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  1. Drug-Induced Acute-on-Chronic Liver Failure in Asian Patients
    Devarbhavi H, Choudhury AK, Sharma MK, Maiwall R, Al Mahtab M, Rahman S, et al.
    Am J Gastroenterol, 2019 06;114(6):929-937.
    PMID: 31021832 DOI: 10.14309/ajg.0000000000000201
    OBJECTIVES: Acute insults from viruses, infections, or alcohol are established causes of decompensation leading to acute-on-chronic liver failure (ACLF). Information regarding drugs as triggers of ACLF is lacking. We examined data regarding drugs producing ACLF and analyzed clinical features, laboratory characteristics, outcome, and predictors of mortality in patients with drug-induced ACLF.

    METHODS: We identified drugs as precipitants of ACLF among prospective cohort of patients with ACLF from the Asian Pacific Association of Study of Liver (APASL) ACLF Research Consortium (AARC) database. Drugs were considered precipitants after exclusion of known causes together with a temporal association between exposure and decompensation. Outcome was defined as death from decompensation.

    RESULTS: Of the 3,132 patients with ACLF, drugs were implicated as a cause in 329 (10.5%, mean age 47 years, 65% men) and other nondrug causes in 2,803 (89.5%) (group B). Complementary and alternative medications (71.7%) were the commonest insult, followed by combination antituberculosis therapy drugs (27.3%). Alcoholic liver disease (28.6%), cryptogenic liver disease (25.5%), and non-alcoholic steatohepatitis (NASH) (16.7%) were common causes of underlying liver diseases. Patients with drug-induced ACLF had jaundice (100%), ascites (88%), encephalopathy (46.5%), high Model for End-Stage Liver Disease (MELD) (30.2), and Child-Turcotte-Pugh score (12.1). The overall 90-day mortality was higher in drug-induced (46.5%) than in non-drug-induced ACLF (38.8%) (P = 0.007). The Cox regression model identified arterial lactate (P < 0.001) and total bilirubin (P = 0.008) as predictors of mortality.

    DISCUSSION: Drugs are important identifiable causes of ACLF in Asia-Pacific countries, predominantly from complementary and alternative medications, followed by antituberculosis drugs. Encephalopathy, bilirubin, blood urea, lactate, and international normalized ratio (INR) predict mortality in drug-induced ACLF.

    Matched MeSH terms: Biopsy
  2. Parotid gland oncocytic carcinoma: A rare entity in head and neck region
    Wan Ahmad Kammal WS, Azman M, Salleh AA, Md Pauzi SH, Abd Shukor N
    Malays J Pathol, 2020 Aug;42(2):283-286.
    PMID: 32860383
    Oncocytic carcinoma of the salivary gland is an uncommon tumour in the head and neck region. Owing to its rarity, identifying the histopathological features of a malignant tumour can be difficult and challenging. We report a case of a 70-year-old man who presented with a left facial weakness for six months in a background history of left parotid swelling over the past 10 years. Clinical examination revealed a 3x3cm left parotid mass and grade 4 facial nerve palsy. Fine needle aspiration of the mass showed scattered cohesive, monolayered sheets of uniform oncocytic cells. Subsequently, a left total parotidectomy and selective neck dissection were performed. Histological examination showed sheets of small oncocytes with minimal nuclear atypia. Evidence of nerve entrapment, capsular invasion and perivascular permeation were identified in focal areas. Thus, a final diagnosis of oncocytic carcinoma was rendered.
    Matched MeSH terms: Biopsy, Fine-Needle
  3. Fulltext Shearwave Elastography Increases Diagnostic Accuracy in Characterization of Breast Lesions
    Ng WL, Rahmat K, Fadzli F, Rozalli FI, Mohd-Shah MN, Chandran PA, et al.
    Medicine (Baltimore), 2016 Mar;95(12):e3146.
