms: Biopsy, Fine-Needle
  12. Fulltext Ki-67 protein as a prognostic indicator in ovarian carcinoma
    Rima Melati Mat Satar, Zed Zakari Abdul Hamid, Hartini Yusuf, Maimunah Mustakim
    The Pertanika Journal of Scholarly Research Reviews, 2018;4(2):71-77.
    MyJurnal
    Ki-67 expression is strongly correlated with tumour cell proliferation and growth. It is widely used as a proliferation marker in the routine pathological investigation. The nuclear protein Ki- 67 (pKi67) is recognised prognostic and predictive indicator for the biopsies assessment for cancer patients. Clinically, pKi67 has been revealed to associate with metastasis and the clinical stage of tumours. Furthermore, it has been presented that the expression of Ki-67 is significantly higher in malignant tissues with poorly differentiated tumour cells, as compared with normal tissue. The Ki-67 labelling index plays a vital role as an independent prognostic factor for survival rate, which includes all stages and grade categories. There is an association between the ratios of Ki-67 positive malignant cells and patient survival. This review provides an overview of recent advances in detecting Ki-67 in ovarian carcinoma.
    Matched MeSH terms: Biopsy
  13. Optimize Transfer Learning for Lung Diseases in Bronchoscopy Using a New Concept: Sequential Fine-Tuning
    Tan T, Li Z, Liu H, Zanjani FG, Ouyang Q, Tang Y, et al.
    IEEE J Transl Eng Health Med, 2018;6:1800808.
    PMID: 30324036 DOI: 10.1109/JTEHM.2018.2865787
    Bronchoscopy inspection, as a follow-up procedure next to the radiological imaging, plays a key role in the diagnosis and treatment design for lung disease patients. When performing bronchoscopy, doctors have to make a decision immediately whether to perform a biopsy. Because biopsies may cause uncontrollable and life-threatening bleeding of the lung tissue, thus doctors need to be selective with biopsies. In this paper, to help doctors to be more selective on biopsies and provide a second opinion on diagnosis, we propose a computer-aided diagnosis (CAD) system for lung diseases, including cancers and tuberculosis (TB). Based on transfer learning (TL), we propose a novel TL method on the top of DenseNet: sequential fine-tuning (SFT). Compared with traditional fine-tuning (FT) methods, our method achieves the best performance. In a data set of recruited 81 normal cases, 76 TB cases and 277 lung cancer cases, SFT provided an overall accuracy of 82% while other traditional TL methods achieved an accuracy from 70% to 74%. The detection accuracy of SFT for cancers, TB, and normal cases are 87%, 54%, and 91%, respectively. This indicates that the CAD system has the potential to improve lung disease diagnosis accuracy in bronchoscopy and it may be used to be more selective with biopsies.
    Matched MeSH terms: Biopsy
  14. Bilateral xanthomas of tendoachilles in a slow learner adolescent - A rare case report of van bogaert scherer epstein disease
    Jesslyn L, Ngah KC, Muhammad Zaidulkhair Mhd R, Ashwini S
    Med J Malaysia, 2018 10;73(5):321-322.
    PMID: 30350812 MyJurnal
    Van Bogaert Scherer Epstein Disease is a rare autosomal recessive condition involving abnormal deposition of cholesterol and cholestanol in various parts of body, various clinical symptoms manifest on different age group, significantly neurological impairment in late presentation. We are reporting a slow learner young lady presented with bilateral painless ankle swelling, our initial clinical impression were torn Achilles tendon or Haglund's deformity. On further detail history taking, it leads us towards this disease and confirmed with biopsy. A proper history taking and assessment can easily diagnose this condition, early treatment can perhaps change the fate of these unfortunate patients.
    Matched MeSH terms: Biopsy
  15. Fulltext Intramuscular haemangioma of the masseter muscle: a case report
    Ahmad Sahril Hussin, Nik Azrizie Muhamed, Haryati Husin, Irfan Mohamad
    Archives of Orofacial Sciences, 2018;13(1):41-44.
    MyJurnal
    Intramuscular haemangioma is relatively rare and accounts for less than 1% of all haemangioma.
    Most of these tumours occur in the trunk, arms and legs. Only 14% of all intramuscular haemangioma arise
    from the head and neck region, with masseter muscle representing the most common site of involvement,
    followed by the trapezius and sternocleidomastoid muscles. We present a case of a 60-year-old man with a
    soft lump in the left cheek. Imaging of the neck showed irregular, dilated enhancing vessels seen in the left
    masseter muscle suggestive of intramuscular haemangioma. Excisional biopsy was performed, and
    histopathological findings confirmed the diagnosis.
    Matched MeSH terms: Biopsy
  16. Fulltext Safety and efficacy of two tacrolimus formulations (Prograf® and Advagraf®) in Malaysian renal transplant patients: a comparative study
    Mac Guad, R., Zaharan, N.L., Wan Md Adnan, W.A.H., Gan, S.H., Chik, Z.,
    JUMMEC, 2019;22(1):20-26.
    MyJurnal
    Aim: A once-daily formulation of tacrolimus, Advagraf®, is increasingly being used in place of twice-daily
    tacrolimus, Prograf®, as a standard immunosuppressive agent for transplant patients. In this study, the
    clinical safety and efficacy of Advagraf® were compared with Prograf®, among multi-ethnic Malaysian renal
    transplanted population.

    Method: This retrospective study identified renal transplant patients who were converted from Prograf® to
    Advagraf® at the University Malaya Medical Centre (UMMC) (n=69). Clinical notes and laboratory records,
    including tacrolimus daily dose and trough levels, were obtained for one-year, pre-and post-conversion. Causality
    assessment of suspected adverse events were based on the WHO-Uppsala Monitoring Center criteria. Renal
    biopsy records were re-evaluated based on the updated Banff 2007 classification for biopsy-confirmed acute
    rejection (BPAR).

