MyMedR

A case of childhood hepatitis B virus infection related primary hepatocellular carcinoma with short malignant transformation time

Cheah PL, Looi LM, Lin HP, Yap SF

Pathology, 1991 Jan;23(1):66-8.

PMID: 1648195

A case of primary hepatocellular carcinoma (PHC) developing in a 10 year old boy who contracted Hepatitis B virus (HBV) infection in the course of maintenance phase chemotherapy for acute lymphoblastic leukemia was seen at University Hospital, Kuala Lumpur. This case is of interest in that it (1) supports an etiological relationship between HBV infection and PHC, (2) manifested a distinctly short malignant transformation time, and (3) draws attention to the possible contributory role of chemotherapy in increasing the risk of developing PHC.

Matched MeSH terms: Carcinoma, Hepatocellular/pathology; Liver Neoplasms/pathology

A molecular marker associated with mild hemoglobin H disease

George E, Ferguson V, Yakas J, Kronenberg H, Trent RJ

Pathology, 1989 Jan;21(1):27-30.

PMID: 2762043

The clinical spectrum of HbH disease varies from a benign disorder to a severe anemia which is blood-transfusion dependent. Heterogeneity at the clinical level is now being understood in terms of the underlying molecular defects. In this study a mild phenotype found in a group of patients with HbH disease is associated with two types of alpha-thalassemia. These are: alpha+-thalassemia (-alpha 3.7/) and alpha 0-thalassemia (--SEA/). In contrast, a second group with more severe HbH disease has a non-deletional alpha-thalassemia defect instead of alpha+-thalassemia (genotype alpha alpha T/--SEA). In the majority of cases, the basis for non-deletional alpha-thalassemia is Hb Constant Spring.

A rare case of metastatic lung carcinoma with t(15;19)(q13;p13.1) and trisomy 12

Tay Za K, Bee PC, Shanmugam H

Pathology, 2020 Feb;52(2):273-276.

PMID: 31883672 DOI: 10.1016/j.pathol.2019.10.013

Matched MeSH terms: Carcinoma/pathology*; Lung Neoplasms/pathology*

Saw S, Aw TC

Pathology, 2000 Nov;32(4):245-9.

PMID: 11186419

Cancer of the prostate is the sixth most frequently found cancer in Singapore. Prostate-specific antigen (PSA) is the most clinically useful tumour marker available today for the diagnosis and management of prostate cancer. To enhance the value of PSA as a screening test we developed age-specific intervals for our ethnic population. The measurement of free PSA was included in the study to calculate the free:total ratio which enhances the differential diagnosis of prostate cancer from benign prostatic hyperplasia or prostatitis. The total PSA upper limits of 10-year intervals, beginning at 30-years-old, were 1.4, 1.7, 2.3, 4.0, 6.3 and 6.6 microg/l. Free PSA cut-off limits were 0.4, 0.5, 0.5, 1.0, 1.5 and 1.6 microg/l. The free:total ratio of PSA was not age dependent. Abbott AxSym standardised their calibration material for both free and total PSA assays with the Stanford 90:10 reference material. This laboratory has implemented these age-specific reference intervals and are currently following up their pick-up rate in the detection of prostate cancer.

Aggressive angiomyxoma of the vulva with an unusual vascular finding

Cheah PL, Looi LM, Sivanesaratnam V

Pathology, 1993 Jul;25(3):250-2.

PMID: 8265242

We report the first documented Malaysian case of aggressive angiomyxoma (AAM) of the vulva. A 56-yr-old woman of Indian ethnic origin presented with a vulval lesion which was clinically mistaken for a Bartholin's cyst. The lesion was surgically excised and a diagnosis of AAM was made histologically. Of particular interest was the finding of foamy and mononuclear inflammatory cells and fibrin in the walls of most of the lesional blood vessels. The patient recovered uneventfully and remains without tumor recurrence at the time of writing 37 mths after initial presentation.

Matched MeSH terms: Foam Cells/pathology; Leukocytes, Mononuclear/pathology; Myxoma/pathology*; Vulvar Neoplasms/pathology*

Amyloidosis in Malaysian aborigines (Orang Asli)

Looi LM, Prathap K

Pathology, 1979 Oct;11(4):575-82.

PMID: 93739

Material from 334 consecutive autopsies on Orang Asli subjects performed in the University Hospital, Kuala Lumpur between May 1967 and June 1978 was examined for amyloidosis. Nine positive cases were found, all in patients above 40 years of age, giving an age-corrected incidence of about 9%. In 6 cases, amyloidosis was probably secondary to tuberculosis. The remaining 3 cases exhibited a pericollagenous distribution characteristic of primary amyloidosis. Involvement of the heart and lungs was prominent. However, there were considerable similarities in the distribution and staining properties of the amyloid in the 2 groups. Though both the heart and kidney were frequently affected, the kidney was the most common organ to give rise to clinical symptoms. Infection probably plays a major contributory role in amyloidosis in the Orang Asli.