    PMID: 27015196 DOI: 10.1097/MD.0000000000003146
    The purpose of this study was to investigate the diagnostic efficacy of shearwave elastography (SWE) in differentiating between benign and malignant breast lesions.One hundred and fifty-nine lesions were assessed using B-mode ultrasound (US) and SWE parameters were recorded (Emax, Emean, Emin, Eratio, SD). SWE measurements were then correlated with histopathological diagnosis.The final sample contained 85 benign and 74 malignant lesions. The maximum stiffness (Emax) with a cutoff point of ≥ 56.0 kPa (based on ROC curves) provided sensitivity of 100.0%, specificity of 97.6%, positive predictive value (PPV) of 97.4%, and negative predictive value (NPV) of 100% in detecting malignant lesions. A cutoff of ≥80 kPa managed to downgrade 95.5% of the Breast Imaging-Reporting and Data System (BI-RADS) 4a lesions to BI-RADS 3, negating the need for biopsy. Using a combination of BI-RADS and SWE, the authors managed to improve the PPV from 2.3% to 50% in BI-RADS 4a lesions.SWE of the breast provides highly specific and sensitive quantitative values that are beneficial in the characterization of breast lesions. Our results showed that Emax is the most accurate value for differentiating benign from malignant lesions.
    Matched MeSH terms: Biopsy
  4. Fulltext One stop centre staging by contrast-enhanced 18F-FDG PET/CT in preoperative assessment of ovarian cancer and proposed diagnostic imaging algorithm: a single centre experience in Malaysia
    Subapriya Suppiah, Andi Anggeriana Andi Asri, Fathinul Fikri Ahmad Saad, Hasyma Abu Hassan, Norhafizah Mohtarrudin, Chang, Wing Liong, et al.
    Malaysian Journal of Medicine and Health Sciences, 2017;13(2):29-37.
    MyJurnal
    Introduction: Suspicious adnexal masses need to be investigated thoroughly as it may represent ovarian cancer, which is the fourth most common gynaecological cancer in Malaysia. Conventional cross sectional imaging may reveal non-specific findings, thus lead to unnecessary biopsies. 18F-Fluorodeoxyglucose positron emission tomography/ computed tomography (18F-FDG PET/CT) has emerged as a useful tool, for characterization of indeterminate adnexal masses. Most studies have been conducted in Western population, and little information is available in Asian population in general and Malaysian population in particular. Methods: Prospective study of women with suspicious adnexal masses, referred to the Centre for Nuclear Diagnostic Imaging, Universiti Putra Malaysia to undergo pre-operative whole-body contrast-enhanced 18F-FDG PET/CT scans from January 2014 to January 2016. Subjects underwent Contrast-Enhanced Computed Tomography (CECT) scans followed by positron emission tomography (PET) scans using a hybrid scanner. Two radiologists analyzed the CECT and PET/CT images by consensus; blinded to the HPE results. Then the PET/CT findings were correlated with HPE results as the gold standard. Results: 11 whole-body PET/CT scans and 18 adnexal masses (12 HPE-proven malignant lesions and 6 benign lesions) were analyzed. The sensitivity, specificity, PPV, and NPV of CECT alone compared to PET/CT was 91.7%, 50.0%, 78.6%, and 75.0% vs. 91.7%, 100%, 100% and 85.7% respectively. Conclusions: Improved diagnostic accuracy for characterizing benign and malignant adnexal masses can be achieved using contrast-enhanced 18F-FDG PET/CT, making it a potential investigation of choice which can help in treatment planning.
    Matched MeSH terms: Biopsy
  5. Cytology of Ki-1-positive anaplastic large cell lymphoma. A report of two cases
    Jayaram G, Abdul Rahman N
    Acta Cytol., 1997 Jul-Aug;41(4 Suppl):1253-60.
    PMID: 9990253
    Ki-1-positive anaplastic large cell lymphoma (Ki-1 ALCL), one of the more recently described pleomorphic types of lymphoma, affects mostly children and adolescents and is sometimes mistaken for carcinoma or sarcoma.
    Matched MeSH terms: Biopsy, Needle
  6. Fulltext Florid cemento-osseous dysplasia as a possible aggravating factor in a case of trigeminal neuralgia.
    Siar, C.H., Ibrahim, N., Omar, A.N., Abdul Rahman, Z.A.
    Ann Dent, 2010;17(1):21-24.