    Results: Following conversion to Advagraf®, the mean tacrolimus trough level and daily dose decreased
    significantly (p
    Matched MeSH terms: Biopsy
  17. Fulltext Upper Gastrointestinal Bleed due to Duodenal Metastases of Lung Adenocarcinoma: Report of Two Cases and Review of Literature
    Kosasih S, Muhammad Nawawi KN, Wong Z, Chia Hsin DC, Ban AY, Raja Ali RA
    Case Rep Med, 2019;2019:3437056.
    PMID: 31772583 DOI: 10.1155/2019/3437056
    Upper gastrointestinal bleeding as a result of gastrointestinal metastases from lung cancer is extremely rare. We report two cases of patients with duodenal metastases from lung adenocarcinoma presented with recurrent melena. Histopathological examination and immunohistochemical staining of the duodenal biopsies supported the diagnosis of metastatic lung adenocarcinoma.
    Matched MeSH terms: Biopsy
  18. Rapid urease test in the diagnosis of Helicobacter pylori infection
    Rosaida MS, Goh KL
    JUMMEC, 2000;5:11-16.
    Many tests are available for the diagnosis of H. pylori infection. Broadly they can be divided into invasive- endoscopy biopsy based tests and non-invasive tests. Of the endoscopy biopsy based tests the rapid urease tests (RUT) have been found to be the most convenient, accurate and inexpensive tests and they have therefore been recommended by several consensus panels and working parties as the test of choice during endoscopy. Several RUTS are available; some are commercial: CLO test, Pyloritek, Helicobacter urease test, H. yylori test and others- "homemade". We strongly recommend the "homemade" 1 min rapid urease test using an unbuffered solution as originally described by Arvind et al. This test has been shown to be easy to prepare, inexpensive and accurate on field-testing. Several factors affect the accuracy of the RUT. The larger the size of biopsy samples, the quicker is the postive reaction time. With the CLO test, warming the tests to 37'C has also been shown to hasten the reaction time. The effect of blood on the RUT poses an important problem in testing. It is vitally important to determine the H. yylori status in patients with bleeding peptic ulcers as the recurrence of bleeding has been shown to be markedly reduced or virtually abolished with H. yylori eradication. While the results of studies have not been entirely consistent, it is likely that presence of blood does reduce the sensitivity of the RUT. It is therefore sensible that in patients with bleeding ulcers, the RUT should not be the sole endoscopy biopsy test used and that samples should also be taken for histological examination.
    Matched MeSH terms: Biopsy
  19. Evaluation of contrast-enhanced digital mammography (CEDM) in the preoperative staging of breast cancer: Large-scale single-center experience
    Bicchierai G, Tonelli P, Piacenti A, De Benedetto D, Boeri C, Vanzi E, et al.
    Breast J, 2020 Jul;26(7):1276-1283.
    PMID: 31999029 DOI: 10.1111/tbj.13766
    One of the most important indications for contrast-enhanced breast imaging is the presurgical breast cancer (BC) staging. This is a large-scale single-center experience which evaluates the role of CEDM in presurgical staging and its impact on surgical planning. The aims of this retrospective study were to define the diagnostic performance of CEDM in the presurgical setting and to identify which types of patients could benefit from having CEDM. We selected 326 patients with BC who underwent CEDM as preoperative staging and had breast cancer-related surgery at our institution. We analyzed those cases in which CEDM led to additional imaging or biopsy and those in which it changed the type of surgery that was planned according to conventional breast imaging (CI) techniques (digital mammography, tomosynthesis and bilateral handheld ultrasound). CEDM sensitivity in identifying the index lesion and sensitivity, specificity, positive (PPV) and negative (NPV) predictive values, and accuracy in the correct preoperative staging of BC of the whole population and in various subgroups were calculated. CEDM sensitivity for the index lesion was 98.8% (322/326), which led to additional breast imaging in 23.6% (77/326) of patients and additional biopsies in 17.5% (57/326). CEDM changed the type of surgery in 18.4% (60/326). In the preoperative breast cancer staging, CEDM sensitivity, specificity, PPV, NPV, and accuracy produced results of 93%, 98%, 90%, 98%, and 97%, respectively. CEDM performance was better in patients with palpable lesions. CEDM has an excellent diagnostic performance in the presurgical staging of BC. Symptomatic patients with palpable lesions benefitted most from preoperative CEDM, with a statistically significant difference compared with nonpalpable.
    Matched MeSH terms: Biopsy
  20. Fulltext Fine-needle aspiration to improve diagnosis of melioidosis of the head and neck in children: a study from Sarawak, Malaysia
    Mohan A, Podin Y, Liew DW, Mahendra Kumar J, Lau PS, Tan YY, et al.
    BMC Infect Dis, 2021 Oct 15;21(1):1069.
    PMID: 34654392 DOI: 10.1186/s12879-021-06754-9
    BACKGROUND: Melioidosis, the infection caused by Burkholderia pseudomallei, is associated with a high case fatality rate, due in part to difficulties in clinical recognition and diagnostic confirmation of the disease. Although head and neck involvement is common in children, specific disease manifestations differ between geographic regions. The aim of this study was to provide a detailed description of melioidosis of the head and neck among children in Sarawak, Malaysia, and determine if fine-needle aspiration of suspected head or neck lesions could improve melioidosis diagnosis.

    METHODS: We conducted a retrospective descriptive study of all children aged

    Matched MeSH terms: Biopsy, Fine-Needle
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