Displaying publications 1 - 20 of 83 in total

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  1. 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
  2. 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to this procedure are haemorrhage and implantation of tumour cells in the needle tract after the biopsy needle is withdrawn.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*
  3. 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
  4. 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
  5. 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
  6. Lukman MR, Jasmi AY, Sarinah B, Nurismah MI, Aishah MA
    Asian J Surg, 2005 Jul;28(3):227-9.
    PMID: 16024322
    Extragonadal teratomas and germ cell tumours are uncommon. Most teratomas of the head and neck present in the paediatric age group. Occurrence of such tumours in an adult is extremely rare and, to date, less than 40 cases have been reported in the literature. We report a case of a young man presenting with impending airway obstruction secondary to a malignant teratoma of the neck.
    Matched MeSH terms: Biopsy, Needle
  7. Jayaram G, Razak A, Gan SK, Alhady SF
    Malays J Pathol, 1999 Jun;21(1):17-27.
    PMID: 10879275
    1853 thyroid lesions subjected to cytological sampling (either by the fine needle aspiration or fine needle capillary sampling technique) from January 1992 to December 1997 at the University Hospital, Kuala Lumpur, were reviewed. Nodular goitre was the most common thyroid lesion needled (67.35%). Among the neoplastic lesions, follicular neoplasms predominated (64%), followed by papillary carcinoma (29.4%). In 325 cases, partial or total thyroidectomy had been done, providing material for histological review and cyto-histological correlation. Cytological diagnosis was found to have high sensitivity and specificity rates of over 75%. Besides, most non-neoplastic thyroid lesions could be diagnosed on cytology. The scope of cytology in the diagnosis of lymphomas, anaplastic and metastatic tumours rendered diagnostic biopsies (or thyroidectomy) unnecessary in these cases. Being a cost-effective technique and having the capacity to provide exact morphological diagnosis in a large variety of thyroid lesions, cytology is obviously the method of choice in the assessment of thyroid nodules.
    Matched MeSH terms: Biopsy, Needle
  8. Yip CH, Jayaram G, Alhady SF
    Med J Malaysia, 2000 Sep;55(3):363-7.
    PMID: 11200718
    A total of 676 palpable breast lumps seen in the Breast Clinic, University Hospital, Kuala Lumpur from August 1993 to August 1994 were subjected to fine needle aspiration cytology. Fifty-four were reported as inadequate, 501 benign, 95 malignant and 26 suspicious. One hundred and eighty-seven aspirates had histological correlation, while 34 of the malignant aspirates had clinical correlation. The majority of the other 455 patients were followed up for a period of 60 to 72 months without any malignancies becoming apparent. For analysis, only the 221 cases with histological or clinical correlation were included, (the suspicious category was included into the positive group and the inadequate cases were excluded), giving a sensitivity of 91.7%, a specificity of 91.7% and a diagnostic accuracy of 91.7%. Breast cytology was an accurate and rapid method of diagnosis of breast diseases, and in a busy surgical unit with limited operating time, it allowed for the triage of patients with breast complaints in deciding which cases needed early open biopsy. A negative cytology does not exclude the possibility of cancer, as there was a false negative rate of 11%. However by utilising a diagnostic triad of clinical examination, radiological assessment and fine needle aspiration cytology, the risk of missing a malignancy is small.
    Matched MeSH terms: Biopsy, Needle*
  9. Kowdley KV, Sundaram V, Jeon CY, Qureshi K, Latt NL, Sahota A, et al.
    Hepatology, 2017 04;65(4):1094-1103.
    PMID: 28027579 DOI: 10.1002/hep.29005
    Eight weeks duration of ledipasvir/sofosbuvir (LDV/SOF) can be considered in genotype 1 hepatitis C virus-infected patients who are treatment-naive, do not have cirrhosis, and have a pretreatment viral load <6,000,000 IU/mL. The effectiveness of this regimen, however, has not been fully confirmed by real-world experience. Using data from real-world cohorts, we aimed to determine the effectiveness of 8 weeks of LDV/SOF treatment, examine variables associated with relapse after treatment with this regimen, and compare the effectiveness of 8 weeks and 12 weeks of LDV/SOF treatment. To evaluate the effectiveness of 8 weeks of therapy and characteristics associated with relapse, we used individual patient data from the IFI (Institut für Interdisziplinäre Medizin), Burman's Pharmacy, and Kaiser Permanente Southern California. All patients had fibrosis staging assessed with biopsy, transient elastography, or serum biomarkers. We also performed a systematic review and meta-analysis of six additional real-world cohorts, to compare effectiveness of 8 weeks to 12 weeks duration. In our pooled data analysis, 634 patients were treated for 8 weeks with LDV/SOF, of whom all had outcomes of cure or relapse without loss to follow-up. Per protocol rates of sustained virologic response at 12 weeks were 98.1% (622/634) in the full cohort and 97.9% (571/583) among treatment-eligible patients. Exact logistic regression revealed no specific patient characteristics associated with relapse. Our meta-analysis of six additional real-world cohorts, comprised of 5,637 patients, demonstrated similar risk for relapse between 8 weeks and 12 weeks of LDV/SOF (relative risk = 0.99, 95% confidence interval 0.98-1.00).