Matched MeSH terms: Amyloidosis/pathology*; Kidney/pathology; Liver/pathology; Myocardium/pathology; Spleen/pathology

An immunohistochemical method for the diagnosis of melioidosis

Wong KT, Vadivelu J, Puthucheary SD, Tan KL

Pathology, 1996 May;28(2):188-91.

PMID: 8743829

In order to assess the usefulness of immunohistochemistry in the diagnosis of melioidosis, an infection by Burkholderia pseudomallei, polyclonal antibodies were applied to tissues from known cases of melioidosis and to other infected tissues. Formalin-fixed, paraffin-embedded tissues were stained by a modified immunoperoxidase technique. In autopsy tissues with inflammatory lesions of melioidosis, the cytoplasm of phagocytes and intact bacilli, both intra- and extracellular, were stained very strongly positive. Relatively more focal positive staining was observed in some but not all surgical biopsies from proven cases of melioidosis. In granulomas staining was mainly found in the central necrotic areas, with little staining of peripheral phagocytes. All control materials stained negative. Immunohistochemistry appears to be a useful diagnostic tool in melioidosis.

Matched MeSH terms: Melioidosis/pathology

An immunohistochemical study comparing clear cell sarcoma of the kidney and Wilms' tumor

Looi LM, Cheah PL

Pathology, 1993 Apr;25(2):106-9.

PMID: 8396229

This study explores immunohistochemical characteristics that may be of diagnostic value in differentiating clear cell sarcoma of the kidney (CCSK) from Wilms' tumor (WT) and may provide some insight into the histogenesis of CCSK. Formalin-fixed, paraffin-embedded sections of 8 CCSK and 9 WT were stained, using the standard avidin-biotin peroxidase complex method, for vimentin (VIM), Factor-8 related antigen (F8A), epithelial membrane antigen (EMA), desmin (DES), S-100 protein and Mac 387. CCSK cells consistently exhibited moderate to strong diffuse cytoplasmic positivity for VIM and were negative for F8A, EMA, DES, S-100 and Mac 387. In contrast, only patchy groups of stromal cells and primitive glomeruloid structures in WT exhibited VIM-positivity. Blastemal cells were VIM-negative. Stromal cells with rhabdomyomatous differentiation exhibited cytoplasmic positivity for DES. Epithelial cells of maturing tubular structures showed EMA-positivity whereas immature tubular structures were EMA-negative. Neither blastemal, stromal nor epithelial elements in WT were positive for F8A, S-100 or Mac 387. Podocytes and mesangial cells of glomeruli in 3 mid-trimester human abortuses (controls) exhibited moderate to strong VIM-positivity. The importance of differentiating CCSK from WT has been repeatedly emphasized because of its poorer prognosis and the necessity of adding Adriamycin to the chemotherapeutic regime. The consistent VIM-positivity of CCSK cells can be a useful feature in differentiating it from "blastemal-predominant" WT, with which it is often confused. Although vimentin expression by CCSK cells is consistent with a mesenchymal character, the possibility of a histogenetic link with glomerular podocytes or mesangial cells should also be considered.

Matched MeSH terms: Kidney Neoplasms/pathology*; Wilms Tumor/pathology*; Sarcoma/pathology*

Aortic and coronary atherosclerosis in the Malaysian Orang Asli

Prathap K, Montgomery GL

Pathology, 1974 Jul;6(3):255-61.

PMID: 4412062

Matched MeSH terms: Aorta/pathology; Aortic Diseases/pathology; Arteriosclerosis/pathology; Coronary Disease/pathology; Coronary Vessels/pathology

Bilateral adrenal masses in a diabetic patient: An unusual presentation of histoplasmosis

Saremi N, Ameli F, Rahman WF, Lam AK

Pathology, 2016 Feb;48 Suppl 1:S154.

PMID: 27772945 DOI: 10.1016/j.pathol.2015.12.421

Bilateral orbital paraganglioma: A report of a unique case and updates on its clinicopathological features

Rahman WF, Ismail S, Saremi N, Lam AK

Pathology, 2016 Feb;48 Suppl 1:S160.

PMID: 27772968 DOI: 10.1016/j.pathol.2015.12.438

Breast cancer hormone receptor testing in Asia: is it time to think again on expected positivity rates and methods of scoring?

Rhodes A, Teoh KH, See MH, Ganesan K, Looi LM

Pathology, 2020 Apr;52(3):385-387.

