MyMedR

Fulltext Cotton-ball granuloma mimicking axillary lymphadenopathy in a breast cancer patient

Hashim H, Alli K, Faridah Y, Rahmat K

Biomed Imaging Interv J, 2011 07 01;7(3):e19.

PMID: 22279496 MyJurnal DOI: 10.2349/biij.7.3.e19

Foreign body granuloma is a reaction to either a biodegradable substance or inert material. In a breast cancer patient who had undergone an excision or mastectomy with axillary clearance, a foreign body granuloma in the axilla may be misinterpreted as an axillary lymph node. We report our experience with a case of cotton-ball granuloma of the axilla in a breast cancer patient, which mimics a lymph node radiologically from the CT scan, mammogram and ultrasonography. Following biopsy and excision, the mass was diagnosed histologically as a foreign body granuloma.

Fulltext Ptosis due to cavernous sinus syndrome as a rare presentation of advanced breast metastasis in a patient with delayed diagnosis

Khaw K, Ramli N, Rahmat K

Malays Fam Physician, 2012;7(1):31-3.

PMID: 25606243 MyJurnal

Complications of breast cancer metastasis may be the first manifestation of the disease. We report a rare case of left eye ptosis secondary to cavernous sinus syndrome in a 34-year-old lady due to refusal of proper medical treatment for metastatic breast cancer. The delay in seeking medical treatment was attributed to her use of Traditional Chinese Medicine (TCM).

Benign Disorders of the Breast in Pregnancy and Lactation

Taib NA, Rahmat K

Adv Exp Med Biol, 2020;1252:43-51.

PMID: 32816261 DOI: 10.1007/978-3-030-41596-9_6

Benign cystic or solid lumps frequently occur in the breasts of young women, and consequently can also be seen during pregnancy and lactation. Simple cysts do not increase the risk of malignancy. The current management is routine follow-up. Complex cysts are thick walled or contain a mass, and should be followed by a US-guided biopsy and then treated similar to any non-gravid, non-lactating patient.Galactoceles can be detected during the last trimester of pregnancy and during or after stopping lactation. Aspiration can be done to confirm the content. Co-existence of galactocele and malignancy is extremely rare, and the key is to follow up until it resolves.Fibroadenoma is the most frequent lesion found during pregnancy and lactation. Management is usually conservative after triple assessment. Surgery is usually not recommended in pregnant and lactating women unless rapid increase in size occurs or there is discordance in the triple assessment.Lactating adenomas are sometimes interpreted as a variant of fibroadenoma . They can naturally disappear at the end of pregnancy or lactation. Management is usually conservative, and an excisional biopsy is only mandated if it is rapidly enlarging or if there is discordance in the triple assessment.Gestational gigantomastia is a rare condition consisting of diffuse severe hypertrophy of both breasts during pregnancy . Mastectomy and reconstruction may rarely be required in such cases.

The past, present and future of imaging in multiple sclerosis

Ramli N, Rahmat K, Azmi K, Chong HT

J Clin Neurosci, 2010 Apr;17(4):422-7.

PMID: 20167498 DOI: 10.1016/j.jocn.2009.09.014

Despite technological advances in imaging, multiple sclerosis (MS) remains a clinical diagnosis that is supported, but not replaced, by laboratory or imaging findings. However, imaging is essential in the current diagnostic criteria of MS, for prediction of the likelihood of MS for patients with clinically isolated syndromes, correlation with lesion pathology and assessment of treatment outcome. This article gives an overview of imaging in MS with particular emphasis on the role of MRI in various diagnostic imaging criteria. Novel imaging for MS using 3 Tesla field strengths, magnetization transfer imaging, diffusion tensor imaging, magnetic resonance spectroscopy and cell-specific contrast will be reviewed.

Fulltext Primary bone lymphoma: report of a case with multifocal skeletal involvement

Rahmat K, Wastie M, Abdullah B

Biomed Imaging Interv J, 2007 Oct;3(4):e52.