    CONCLUSION: An 8-week duration of treatment with LDV/SOF is highly effective in properly selected patients; greater use of this regimen is recommended. (Hepatology 2017;65:1094-1103).

    Matched MeSH terms: Biopsy, Needle
  10. Ng WM, Chan KY
    Med J Malaysia, 2004 Dec;59 Suppl F:69-71.
    PMID: 15941169
    We report a case of delayed diagnosis of tarsal tunnel syndrome caused by a ganglion arising from the talo-calcaneal joint. Unusually the symptoms were mainly due to the lateral planter nerve compression with a positive Tinel's sign. A surgical decompression was successful in relieving the dysaesthesia in spite of a 7 years history.
    Matched MeSH terms: Biopsy, Needle
  11. Ng, W.M., Ong, T.C., Kwan, M.K., Cheok, C.Y.
    Malays Orthop J, 2008;2(1):49-51.
    MyJurnal
    We report here a rare presentation of an extra-nodal non-Hodgkin's lymphoma. Both clinical presentation radiological findings were suggestive of psoas abscess. Surgical debridement was performed and histopathological examination of the tissue sample revealed the diagnosis of non-Hodgkin's lymphoma. It is therefore important to note that non-Hodgkin's lymphoma can mimic psoas abscess and that psoas lesion with vertebral involvement does not necessarily indicate infection. It is always advisable to obtain needle biopsy to establish diagnosis before embarking on surgical intervention. The practice to send any suspicious tissue obtained intra-operatively for histopathological examination is also warranted.
    Matched MeSH terms: Biopsy, Needle
  12. Leong CF, Zainina S, Cheong SK
    Malays J Pathol, 2005 Jun;27(1):39-43.
    PMID: 16676692
    Anaemia is a frequent complication in patients with haematological malignancies and is caused by a variety of mechanisms including neoplastic cell infiltration into the bone marrow, haemolysis, nutritional deficiencies and defect in erythropoiesis or dysplastic anaemia as a result of the disease itself. However, acquired dysplastic anaemia which mimic congenital dyserythropoietic anaemia (CDA) type II morphology in the bone marrow is very rare. A 41-year-old Chinese man presented with refractory symptomatic anaemia in September 2001. He was clinically pale with no other significant physical finding. His initial peripheral blood picture showed normochromic normocytic anaemia with haemoglobin level of 26g/L, with no evidence of haemolysis and a poor reticulocyte response of 0.6%. Bone marrow aspiration was done and showed congenital dyserythropoietic anaemia (CDA) type II-like morphology. He was treated symptomatically with regular blood transfusions approximately every 3 weeks, until August 2002 when he developed multiple cervical lymphadenopathy with loss of appetite, loss of weight and low grade fever. Biopsy of the lymph node confirmed the diagnosis of small lymphocytic lymphoma. Staging with computed tomography and bone marrow aspirate revealed the infiltration of lymphoma cells into the marrow cavity consistent with the staging of IVB. This case report illustrates that CDA type II-like dysplastic anaemia can preceed the development of lymphoma.
    Matched MeSH terms: Biopsy, Needle
  13. Fadilah SA, Cheong SK
    Singapore Med J, 2000 Dec;41(12):595-8.
    PMID: 11296785
    A 37-year-old Malay man presented initially with the clinical picture of essential thrombocythaemia (ET) without the extreme leukocytosis, marked splenomegaly and low neutrophil alkaline phosphatase characteristic of chronic myelogenous leukaemia (CML). Bone marrow examination showed massive megakaryocytic hyperplasia; cytogenetic studies showed the presence of Philadelphia chromosome. The patient was treated with hydroxyurea that resulted in reduction in the platelet count. Seventeen months later, he presented with fever associated with tender massive splenomegaly. Bone marrow finding was consistent with chronic phase CML. The presence of a rearrangement involving the major breakpoint cluster region (M-bcr) on chromosome 22 was confirmed by reverse transcriptase-polymerase chain reaction. The clinical importance of finding the Philadelphia chromosome in patients who seem to have ET is in assessing prognosis. ET generally follows a chronic, indolent course. However, this patient who had Philadelphia chromosome underwent clinical transition to chronic phase CML17 months and blast crisis 29 months after presentation.
    Matched MeSH terms: Biopsy, Needle
  14. Jayaram G, Chew MT
    Acta Cytol., 2000 Nov-Dec;44(6):960-6.
    PMID: 11127753
    OBJECTIVE: To assess the role of fine needle aspiration cytology (FNAC) in lymphadenopathy in human immunodeficiency virus-infected individuals (HIVII).