PMID: 32107079 DOI: 10.1016/j.pathol.2019.12.006

Breast carcinoma in women 35 years and younger: a pathological study

Fernandopulle SM, Cher-Siangang P, Tan PH

Pathology, 2006 Jun;38(3):219-22.

PMID: 16753742

To document the pathological features of breast carcinoma diagnosed in women aged 35 years or less.

Matched MeSH terms: Breast Neoplasms/pathology*; Carcinoma, Intraductal, Noninfiltrating/pathology*; Cell Nucleus/pathology; Lymph Nodes/pathology; Carcinoma, Ductal, Breast/pathology*

CD44s expression correlated with the International Neuroblastoma Pathology Classification (Shimada system) for neuroblastic tumours

Munchar MJ, Sharifah NA, Jamal R, Looi LM

Pathology, 2003 Apr;35(2):125-9.

PMID: 12745459

CD44 is a cell adhesion molecule that plays an important role in the cascade of metastasis and progression of human malignant tumours. A large family of variants or isoforms, generated by alternative splicing of a single gene, has been reported to be involved in the malignant process by conferring metastatic potential to non-metastatic cells. The objective of this study was to compare the expression of CD44 standard molecule with the International Neuroblastoma Pathology Classification (INPC) for neuroblastic tumours, a histological grading system based on the Shimada system for predicting the clinical outcome in neuroblastic tumours.

Matched MeSH terms: Ganglioneuroma/pathology; Neuroblastoma/pathology

Characterisation and confirmation of rare beta-thalassaemia mutations in the Malay, Chinese and Indian ethnic groups in Malaysia

Tan JA, Chin PS, Wong YC, Tan KL, Chan LL, George E

Pathology, 2006 Oct;38(5):437-41.

PMID: 17008283

In Malaysia, about 4.5% of the Malay and Chinese populations are heterozygous carriers of beta-thalassaemia. The initial identification of rare beta-globin gene mutations by genomic sequencing will allow the development of simpler and cost-effective PCR-based techniques to complement the existing amplification refractory mutation system (ARMS) and gap-PCR used for the identification of beta-thalassaemia mutations.

Matched MeSH terms: beta-Thalassemia/pathology

Clear cell sarcoma of kidney: report of the first Malaysian case

Looi LM, Cheah PL, Lin HP

Pathology, 1992 Jan;24(1):34-6.

PMID: 1374551

Clear cell sarcoma of kidney (CCSK) is a rare but distinct tumor of childhood frequently confused with Wilms' tumor (nephroblastoma). It has a characteristic histology, a marked predilection for metastasis to bone, and an aggressive clinical course with a high relapse rate in spite of surgical excision, chemotherapy and radiotherapy. We report the first histologically proven CCSK in a Malaysian patient. This was an 8-mth-old Malay boy who was clinically diagnosed to have stage I Wilms' tumor. Despite treatment, he developed multiple metastases 10 mths after initial presentation and died soon after. Emphasis is placed on recognizing this entity in view of (1) its naturally aggressive behaviour and (2) the prospect of improving prognosis with currently recommended intensified chemotherapeutic regimes. Its immunohistochemical profile of vimentin-positivity and negativity for epithelial membrane antigen, cytokeratin and Factor-8 related antigen is more in favour of a mesenchymal or glomerular origin than a tubular or vascular origin.

Common ALK gene rearrangement in Asian CD30+ anaplastic large cell lymphoma: an immunohistochemical and fluorescence in situ hybridisation (FISH) study on paraffin-embedded tissue

Tai YC, Kim LH, Peh SC

Pathology, 2003 Oct;35(5):436-43.

PMID: 14555389

AIMS: The most common recurrent genetic aberration in anaplastic large cell lymphoma (ALCL) is translocation involving the ALK gene that results in ectopic expression of ALK protein in lymphoid tissue. This study aims to investigate the frequency of ALK gene rearrangement in a series of Asian ALCL.

METHODS: ALK gene rearrangement was detected by immunostaining of ALK protein and fluorescence in situ hybridisation (FISH) targeting at the 2p23 region.

RESULTS: The expression of ALK protein was detected in 24/34 (71%) of the cases, and it was significantly higher in childhood cases (100%) when compared to adult cases (47%). The analyses by FISH were consistent with the results from immunostaining of ALK protein, but the analyses were only successful in 15/34 (44%) cases. FISH analyses detected extra copies of ALK gene in three cases, including one case that expressed ALK protein and showed 2p23 rearrangement.

CONCLUSIONS: The current series revealed a high frequency of ALK gene rearrangement, especially in the children. Immunostaining of ALK protein is a reliable indication of ALK gene rearrangement, and is superior to FISH. However, FISH analysis is useful in detecting other genetic aberrations that are not related to ALK gene rearrangement.

