MyMedR

Teh CS, Jayalakshmi P, Chong SY

Ear Nose Throat J, 2014 Sep;93(9):E22-5.

We encountered a patient with a tongue base lymphoma that we initially diagnosed as a lingual tonsil in view of its benign appearance. We established the correct diagnosis of Waldeyer ring lymphoma by histology. This case led us to conduct a study of all cases of Waldeyer ring lymphoma that had been treated at our center during a 10-year period. We retrospectively examined our case records and found 35 such cases. From this group, we excluded 5 cases because of incomplete data. Thus our final study group was made up of 30 patients-14 males and 16 females, aged 14 to 76 years (mean: 51.6; median 54). The primary presenting signs and symptoms were dysphagia (n = 17 [57%]), a neck mass (n = 7 [23%]), nasal symptoms (n = 5 [17%]), and pain (n = 1 [3%]). Only 4 patients (13%) had B symptoms. A total of 20 patients (67%) presented with tonsillar involvement, 8 (27%) with nasopharyngeal involvement, 1 (3%) with tongue base lymphoma, and 1 with anterior tongue involvement. Most patients (77%) presented at an early stage. Histologically, 25 patients (83%) had high-grade diffuse large B-cell lymphoma, 4 (13%) had T-cell lymphoblastic lymphoma, and 1 (3%) had follicular lymphoma. Twenty-one patients (70%) were treated with chemotherapy, 4 (13%) received adjuvant chemotherapy with either radiotherapy or surgery, 3 (10%) resorted to other forms of treatment (primarily traditional remedies), and 2 (7%) declined treatment altogether. There were 14 patients (47%) alive at the end of the study period.

Matched MeSH terms: Nasopharyngeal Neoplasms/diagnosis*

Fulltext Social impact of nasopharyngeal carcinoma on Chinese households in Selangor, Malaysia

Armstrong RW, Armstrong MJ, Lye MS

Singapore Med J, 2000 Dec;41(12):582-7.

PMID: 11296783

With a five-year survival rate of 20% in 1970 and 40-45% in 1990, and highest incidence and mortality in early and middle adult years, nasopharyngeal carcinoma (NPC) may have a severe social impact on families and households. The aim of this study was to measure the social impact of NPC in the Chinese population of Selangor, Malaysia.

Matched MeSH terms: Nasopharyngeal Neoplasms/diagnosis

Fulltext Sino-nasal hemangiopericytoma--a rare tumor

Vikneswaran T, Gendeh BS, Tan VES, Phang KS, Saravanan K

Med J Malaysia, 2005 Oct;60(4):485-8.

PMID: 16570712

Hemangiopericytoma is a very rare angiogenic tumor. In the nasal cavity, it can be considered malignant. It occurs in various parts of the body but those in the nasal cavity account for only 5% of total cases. Less than 200 cases have been reported worldwide involving the nose and paranasal sinuses. Due to its rarity a proper line of management has not been established to tackle this tumour. This article highlights two cases of hemangiopericytoma (HPC), one in an adult and the other in a child, presenting as an intranasal mass.

Matched MeSH terms: Nasopharyngeal Neoplasms/diagnosis*

Serological markers in the diagnosis of histopathological types of nasopharyngeal carcinoma

Sam CK, Prasad U, Pathmanathan R

Eur J Surg Oncol, 1989 Aug;15(4):357-60.

PMID: 2547665

The titres of IgA against Epstein-Barr virus, viral capsid antigens and the titres of IgG against early antigen were found to be useful markers for the diagnosis of different histopathological types of nasopharyngeal carcinoma.

Matched MeSH terms: Nasopharyngeal Neoplasms/diagnosis*

Screening for nasopharyngeal carcinoma with an ELISA using the Epstein-Barr virus nuclear antigen, EBNA 1: a complementary test to the IgA/VCA immunofluorescence assay

Cheng HM, Foong YT, Mathew A, Sam CK, Dillner J, Prasad U

J Virol Methods, 1993 Apr;42(1):45-51.

PMID: 7686558

An ELISA using the Epstein-Barr virus nuclear antigen 1 (EBNA 1) was found to detect selectively specific IgA in sera from patients with nasopharyngeal carcinoma (NPC). The antigen, p107, was a 20-amino acid synthetic peptide, representing a major epitope of EBNA 1.267/294 (90.8%) of NPC patients had IgA antibodies to p107 but in normal individuals, only 41/577 (7.1%) had IgA/p107. In sera from patients with other cancers, 11/77 (14.3%) had IgA/p107 reactivity. 124 IgA/VCA positive and 86 IgA/VCA negative NPC sera were also tested for IgA/p107 binding in ELISA. The majority of IgA/VCA positive sera (117) also contained IgA/p107 antibodies. Of interest was the detection of 74/86 IgA/p107 reactive sera in the IgA/VCA negative group. The results suggest that the IgA/p107 ELISA could become a useful, complementary screening assay to the IgA/VCA immunofluorescence test for detection of NPC.