    MyJurnal
    Differential diagnosis of orofacial pain is crucial, as the course of each process and its clinical management varies markedly. A case is illustrated here of trigeminal neuralgia in a 49-year-old Indian female whose complaint was initially diagnosed as dental pain leading to sequential extractions of her right mandibular and maxillary molars but with no pain abatement. Subsequent neurological assessment diagnosed her complaint as trigeminal neuralgia but pain remained poorly controlled even with high doses of carbamazepine and gabapentin. A dental referral and orthopantomographic examination revealed multifocal sclerotic masses in her jaws, suggestive of florid cemento-osseous dysplasia (FCOD). Right mandibular incisional biopsy confirmed the diagnosis. A decision was made to curette the right mandibular masses and lateralised the right inferior dental nerve. Follow-up disclosed considerable pain reduction. This case raises the issue as to whether the sclerotic bone masses in FCOD may have caused nerve compression which
    aggravated her neuralgic pain.
    Matched MeSH terms: Biopsy
  7. Fulltext A case report of juvenile giant fibroadenoma of the breast: How common?
    Mohd Firdaus CA, Norjazliney AJ, Abdul Rashid NF
    Ci Ji Yi Xue Za Zhi, 2017 10 5;29(3):177-179.
    PMID: 28974914 DOI: 10.4103/tcmj.tcmj_64_17
    Breast lesions are rare prepubescents. The majority of breast lesions in this age group are benign. The most common of these rare lesions is juvenile fibroadenoma, which accounts for only 0.5% of all fibroadenomas. It is uncommon to have a palpable lesion in juveniles as very small lesions show obvious asymmetry. Fibroadenomas can grow to a large size, and surgical intervention is cosmetically challenging, especially in achieving symmetry in a developing breast. A 12-year-old girl presented with right breast swelling associated with tenderness. The mass had initially been small on self-discovery 1 year previously and grew with time. There was no overlying skin changes or any significant risk factors for breast malignancy. Triple assessment showed features of fibroadenoma, but we were unable to rule out a phyllodes tumor. She subsequently underwent excision biopsy of the right breast lesion for symptomatic control and histopathology examination (HPE) of the lesion. The HPE report confirmed the diagnosis of fibroadenoma. The patient recovered well postoperatively with no complications. Juvenile breast lesions are rare, and it is a challenge to provide an adolescent with the best treatment in terms of clinical and psychological care. A surgical approach requires meticulous planning to ensure a fine balance between adequate resection and the best cosmetic outcome for a developing breast.
    Matched MeSH terms: Biopsy
  8. Fulltext Predictive factors of prostate cancer diagnosis with PSA 4.0-10.0 ng/ml in a multi-ethnic Asian population, Malaysia
    Yii RSL, Lim J, Sothilingam S, Yeoh WS, Fadzli AN, Ong TA, et al.
    Asian J Surg, 2020 Jan;43(1):87-94.
    PMID: 30962017 DOI: 10.1016/j.asjsur.2019.02.014
    OBJECTIVES: To identify the associated factors determining prostate cancer detection using transrectal ultrasound (TRUS)-guided prostate biopsy, within a multi-ethnic Malaysian population with prostate specific antigen (PSA) between 4.0 and 10.0 ng/ml.

    METHODS: Study subjects included men with initial PSA between 4.0 and 10.0 ng/ml that have undergone 12-core TRUS-guided prostate biopsy between 2009 and 2016. The prostate cancer detection rate was calculated, while potential factors associated with detection were investigated via univariable and multivariable analysis.

    RESULTS: A total of 617 men from a multi-ethnic background encompassing Chinese (63.5%), Malay (23.1%) and Indian (13.3%) were studied. The overall cancer detection rate was 14.3% (88/617), which included cancers detected at biopsy 1 (first biopsy), biopsy 2 (second biopsy with previous negative biopsy) and biopsy ≥ 3 (third or more biopsies with prior negative biopsies). Indian men displayed higher detection rate (23.2%) and increased risk of prostate cancer development (OR 1.85, 95% CI 1.03-3.32, p 

    Matched MeSH terms: Image-Guided Biopsy/methods
  9. Fulltext Biomarkers for Bone Tumors: Discovery from Genomics and Proteomics Studies and Their Challenges
    Wan-Ibrahim WI, Singh VA, Hashim OH, Abdul-Rahman PS
    Mol. Med., 2016 Mar;21(1):861-872.