Matched MeSH terms: Lymphoma, Large B-Cell, Diffuse/pathology

Comparative study between Pap smear cytology and FTIR spectroscopy: a new tool for screening for cervical cancer

El-Tawil SG, Adnan R, Muhamed ZN, Othman NH

Pathology, 2008 Oct;40(6):600-3.

PMID: 18752127 DOI: 10.1080/00313020802320622

AIMS: To evaluate Fourier transform infrared (FTIR) spectroscopy as new tool for screening of cervical cancer in comparison with cervical cytology.

METHODS: A total of 800 cervical scrapings were taken by cytobrush and placed in ThinPrep medium. The samples were dried over infrared transparent matrix. Beams of infrared light were directed at the dried samples at frequency of 4000 to 400 cm(-1). The absorption data were produced using a Spectrum BX II FTIR spectrometer. Data were compared with the reference absorption data of known samples using FTIR spectroscopy software. FTIR spectroscopy was compared with cytology (gold standard).

RESULTS: FTIR spectroscopy could differentiate normal from abnormal cervical cells in the samples examined. The sensitivity was 85%, specificity 91%, positive predictive value 19.5% and negative predictive value of 99.5%.

CONCLUSION: This study suggests that FTIR spectroscopy could be used as an alternative method for screening for cervical cancer.

DNMT1 is predictive of survival and associated with Ki-67 expression in R-CHOP-treated diffuse large B-cell lymphomas

Loo SK, Ch'ng ES, Lawrie CH, Muruzabal MA, Gaafar A, Pomposo MP, et al.

Pathology, 2017 Dec;49(7):731-739.

PMID: 29074044 DOI: 10.1016/j.pathol.2017.08.009

DNMT1 is a target of approved anti-cancer drugs including decitabine. However, the prognostic value of DNMT1 protein expression in R-CHOP-treated diffuse large B-cell lymphomas (DLBCLs) remains unexplored. Here we showed that DNMT1 was expressed in the majority of DLBCL cases (n = 209/230, 90.9%) with higher expression in germinal centre B-cell-like (GCB)-DLBCL subtype. Low and negative DNMT1 expression (20% cut-off, n = 33/230, 14.3%) was predictive of worse overall survival (OS; p < 0.001) and progression-free survival (PFS; p < 0.001). Nonetheless, of the 209 DNMT1 positive patients, 33% and 42% did not achieve 5-year OS and PFS, respectively, indicating that DNMT1 positive patients showed considerably heterogeneous outcomes. Moreover, DNMT1 was frequently expressed in mitotic cells and significantly correlated with Ki-67 or BCL6 expression (r = 0.60 or 0.44, respectively; p < 0.001). We demonstrate that DNMT1 is predictive of DLBCL patients' survival, and suggest that DNMT1 could be a DLBCL therapeutic target due to its significant association with Ki-67.

Matched MeSH terms: B-Lymphocytes/pathology; Lymphoma, Large B-Cell, Diffuse/pathology; Germinal Center/pathology

Differentiation of human mesenchymal stem cells into mesangial cells in post-glomerular injury murine model

Wong CY, Cheong SK, Mok PL, Leong CF

Pathology, 2008 Jan;40(1):52-7.

PMID: 18038316

AIMS: Adult human bone marrow contains a population of mesenchymal stem cells (MSC) that contributes to the regeneration of tissues such as bone, cartilage, muscle, tendon, and fat. In recent years, it has been shown that functional stem cells exist in the adult bone marrow, and they can contribute to renal remodelling or reconstitution of injured renal glomeruli, especially mesangial cells. The purpose of this study is to examine the ability of MSC isolated from human bone marrow to differentiate into mesangial cells in glomerular injured athymic mice.

METHODS: MSC were isolated from human bone marrow mononuclear cells based on plastic adherent properties and expanded in vitro in the culture medium. Human mesenchymal stem cells (hMSC) were characterised using microscopy, immunophenotyping, and their ability to differentiate into adipocytes, chondrocytes, and osteocytes. hMSC were then injected into athymic mice, which had induced glomerulonephropathy (GN).

RESULTS: Test mice (induced GN and infused hMSC) were shown to have anti-human CD105(+) cells present in the kidneys and were also positive to anti-human desmin, a marker for mesangial cells. Furthermore, immunofluorescence assays also demonstrated that anti-human desmin(+) cells in the glomeruli of these test mice were in the proliferation stage, being positive to anti-human Ki-67.

CONCLUSIONS: These findings indicate that hMSC found in renal glomeruli differentiated into mesangial cells in vivo after glomerular injury occurred.

Matched MeSH terms: Bone Marrow Cells/pathology; Glomerulonephritis/pathology*; Kidney Glomerulus/pathology*; Mesangial Cells/pathology*; Mesenchymal Stromal Cells/pathology*

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