PMID: 21614300 MyJurnal DOI: 10.2349/biij.3.4.e52

Primary bone lymphoma is an uncommon tumour accounting for approximately 4-5% of extra nodal lymphoma and less than 1% of all Non-Hodgkin's lymphoma. The radiographic appearance of primary bone lymphoma is variable. As lesions frequently resemble other disease processes namely chronic osteomyelitis and metastases, further imaging evaluation and histopathological examination allow early identification for appropriate treatment. The authors present a case of anaplastic large cell lymphoma of bone presenting with multifocal osseus involvement.

Correlation and accuracy of contrast-enhanced computed tomography in assessing depth of invasion of oral tongue carcinoma

Chin SY, Kadir K, Ibrahim N, Rahmat K

Int J Oral Maxillofac Surg, 2021 Jun;50(6):718-724.

PMID: 33162298 DOI: 10.1016/j.ijom.2020.09.025

The aim of this study was to evaluate the correlation and accuracy of depth of invasion (DOI) measurement from preoperative contrast-enhanced computed tomography (CECT) scans in comparison to histopathological examination (HPE) in oral tongue squamous cell carcinoma (OTSCC). Preoperative CT scans of 18 OTSCC patients were reviewed retrospectively by a single observer to measure the DOI on axial and coronal sections; these were then compared to the HPE report. Mean DOI was compared between CECT and HPE using repeated measures ANOVA. The strength of correlation of CT-derived tumour depth was determined using the intra-class correlation coefficient (ICC) followed by assessment of accuracy by Bland-Altman plot. In general, the measurement of DOI was smaller on CECT, with a mean difference of 0.743mm on axial CT and 1.106mm on coronal CT. Regarding the correlation between CECT and HPE tumour depths, ICC was 0.956 for axial CT and 0.965 for coronal CT. Bland-Altman analysis showed that DOI from CECT and histopathological depth were in agreement with each other. In conclusion, there was excellent correlation and accurate measurement of DOI from CECT.

Fulltext Bilateral internal carotid artery hypotrophy in malignant osteopetrosis

Ramli N, Rahmat K, Tan GP

Singapore Med J, 2008 Jul;49(7):e175-7.

PMID: 18695851

Malignant osteopetrosis is associated with petrous carotid canal and internal carotid artery stenosis in the skull base. We present a four-year-old boy with malignant osteopetrosis who developed right frontal lobe infarction as a result of bilateral internal carotid artery hypotrophy.

Fulltext A child with atypical teratoid/rhabdoid tumour of the posterior cranial fossa

Rahmat K, Kua CH, Ramli N

Singapore Med J, 2008 Dec;49(12):e365-8.

PMID: 19122937

Primary central nervous system (CNS) atypical teratoid/rhabdoid tumours (ATRT) are highly malignant neoplasms which usually present in infancy or early childhood. Although ATRT may arise anywhere within the CNS, the majority (approximately two-thirds) arise in the cerebellum or posterior fossa, and the remainder in the cerebrum. We described the imaging characteristics of CNS ATRT in the posterior cranial fossa of a 14-month-old boy.

Reply to "Critique of a Study on Breast Ultrasound as an Adjunct to Breast Tomosynthesis for Breast Cancer Screening and Diagnosis"

Rahmat K, Ab Mumin N

Ultrasound Med Biol, 2024 Mar;50(3):454.

PMID: 38176983 DOI: 10.1016/j.ultrasmedbio.2023.11.014

Re: Improved diagnostic accuracy in differentiating malignant and benign lesions using single-voxel proton MRS of the breast at 3 T MRI. A reply

Suppiah S, Rahmat K, Rozalli FI, Azlan CA

Clin Radiol, 2014 Feb;69(2):e110-1.

PMID: 24183264 DOI: 10.1016/j.crad.2013.09.012

Radiological analysis of the ethmoid roof in the Malaysian population

Alazzawi S, Omar R, Rahmat K, Alli K

Auris Nasus Larynx, 2012 Aug;39(4):393-6.

PMID: 22055509 DOI: 10.1016/j.anl.2011.10.002

To ascertain the prevalence of the lateral lamella of the cribriform plate height according to Keros classification in the Malaysian population, and to find if there is any difference between the major ethnic groups in Malaysia (Malay, Chinese, Indian).