    STUDY DESIGN: Thirty-nine HIVII presenting with lymphadenopathy at University Hospital, Kuala Lumpur, were subjected to FNAC. Cytologic smears were routinely stained with May-Grünwald-Giemsa stain. Special stains and immunostains were used when necessary.

    RESULTS: In nine cases, the cytologic appearance was compatible with HIV type A and in one case with HIV type C lymphadenopathy. In 21 cases, acid-fast bacilli (AFB) were demonstrated in the cytologic smears, enabling a diagnosis of mycobacterial lymphadenitis. In one of these cases there was a concomitant infection with Penicillium marneffei that was overlooked on initial cytologic examination. The cause of granulomatous lymphadenitis could not be ascertained in one case, where neither AFB nor any other organisms were demonstrable. Two cases of histoplasma and one of cryptococcal lymphadenitis were diagnosed, as was one high grade non-Hodgkin's lymphoma that could be immunophenotyped on cytologic material. In three cases the aspirates were inadequate for a cytologic diagnosis.

    CONCLUSION: Lymph node FNAC is a valuable investigative modality in HIVII. Most opportunistic infections (bacterial and fungal) can be correctly identified, and high grade lymphoma can be diagnosed and phenotyped.
    Matched MeSH terms: Biopsy, Needle*
  15. Anandan S, Othman M, Cheong I, Chin GL
    Singapore Med J, 1995 Oct;36(5):559-61.
    PMID: 8882549
    In recent years there have been many reports of connective tissue diseases especially scleroderma following exposure to silica and silicone. We report a 51-year-old Chinese who developed a scleroderma-like disease and pulmonary silicosis eight years after exposure to silica. To our knowledge, this is the first case to be reported in Malaysia.
    Matched MeSH terms: Biopsy, Needle
  16. Lee JS, Choi SJ, Kim L, Park IS, Han JY, Kim JM, et al.
    Malays J Pathol, 2019 Aug;41(2):213-222.
    PMID: 31427559
    INTRODUCTION: Anaplastic lymphoma kinase-positive (ALK+) anaplastic large cell lymphoma (ALCL) with a non-common pattern can be diagnostic challenging. Pathologists can be unavoidably and unintentionally blind to non-descript tumor cells in a lymphohistiocytic- (LH) or small-cell (SC)-pattern. We report a case of primary systemic ALK+ ALCL with a SC pattern that presented as secondary gastric lesions with a mixed LH and SC pattern that was masqueraded as inflammatory lesions.

    CASE REPORT: A 34-year-old woman with intractable epigastric pain was referred to have repeated endoscopy with biopsy. She was found to multiple gastric erosions and nodules that were diagnosed as inflammatory lesions both endoscopically and histologically. Meanwhile, she developed an acute onset of severe back pain associated with a pathologic compression fracture in the T3 thoracic vertebral body. Imaging studies disclosed a disseminated systemic disease involving abdominopelvic lymph nodes and cervical and thoracic vertebral bodies. The needle biopsy of the pelvic lymph node disclosed diffuse proliferation of monomorphic small round cells that were diffusely positive for CD30 and ALK. A diagnosis of ALK+ ALCL with a monomorphic SC pattern was rendered.