Matched MeSH terms: Nasopharyngeal Neoplasms/diagnosis*

Salivary gland anlage tumour of the nasopharynx: A case report and review for histopathological characteristics

Başak K, Günhan Ö, Akbulut S, Aydin S

Malays J Pathol, 2019 Dec;41(3):345-350.

PMID: 31901920

INTRODUCTION: Congenital salivary gland anlage tumour of the nasopharynx is a lesion which usually presents with nasal and upper respiratory tract obstruction in the neonatal period. Timely diagnosis is essential to prevent the occurrence of respiratory complications in later childhood.

CASE REPORT: We present a 8-year-old boy complaining from difficulty in breathing and breastfeeding in the neonatal period due to an adenoid-like nasopharyngeal mass. Histological examination revealed solid and cystic squamous nests and numerous duct-like structures within collagenised stroma. Both epithelial and myoepithelial differentiation were noted in the tubular component.

DISCUSSION: A review of the clinical and histopathological features of published cases revealed that ancient lesions showed more prominent and complex epithelial component and more collagen rich stroma. We would like to suggest the possibility of salivary gland anlage tumour to be considered in the differential diagnosis of neonatal respiratory distress cases.

Matched MeSH terms: Nasopharyngeal Neoplasms/diagnosis

Reducing by half the percentage of late-stage presentation for breast and cervix cancer over 4 years: a pilot study of clinical downstaging in Sarawak, Malaysia

Devi BC, Tang TS, Corbex M

Ann. Oncol., 2007 Jul;18(7):1172-6.

PMID: 17434897 DOI: 10.1093/annonc/mdm105

BACKGROUND:
The registry of the Oncology Departmental in Sarawak General Hospital showed that 79% of nasopharyngeal, 77% of breast and 70% of cervix cancer patients were diagnosed at an advanced stage (stages III and IV) for year 1993. Hence, a low cost Early Cancer Surveillance Program was started in 1994, with the intent of downstaging these three most common cancers in Sarawak.

MATERIALS AND METHODS:
The program consisted of (i) training health staff in hospital and rural clinics to improve their skills in early cancer detection, (ii) raising public awareness through pamphlets, posters and sensitization by health staff.

RESULTS:
Data analysis revealed that the program achieved downstaging in two of the cancers. Breast cancer in stage III and IV was reduced from 60% (1994) to 35% (1998) (P < 0.0001) and cervical cancer in stage III and IV from 60% (1994) to 26% (1998) (P < 0.0001). No reduction was observed for nasopharyngeal cancer at 88% (1994) to 91% (1998).

CONCLUSIONS:
The overall cost of this program was

Matched MeSH terms: Nasopharyngeal Neoplasms/diagnosis

Quantification of Epstein-Barr virus DNA load, interleukin-6, interleukin-10, transforming growth factor-beta1 and stem cell factor in plasma of patients with nasopharyngeal carcinoma

Tan EL, Selvaratnam G, Kananathan R, Sam CK

BMC Cancer, 2006;6:227.

PMID: 16995954

Nasopharyngeal carcinoma (NPC) is a common epithelial neoplasm among the Chinese populations in Southern China and South East Asia. Epstein-Barr virus (EBV) is known to be an important etiologic agent of NPC and the viral gene products are frequently detected in NPC tissues along with elevated antibody titres to the viral proteins (VCA and EA) in a majority of patients. Elevated plasma EBV DNA load is regarded as an important marker for the presence of the disease and for the monitoring of disease progression. However, other serum/plasma parameters such as the levels of certain interleukins and growth factors have also been implicated in NPC. The objectives of the present study are, 1) to investigate the correlations between plasma EBV DNA load and the levels of interleukin (IL)-6, IL-10, TGF-beta1 and SCF (steel factor) and 2) to relate these parameters to the stages of NPC and the effect of treatment.

Matched MeSH terms: Nasopharyngeal Neoplasms/diagnosis*

On optimizing the blocking step of indirect enzyme-linked immunosorbent assay for Epstein-Barr virus serology

Lim CS, Krishnan G, Sam CK, Ng CC

Clin Chim Acta, 2013 Jan 16;415:158-61.

PMID: 23043757 DOI: 10.1016/j.cca.2012.08.031

Because blocking agent occupies most binding surface of a solid phase, its ability to prevent nonspecific binding determines the signal-to-noise ratio (SNR) and reliability of an enzyme-linked immunosorbent assay (ELISA).

Matched MeSH terms: Nasopharyngeal Neoplasms/diagnosis*

Novel Epstein-Barr virus immunoglobulin G-based approach for the specific detection of nasopharyngeal carcinoma

Abdulamir AS, Hafidh RR, Abu Bakar F, Abbas K

Am J Otolaryngol, 2010 Nov-Dec;31(6):410-7.

