Solitary fibrous tumours of the head and neck region are
extremely rare. The clinical diagnosis is often difficult to
establish, and this lesion may be indistinguishable from other
soft tissue neoplasms. An 18-year old Chinese gentleman
presented with a painless right submandibular swelling which
was increasing in size for eight months. A computed
tomography scan showed a well-defined solid mass measuring
about 2.0 x 2.96 cm in the submandibular region. The tumour
was resected and was confined within its capsule.
Immunohistochemical staining was strongly positive for CD34,
CD 99, and vimentin and negative for desmin, smooth muscle
actin (SMA), cytokeratin, S100 and CD68. The microscopic and
immunohistochemical profile were compatible with solitary
fibrous tumour. Distinguishing solitary fibrous tumours from
various spindle neoplasms can be difficult. In view of the
resemblance, immunohistochemical staining can help
differentiate solitary fibrous tumour from spindle neoplasm.
The Gleason grading system assists in evaluating the prognosis of men with prostate cancer. Cancers with a higher score are more aggressive and have a worse prognosis. The pathologists observe the tissue components (e.g. lumen, nuclei) of the histopathological image to grade it. The differentiation between Grade 3 and Grade 4 is the most challenging, and receives the most consideration from scholars. However, since the grading is subjective and time-consuming, a reliable computer-aided prostate cancer diagnosing techniques are in high demand. This study proposed an ensemble computer-added system (CAD) consisting of two single classifiers: a) a specialist, trained specifically for texture features of the lumen and the other for nuclei tissue component; b) a fusion method to aggregate the decision of the single classifiers. Experimental results show promising results that the proposed ensemble system (area under the ROC curve (Az) of 88.9% for Grade 3 versus Grad 4 classification task) impressively outperforms the single classifier of nuclei (Az=87.7) and lumen (Az=86.6).
Hydatid cysts are not endemic in Malaysia and are rarely seen. We hereby report a case of hydatid cyst of the liver in a 55-year-old Chinese-Australian lady who presented with a calcified liver cyst and negative hydatid serology. A liver segmentectomy was performed and revealed a well-circumscribed, calcified liver cyst containing only creamy whitish material without the typical daughter cyst. A histological examination revealed different layers of the cyst wall and the presence of loose, calcified scolices without a daughter cyst. The case highlights the importance of considering hydatid cyst in the differential diagnosis of liver cyst even in non-endemic areas, as the ease of travelling and migration allows the condition to be seen outside the endemic region.