Fulltext Medullary carcinoma of the breast: Role of contrast-enhanced MRI in the diagnosis of multiple breast lesions

Abdul Rashid S, Rahmat K, Jayaprasagam K, Alli K, Moosa F

Biomed Imaging Interv J, 2009 Oct;5(4):e27.

PMID: 21610994 MyJurnal DOI: 10.2349/biij.5.4.e27

Medullary carcinoma is a rare breast carcinoma with a syncytial growth pattern and high-grade cytology. It can be difficult to diagnose and may be missed on conventional imaging as the findings may overlap with benign lesions i.e. fibroadenomas. The authors report a case of a 25-year-old female who presented with multifocal breast lumps diagnosed with medullary carcinoma and fibroadenomas. Imaging and pathological correlation with contrast-enhanced MRI are presented in the diagnosis of these lesions.

Fulltext Benign teratoma of the liver: a rare cause of cholangitis

Rahmat K, Vijayananthan A, Abdullah B, Amin S

Biomed Imaging Interv J, 2006 Jul;2(3):e20.

PMID: 21614237 MyJurnal DOI: 10.2349/biij.2.3.e20

Teratomas are neoplasms characterised by an abnormal growth of tissues derived from the three germinal layers. The term 'teratoma' is derived from the Greek root 'teratos', meaning monster. Germ cells develop in the embryo and subsequently become the cells that make up the reproductive system. During fetal development, these cells follow a midline path and descend into the pelvis as ovarian cells or the scrotal sac as testicular cells. The presence of germ cells in extragonadal sites is because of the failure of these cells to migrate along the urogenital ridge. Therefore, teratomas occur in order of decreasing frequency in the ovaries, testes, anterior mediastinum, retroperitoneum, sacrococcygeal region and cranium.Liver teratomas are very rare; of the 25 hepatic teratomas described in the literature, only five have occurred in adults. The majority of the cases were in female children below the age of three, mostly arising in the right lobe of liver.We report a case of an adult male with benign mature teratoma arising in the left lobe of liver, compressing the common bile duct and causing obstructive jaundice.

Fulltext A rare case of primary infiltrating neuroendocrine carcinoma of the breast

Nawawi O, Ying Goh K, Rahmat K

Iran J Radiol, 2012 Nov;9(4):212-6.

PMID: 23408015 DOI: 10.5812/iranjradiol.8517

Primary neuroendocrine carcinoma of the breast is a very rare malignant tumor. There are not many cases reported in the English literature since it was first documented in 1983. Reports on the imaging features, in particular the ultrasonographic features of this rare tumor are scarce. Herein, we report a case of aggressive primary infiltrating neuroendocrine carcinoma of the breast, masquerading as an inflammatory breast condition in a 22-year-old young lady, perhaps the youngest case ever reported in the English literature. We discuss the imaging features and highlight the Doppler ultrasonographic findings of this rare breast carcinoma. This is the first documentation on Doppler ultrasonographic findings of primary neuroendocrine carcinoma of the breast in the literature.

Neuroimaging in refractory epilepsy. Current practice and evolving trends

Ramli N, Rahmat K, Lim KS, Tan CT

Eur J Radiol, 2015 Sep;84(9):1791-800.

PMID: 26187861 DOI: 10.1016/j.ejrad.2015.03.024

Identification of the epileptogenic zone is of paramount importance in refractory epilepsy as the success of surgical treatment depends on complete resection of the epileptogenic zone. Imaging plays an important role in the locating and defining anatomic epileptogenic abnormalities in patients with medically refractory epilepsy. The aim of this article is to present an overview of the current MRI sequences used in epilepsy imaging with special emphasis of lesion seen in our practices. Optimisation of epilepsy imaging protocols are addressed and current trends in functional MRI sequences including MR spectroscopy, diffusion tensor imaging and fusion MR with PET and SPECT are discussed.

Fulltext Decidualized Ovarian Endometrioma in a Pregnant Woman Mimicking Ovarian Malignancy: Magnetic Resonance Imaging and Ultrasonographic Findings

Izza Rozalli F, Rahmat K, Fadzli F, Boylan C, Deb P

Iran J Radiol, 2015 Oct;12(4):e21260.