PMID: 20015794 DOI: 10.1016/j.amjoto.2009.06.006

PURPOSE: This study was designed to find a reliable Epstein-Barr virus (EBV) immunoglobulin (Ig) G-based diagnostic/screening test for nasopharyngeal carcinoma (NPC) able to demarcate between the NPC-related seropositivity of EBV IgG antibodies and that of other head and neck cancer (HNCA) and control groups. The NPC-associated immunosuppression affects EBV IgA much more than IgG, leading to inconsistent detection of NPC using EBV IgA antibodies.
MATERIALS AND METHODS: One hundred twenty-two HNCA patients, 42 NPC, 66 laryngeal carcinoma, and 14 hypopharyngeal carcinoma and 3 groups of 100 control subjects were enrolled in this study. Enzyme-linked immunosorbent assay (ELISA) was used to find a specific cutoff value for the NPC-related seropositivity of EBV IgG antibodies.
RESULTS: NPC group showed higher serum level of EBV IgG antibodies than control and other HNCA groups (P < .05). However, the traditional cutoff value, mean + 2 SDs of control subjects, failed to demarcate the seropositives of NPC patients from those of healthy population (P > .05). The new cutoff value, mean + 2 SDs of the seropositives group of control subjects who had already been grouped by the traditional cutoff value, proved successful. It succeeded to demarcate between the NPC-related EBV IgG seropositivity and that issued from the persistent, latent, or reactivated EBV infection in the population (P < .05). The sensitivity/specificity of NPC detection by the new cutoff-based ELISA kit, 76.19% and 86%, was close or higher than that of EBV IgA antibodies.
CONCLUSION: EBV IgG-based ELISA could be used for the diagnosis of NPC using a new cutoff threshold that excludes the population baseline of EBV IgG seropositivity.

Matched MeSH terms: Nasopharyngeal Neoplasms/diagnosis

Nasopharyngeal chordoma

Sakkarapani V, Panicker C

Med J Malaysia, 1977 Mar;31(3):208-12.

PMID: 904513

Matched MeSH terms: Nasopharyngeal Neoplasms/diagnosis*

Fulltext Nasopharyngeal carcinoma: recognizing it early in children with otitis media with effusion

Noorizan Y, Chew YK, Khir A, Brito-Mutunayagam S

Med J Malaysia, 2008 Aug;63(3):261-2.

PMID: 19248706 MyJurnal

Nasopharyngeal carcinoma (NPC) is a rare disease in children. Children with NPC almost always have the undifferentiated variant of the disease, which is associated with advanced locoregional and distant metastasis. We report two cases to illustrate that high index of suspicion is necessary to diagnose NPC in children especially those with atypical presentation of otitis media with effusion (OME).

Matched MeSH terms: Nasopharyngeal Neoplasms/diagnosis*

Nasopharyngeal carcinoma: clinical trends

Indudharan R, Valuyeetham KA, Kannan T, Sidek DS

J Laryngol Otol, 1997 Aug;111(8):724-9.

PMID: 9327009 DOI: 10.1017/s0022215100138460

Nasopharyngeal carcinoma (NPC) is one of the most difficult diseases to diagnose at an early stage. The clinical presentation of 122 patients with confirmed NPC is described and the findings analysed. The common modes of presentation and cases where detailed nasopharyngeal examination need to be performed are highlighted. We emphasize the importance of health education and training for primary care physicians for early detection of these cases.

Matched MeSH terms: Nasopharyngeal Neoplasms/diagnosis*

Fulltext Nasopharyngeal carcinoma: a delay in diagnosis

Prasad U, Pua KC

Med J Malaysia, 2000 Jun;55(2):230-5.

PMID: 19839151

One hundred consecutive newly diagnosed patients with nasopharyngeal carcinoma (NPC) since January 1994 were the subjects for studying various factors that contribute to the delay in the confirmation of the diagnosis. Seventy-nine of them were males and the peak age of incidence was the fifth decade. Ninety two percent were Chinese, 7% Malay and 1% Indian. Seventy six percent were agriculture workers or labourers with 66% having either no formal education (16%) or only primary level education (50%). In 50% of patients neck swelling was the first presenting symptom, 26% had nasal symptoms, 12% ear symptoms and 11% has symptoms due to intracranial extension of tumour. As many as 80% were at UICC Stage IV at the time of diagnosis. While the median delay, on the part of patients, in consulting a doctor was 2.5 days, the median delay on the part of the doctors to confirm the diagnosis of NPC was 127 days, the delays was particularly worse when the patients presented with ear symptoms (266 days) followed by those with neck swelling (94 days). For those patients who were required to undergo more than one nasopharyngoscopy and biopsy the median doctor's delay was 144 days. Since 82% of patient's had first consulted general practitioners, it is suggested that their level of awareness with regards to the diagnosis of NPC be significantly raised so that the delay on their part be greatly minimized.