    PMID: 26581086 DOI: 10.2119/molmed.2015.00183
    Diagnosis of bone tumor currently relies on imaging and biopsy, and hence, the need to find less invasive ways for its accurate detection. More recently, numerous promising deoxyribonucleic acid (DNA) and protein biomarkers with significant prognostic, diagnostic and/or predictive abilities for various types of bone tumors have been identified from genomics and proteomics studies. This article reviewed the putative biomarkers for the more common types of bone tumors (that is, osteosarcoma, Ewing sarcoma, chondrosarcoma [malignant] and giant cell tumor [benign]) that were unveiled from the studies. The benefits and drawbacks of these biomarkers, as well as the technology platforms involved in the research, were also discussed. Challenges faced in the biomarker discovery studies and the problems in their translation from the bench to the clinical settings were also addressed.
    Matched MeSH terms: Biopsy
  10. A low cost solution for post-biopsy complications using available RFA generator and coaxial core biopsy needle
    Azlan CA, Mohd Nasir NF, Saifizul AA, Faizul MS, Ng KH, Abdullah BJ
    Australas Phys Eng Sci Med, 2007 Dec;30(4):288-91.
    PMID: 18274069
    Percutaneous image-guided needle biopsy is typically performed in highly vascular organs or in tumours with rich macroscopic and microscopic blood supply. The main risks related to this procedure are haemorrhage and implantation of tumour cells in the needle tract after the biopsy needle is withdrawn. From numerous conducted studies, it was found that heating the needle tract using alternating current in radiofrequency (RF) range has a potential to minimize these effects. However, this solution requires the use of specially designed needles, which would make the procedure relatively expensive and complicated. Thus, we propose a simple solution by using readily available coaxial core biopsy needles connected to a radiofrequency ablation (RFA) generator. In order to do so, we have designed and developed an adapter to interface between these two devices. For evaluation purpose, we used a bovine liver as a sample tissue. The experimental procedure was done to study the effect of different parameter settings on the size of coagulation necrosis caused by the RF current heating on the subject. The delivery of the RF energy was varied by changing the values for delivered power, power delivery duration, and insertion depth. The results showed that the size of the coagulation necrosis is affected by all of the parameters tested. In general, the size of the region is enlarged with higher delivery of RF power, longer duration of power delivery, and shallower needle insertion and become relatively constant after a certain value. We also found that the solution proposed provides a low cost and practical way to minimizes unwanted post-biopsy effects.
    Matched MeSH terms: Biopsy, Needle/adverse effects; Biopsy, Needle/economics; Biopsy, Needle/instrumentation*
  11. Thyroid cancer: The Kuala Lumpur experience
    Abdullah M
    ANZ J Surg, 2002 Sep;72(9):660-4.
    PMID: 12269919
    There have been few detailed studies on thyroid cancer (TC) in Malaysia, a multiethnic country with three major races - Malays, Chinese and Indians.
    Matched MeSH terms: Biopsy, Needle
  12. Fulltext Detection of human papillomavirus, p53 and c-erbb-2 protein expression in juvenile laryngeal papillomatosis: a report of 2 cases
    Siti Aishah Md Ali, Ilina Isahak, Dahlan Sabi, Fatimah Sahlan, Lokman Saim, Abdullah Sani Mohamed
    Medicine & Health, 2006;1(1):67-74.
    MyJurnal
     The association of human papillomavirus (HPV) with juvenile laryngeal papillomatosis has been well documented. We report two cases of juvenile laryngeal papillomatosis and correlated these cases with presence of HPV, p53 and c-erbB-2 proteins. The first case was a one-year-old male patient and the second a six-year-old female patient. Formalin-fixed paraffin-embedded biopsy specimens were tested for the presence of HPV genome by the technique of in situ hybridisation using wide spectrum and type specific biotinylated probes while the immunohistochemical expression of p53 (D07, 1:50) and c-erbB-2 (DAKO A0485, 1:300) proteins were evaluated with commercially available antibodies. Histologically the tumours in both cases showed papillary configuration of squamous papilloma. The first case detected HPV type 6, HPV type 11 and p53 protein expression while the second case showed only HPV type 6. Both cases of HPV showed positive signals confined to the nuclei in the superficial squamous epithelium. The first case showed p53 positivity seen from the basal region up to one third of the epithelium of laryngeal papillomas and the subsequent recent repeat biopsy showed the positivity of p53 had extended throughout the upper layers of the epithelium. Expression of c-erbB-2 protein was not detected in both cases. These findings were similar as in other studies where follow-up of the cases was recommended since they tend to recur.