    DISCUSSION: A retrospective review of the gastric biopsies with the aid of immunohistochemistry enabled us to recognise the presence of lymphomatous infiltrates with a mixed LH and SC pattern in every piece of gastric biopsies that were repeatedly misdiagnosed as inflammatory lesions. This case illustrates a significant diagnostic pitfall of the LH- and SC-patterns in ALK+ ALCL, in which the tumour cells featuring lymphoid, plasmacytoid or histiocytoid appearance can be masqueraded as inflammatory cells.

    Matched MeSH terms: Biopsy, Needle
  17. Jayaram G, Dashini M
    Malays J Pathol, 2001 Dec;23(2):93-100.
    PMID: 12166598
    141 salivary gland lesions that were subjected to fine needle aspiration (FNA) cytology at the University Hospital, Kuala Lumpur, from January 1993 to October 2000 were reviewed with a view to assess the sensitivity and utility of cytological diagnosis in diseases of salivary glands. The highest number of cases was seen in the sixth decade of life. There was no gender preponderance in salivary gland neoplasms except in Warthin's tumours that occurred predominantly in males. The parotid gland was the most frequent salivary gland needled. Seven cases (5%) presented with bilateral salivary gland enlargement. Cytological study yielded a neoplastic diagnosis in 74.5% cases. Of the neoplastic lesions, 71.4% could be definitely designated as benign and 25.7% as clearly malignant. Pleomorphic adenoma and acinic cell carcinoma were the most common benign and malignant neoplasms diagnosed respectively. 53 cases had histological correlation; of these, 49 (92.5%) were neoplastic. The overall diagnostic accuracy of FNA cytological diagnosis in salivary gland lesions was found to be 73.6%.
    Matched MeSH terms: Biopsy, Needle/standards*
  18. Ross IN, Dass PK
    Med J Malaysia, 1985 Sep;40(3):225-32.
    PMID: 3842717
    We analysed clinical and histological diagnoses in patients admitted with liver-related illnesses in order to determine the spectrum ofliver disease in our community. In a total of 380 such patients, liver disease was sixfold more frequent in males than in females. Admissions for cirrhosis were more common amongst the Indian ethnic group. Indians constituted 39% of the admissions (expected 11. 7%), Chinese 37% (expected 51%) and Malays 21% (expected 36%) (~2 = 293, p = H 0.001). Liver histology from 179 of the patients was reviewed blind by one pathologist. Based on the histological findings, the pre-biopsy diagnosis was 'wrongin 75%of cases. The age standardized incidence rate of hepatocellular carcinoma was 22/100,000/year in males 225 and 5/100,000/year in females. However, the peak age of onset was in the seventh decade and the age specific incidence in males aged 60 years or older was 93/100,000/year. The ethnic group representation of patients with hepatocellular carcinoma did notshow a racial preponderance. This study highlights a public health problem related to acute viral hepatitis and alcohol abuse. It also confirms a high incidence of hepatocellular carcinoma
    Matched MeSH terms: Biopsy, Needle
  19. Rajandram RK, Ramli R, Karim F, Rahman RA, Fun LC
    N Z Med J, 2007;120(1256):U2590.
    PMID: 17589558
    Agranulocytosis is a rare complication of ticlopidine and can be life-threatening. We report a case of ticlopidine-induced agranulocytosis and neutropenia (neutrophil count of 0.1 x 10(9)/L) with necrotizing gingivitis in a 54-year-old Malaysian-Chinese female. She was started on ticlopidine 250 mg twice daily 3 weeks prior to this hospital admission. We started her on intravenous metronidazole and amoxicillin and clavulanic acid (Augmentin) and concurrently stopped ticlopidine. A series of clinical and laboratory investigations were carried out and a final diagnosis of necrotizing gingivitis possibly secondary to agranulocytosis was made. The patient was discharged home after 2 weeks of hospitalisation.
    Matched MeSH terms: Biopsy, Needle
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