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  1. Nur Hidayah Bahrom, Anis Safura Ramli, Nor Suraya Samsudin, Norliana Dalila Mohamad Ali, Nor Salmah Bakar
    MyJurnal
    This is a case of a 62-year-old Indian man who was diagnosed with a rare type of lung
    neuroendocrine tumour (NET) of atypical carcinoid (AC) subtype which comprises only 0.1%–
    0.2% of pulmonary neoplasms. He initially presented to a private hospital in May 2018 with a
    6-month history of chronic productive cough and haemoptysis. Chest X-Ray (CXR), CT scan,
    bronchoscopy, biopsy and broncho-alveolar lavage were conducted. At this stage, imaging and
    histopathological investigations were negative for malignancy. Diagnosis of bronchiectasis was
    made and he was treated with antibiotic and tranexamic acid. Due to financial difficulties, his
    care was transferred to a university respiratory clinic in June 2018. His condition was monitored
    with CXR at every visit and treatment with tranexamic acid was continued for 6 months.
    However, due to persistent haemoptysis, he presented to the university primary care clinic in
    Dec 2018. Investigations were repeated in January 2019 where his CXR showed increased
    opacity of the left retrocardiac region and CT scan revealed a left lower lobe endobronchial
    mass causing collapse with mediastinal lymphadenopathy suggestive of malignancy.
    Bronchoscopy, biopsy and histopathology confirmed the presence of NET. Although the Ki-67
    index was low, the mitotic count, presence of necrosis and evidence of liver metastases
    favoured the diagnosis of AC. A positron emission tomography Ga-68 DONATOC scan showed
    evidence of somatostatin receptor avid known primary malignancy in the lungs with suspicions
    of liver metastasis. He was subsequently referred to the oncology team and chemotherapy was
    initiated. This case highlights the challenge in diagnosis and management of patients with AC.
    Physicians ought to be vigilant and have a high index of suspicion in patients who present with
    persistent symptoms on multiple visits. Early diagnosis of NET would prevent metastasis and
    provide better prognosis. Continuous follow-up shared care between primary care and
    secondary care physicians is also essential to provide ongoing psychosocial support for
    patients with NET, especially those with metastatic disease
  2. Kadhim Jawad Obaid, Yahya Mohammad Arpine, Nor Salmah Bakar, Marlina Tanty Ramli Hamid, Ahmed Ramzi Yusof
    Intramuscular shoulder angiomyolipomas are very rare. We report a case in a 22-year-old male with a well circumscribed lesion located on the back of the shoulder. This lesion, differs from renal angiomyolipoma in terms of non-association with tuberous sclerosis, circumscription and male predominance. Another characteristic feature is the absence of epithelioid cells. Differential diagnosis includes lipoma, angiolipoma, angioleiomyoma, hemangioma, myolipoma and liposarcoma. It is distinguished from the above mentioned entities by the presence of a combination of thick-walled blood vessels, smooth muscle and fat.
  3. Kadhim Jawad Obaid, Yahya Mohammad Arpine, Nor Salmah Bakar, Marlina Tanty Ramli Hamid, Ahmed Ramzi Yusof
    MyJurnal
    Intramuscular shoulder angiomyolipomas are very rare. We report a case in a 22-year-old male with a well circumscribed lesion located on the back of the shoulder. This lesion, differs from renal angiomyolipoma in terms of non-association with tuberous sclerosis, circumscription and male predominance. Another characteristic feature is the absence of epithelioid cells. Differential diagnosis includes lipoma, angiolipoma, angioleiomyoma, hemangioma, myolipoma and liposarcoma. It is distinguished from the above mentioned entities by the presence of a combination of thick-walled blood vessels, smooth muscle and fat.
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