    Matched MeSH terms: Biopsy
  13. Fulltext A case of kala-azar diagnosed by bone marrow aspiration
    Hamidah NH, Cheong SK, Abu Hassan J
    Malays J Pathol, 1995 Jun;17(1):39-41.
    PMID: 8907004
    A 35-year-old man from Bangladesh, who had been in Malaysia for approximately a year, was extensively investigated for more than two months in a state hospital for pyrexia with hepatosplenomegaly. However, no obvious cause of his illness was found. He was treated with multiple antibiotics with no resolution of pyrexia and hepatosplenomegaly. He was later referred to the Haematology Unit, Universiti Kebangsaan Malaysia for further assessment as a case of lymphoma. On carefully reviewing his bone marrow aspirate smears, the diagnosis of leishmaniasis (kala-azar) was finally made. The patient responded to treatment with pentamidine.
    Matched MeSH terms: Biopsy, Needle
  14. Fulltext Synovial Tissue Infection with Burkholderia fungorum
    Loong SK, Soh YH, Mahfodz NH, Johari J, AbuBakar S
    Emerg Infect Dis, 2016 10;22(10):1834-5.
    PMID: 27648477 DOI: 10.3201/eid2210.151114
    Matched MeSH terms: Biopsy
  15. Interpretation of radiomics features-A pictorial review
    Abbasian Ardakani A, Bureau NJ, Ciaccio EJ, Acharya UR
    Comput Methods Programs Biomed, 2022 Mar;215:106609.
    PMID: 34990929 DOI: 10.1016/j.cmpb.2021.106609
    Radiomics is a newcomer field that has opened new windows for precision medicine. It is related to extraction of a large number of quantitative features from medical images, which may be difficult to detect visually. Underlying tumor biology can change physical properties of tissues, which affect patterns of image pixels and radiomics features. The main advantage of radiomics is that it can characterize the whole tumor non-invasively, even after a single sampling from an image. Therefore, it can be linked to a "digital biopsy". Physicians need to know about radiomics features to determine how their values correlate with the appearance of lesions and diseases. Indeed, physicians need practical references to conceive of basics and concepts of each radiomics feature without knowing their sophisticated mathematical formulas. In this review, commonly used radiomics features are illustrated with practical examples to help physicians in their routine diagnostic procedures.
    Matched MeSH terms: Biopsy
  16. Bullous pemphigoid--management of a patient with oral and skin lesions
    Ali TB, Zain RB, Adam BA
    Singapore Dent J, 1994 Jan;19(1):18-21.
    PMID: 9582679
    A case of bullous pemphigoid with extra-oral and intraoral lesions in a 60-year-old female is reported. Diagnosis is based on histopathology and direct immunofluorescence, and the treatment regime described included oral prescription of prednisolone and topical application of a mixture of fluocinonide ointment and triamcinolone acetonide in Orabase on the oral lesions.
    Matched MeSH terms: Biopsy
  17. Fulltext Orbital rhabdomyosarcoma: a case series
    Chen, C.Y., Nor Hidayah, A.B., Adil, H.
    Malaysian Journal of Medicine and Health Sciences, 2013;9(2):69-72.