PMID: 26715980 DOI: 10.5812/iranjradiol.21260

Decidualized ovarian endometrioma is a rare phenomenon in pregnancy, which can mimic ovarian malignancy in imaging and often poses a diagnostic challenge. We report a case of a large ruptured decidualized ovarian endometrioma in a 15 weeks gestation patient, and we will describe the imaging characteristics (ultrasonography and MR imaging findings) and the histopathological findings (macro- and microscopically).

Metastatic hepatocellular carcinoma presenting as a sphenoid sinus mass and meningeal carcinomatosis

Hashim H, Rahmat K, Abdul Aziz YF, Chandran PA

Ear Nose Throat J, 2014 Jun;93(6):E20-3.

PMID: 24932824

We report the case of a 30-year-old woman who was referred to us for evaluation of a 2-week history of fever, headache, vomiting, bilateral ptosis, and blurred vision. Imaging obtained by the referring institution had identified a sphenoid sinus mass and diffuse meningeal infiltration, which was thought to represent an infective process. We subsequently identified the mass as a metastatic hepatocellular carcinoma (HCC). The patient was placed under palliative care, and she died 1 month later. Metastases to the sphenoid sinus from any primary source are very rare, and they are generally not considered in the radiologic differential diagnosis. HCC is known to metastasize to the lung, lymph nodes, and musculoskeletal system; again, reported cases of metastasis to the sphenoid sinus are rare. Indeed, our review of the English-language literature found only 6 previously reported cases of sinonasal metastasis of a primary HCC. A diagnosis of a sinonasal metastasis is more difficult in a patient who has no previous diagnosis of a primary malignancy. In presenting this case, our aim is to remind readers of this possibility.

Fulltext Central pontine and extrapontine myelinolysis: Diffusion weighted imaging and diffusion tensor imaging on follow-up

Nair SR, Ramli NM, Rahmat K, Mei-Ling ST

Neurol India, 2012 Jul-Aug;60(4):426-8.

PMID: 22954982 DOI: 10.4103/0028-3886.100712

Acute bilateral medial medullary infarct with hypoplastic vertebral artery

Tai ML, Katiman E, Rahmat K, Tan CT

Clin Neurol Neurosurg, 2012 Dec;114(10):1365-7.

PMID: 22512947 DOI: 10.1016/j.clineuro.2012.03.031

Quantification of diffusion tensor imaging in normal white matter maturation of early childhood using an automated processing pipeline

Loh KB, Ramli N, Tan LK, Roziah M, Rahmat K, Ariffin H

Eur Radiol, 2012 Jul;22(7):1413-26.

PMID: 22434420 DOI: 10.1007/s00330-012-2396-3

OBJECTIVES: The degree and status of white matter myelination can be sensitively monitored using diffusion tensor imaging (DTI). This study looks at the measurement of fractional anistropy (FA) and mean diffusivity (MD) using an automated ROI with an existing DTI atlas.

METHODS: Anatomical MRI and structural DTI were performed cross-sectionally on 26 normal children (newborn to 48 months old), using 1.5-T MRI. The automated processing pipeline was implemented to convert diffusion-weighted images into the NIfTI format. DTI-TK software was used to register the processed images to the ICBM DTI-81 atlas, while AFNI software was used for automated atlas-based volumes of interest (VOIs) and statistical value extraction.

RESULTS: DTI exhibited consistent grey-white matter contrast. Triphasic temporal variation of the FA and MD values was noted, with FA increasing and MD decreasing rapidly early in the first 12 months. The second phase lasted 12-24 months during which the rate of FA and MD changes was reduced. After 24 months, the FA and MD values plateaued.

CONCLUSION: DTI is a superior technique to conventional MR imaging in depicting WM maturation. The use of the automated processing pipeline provides a reliable environment for quantitative analysis of high-throughput DTI data.

KEY POINTS: Diffusion tensor imaging outperforms conventional MRI in depicting white matter maturation. • DTI will become an important clinical tool for diagnosing paediatric neurological diseases. • DTI appears especially helpful for developmental abnormalities, tumours and white matter disease. • An automated processing pipeline assists quantitative analysis of high throughput DTI data.

Displaying publications 1 - 20 of 99 in total