    MyJurnal
    In this paper, we report three cases of orbital rhabdomyosarcoma in different age groups with different histopathologic types. Case 1 is a 10-year old Malay boy who presented with painless proptosis of the left eye. Magnetic resonance imaging (MRI) showed soft tissue mass arising from the lateral rectus muscle. Tissue biopsy revealed rhabdomyosarcoma of embryonal type. Case 2 is a 32-year old Malay man who presented with a progressive left eye proptosis associated with pain and redness. Computed Tomography (CT) scan showed a retrobulbar mass extending medially in the left orbit. Meanwhile, biopsy showed rhabdomyosarcoma of pleomorphic type. Case 3 is a 67-year old Malay woman who presented with proptosis and fungating growth of left orbital region, epistaxis and nasal blockage. CT scan revealed an ill-defined mass filling up the left orbital cavity. Biopsy showed rhabdomyosarcoma of alveolar type. Rhabdomyosarcoma is the most common in childhood but it should be considered as a differential diagnosis of orbital tumours irrespective of age.
    Matched MeSH terms: Biopsy
  18. Laser-heated needle for biopsy tract ablation: In vivo study of rabbit liver biopsy
    Raziff HHA, Tan D, Tan SH, Wong YH, Lim KS, Yeong CH, et al.
    Phys Med, 2021 Feb;82:40-45.
    PMID: 33581616 DOI: 10.1016/j.ejmp.2021.01.067
    PURPOSE: To investigate the efficacy of a newly-developed laser-heated core biopsy needle in the thermal ablation of biopsy tract to reduce hemorrhage after biopsy using in vivo rabbit's liver model.

    MATERIALS AND METHODS: Five male New Zealand White rabbits weighed between 1.5 and 4.0 kg were anesthetized and their livers were exposed. 18 liver biopsies were performed under control group (without tract ablation, n = 9) and study group (with tract ablation, n = 9) settings. The needle insertion depth (~3 cm) and rate of retraction (~3 mm/s) were fixed in all the experiments. For tract ablation, three different needle temperatures (100, 120 and 150 °C) were compared. The blood loss at each biopsy site was measured by weighing the gauze pads before and after blood absorption. The rabbits were euthanized immediately and the liver specimens were stained with hematoxylin-eosin (H&E) for further histopathological examination (HPE).

    RESULTS: The average blood loss in the study group was reduced significantly (p 

    Matched MeSH terms: Biopsy, Needle
  19. Fulltext Thumb Schwannoma : A Frequent Misdiagnosis
    Mooi SS, Ahmad TS
    Malays Orthop J, 2016 Mar;10(1):53-54.
    PMID: 28435548 MyJurnal DOI: 10.5704/MOJ.1603.010
    A 32 year-old Malay lady presented with a swelling over the dorsal surface of her right thumb for 6 months. The swelling was non-tender, smooth surfaced, mobile and nonfluctuating with no bony involvement. The provisional diagnosis was ganglion cyst. Excisional biopsy did not show features of ganglion cyst as it appeared to be wellencapsulated, multi-lobulated and yellowish in colour. Histopathological examination showed that it was a schwannoma. Schwannomas are relatively rare benign tumours which are frequently misdiagnosed. In this case, it was misdiagnosed both as a ganglion and a lipoma.
    Matched MeSH terms: Biopsy
  20. Fulltext Fibreoptic bronchoscopy--a Malaysian experience
    Yaacob I, Harun Z, Ahmad Z
    Singapore Med J, 1991 Feb;32(1):26-8.
    PMID: 2017700
    Two hundred and ninety-three bronchoscopies were done for 285 patients (78% males, 22% females) at Hospital University Sains Malaysia between 1984 and 1988. The mean age was 56.4 years (range 13 to 90 years). 70.2% of patients underwent bronchoscopies to confirm or exclude the diagnosis of carcinoma of the bronchus, out of which 58% were confirmed to have bronchial carcinoma. 77% of the 98 patients with visible endobronchial tumours had biopsy specimens diagnostic of malignancy. Brushing and washing cytology increased the positive yield to 92%. The commonest histological type of bronchial carcinoma identified was squamous cell carcinoma (48.1%), followed by small cell carcinoma (27.1%), anaplastic/undifferentiated carcinoma (12.9%), adenocarcinoma (9.4%) and large cell carcinoma (2.4%). Bronchoscopy for the investigation of haemoptysis identified the commonest cause as 'bronchitis'. There were no complications noted in our series. Notable differences of our experience compared to that of the western series were the high percentage of bronchoscopy done for infective respiratory disorders and the younger age of our patients.
    Matched MeSH terms: Biopsy
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