Matched MeSH terms: Nasopharyngeal Neoplasms/diagnosis*

Fulltext Nasopharyngeal Carcinoma Database

Pua KC, Khoo AS, Yap YY, Subramaniam SK, Ong CA, Gopala Krishnan G, et al.

Med J Malaysia, 2008 Sep;63 Suppl C:59-62.

PMID: 19230249

Nasopharyngeal carcinoma (NPC) is a cancer which is common in Asia. We report the establishment and early results of a multi-institutional prospective study of nasopharyngeal carcinoma, which seeks to systematically collect data as well as blood and tumour tissue samples from patients diagnosed with nasopharyngeal cancer at six centres in Malaysia. A total of 484 confirmed NPC cases were reported from the six participating centres between 1st July 2007 and 29th February 2008. Of these, 225 were newly diagnosed cases, 53 were recurrent cases and 206 were in remission at the time of reporting. Amongst the newly diagnosed cases, the most common presenting symptom was the presence of neck lumps (42%). Ophthalmo-neurologic symptoms were the presenting symptoms of 11% of the new cases. The majority of cases (75%) presented at stage III/IV.

Matched MeSH terms: Nasopharyngeal Neoplasms/diagnosis

Fulltext Juvenile nasopharyngeal angiofibroma in a tertiary centre: ten-year experience

Tang IP, Shashinder S, Gopala Krishnan G, Narayanan P

Singapore Med J, 2009 Mar;50(3):261-4.

PMID: 19352568

This is a retrospective study that aimed to examine the outcomes of patients presenting with juvenile nasopharyngeal angiofibroma (JNA) at a tertiary centre in Malaysia.

Matched MeSH terms: Nasopharyngeal Neoplasms/diagnosis*

Inclusion bodies of recombinant Epstein-Barr virus capsid antigen p18 as potential immobilized antigens in enzyme immunoassays for detection of nasopharyngeal carcinoma

Lim CS, Goh SL, Kariapper L, Krishnan G, Lim YY, Ng CC

Clin Chim Acta, 2015 Aug 25;448:206-10.

PMID: 26164385 DOI: 10.1016/j.cca.2015.07.008

Development of indirect enzyme-linked immunosorbent assays (ELISAs) often utilizes synthetic peptides or recombinant proteins from Escherichia coli as immobilized antigens. Because inclusion bodies (IBs) formed during recombinant protein expression in E. coli are commonly thought as misfolded aggregates, only refolded proteins from IBs are used to develop new or in-house diagnostic assays. However, the promising utilities of IBs as nanomaterials and immobilized enzymes as shown in recent studies have led us to explore the potential use of IBs of recombinant Epstein-Barr virus viral capsid antigen p18 (VCA p18) as immobilized antigens in ELISAs for serologic detection of nasopharyngeal carcinoma (NPC).

Matched MeSH terms: Nasopharyngeal Neoplasms/diagnosis*

Improved sensitivity of detection by avidin-biotin complex (ABC) immunocytochemistry in Epstein-Barr virus serology

Thoe SY, Sam CK, Cheng HM, Prasad U

J Med Virol, 1989 Dec;29(4):311-4.

PMID: 2559955

Serum antibodies against Epstein-Barr virus (EBV)-determined antigens have traditionally been titrated by the indirect immunofluorescence (IIF) technique. The avidin-biotin complex (ABC) immunocytochemical technique was used to determine the serum levels of IgA against EBV viral capsid antigen (IgA/VCA) and IgA against EBV early antigen (IgA/EA) in sera of 106 nasopharyngeal carcinoma (NPC) patients prior to treatment and 100 normal individuals. The sensitivity of the ABC technique is enhanced by an amplification of the antigen-antibody reaction, which involves the binding of the enzyme-linked ABC to the second biotinylated antibody. There was a good correlation (r = 0.9988) between ABC and IIF-determined IgA/VCA-positive titres, with the ABC technique being more sensitive than IIF in the detection of IgA/VCA in NPC sera: 94% (99/106) and 76% (80/106), respectively. The frequency of IgA/EA reactivity in NPC sera was also markedly increased by immunodetection with the ABC technique as compared with IIF technique: 63% (69/106) and 28% (30/106) respectively. Both the immunocytochemical techniques were equally specific in discriminating between elevated serum titres of IgA/VCA and IgA/EA in NPC sera from normal human sera.

Matched MeSH terms: Nasopharyngeal Neoplasms/diagnosis*

Hypertrophic osteoarthropathy: an unusual manifestation in nasopharyngeal cancer

Biswal BM, Kareem A, Ahmed NM

Australas Radiol, 2001 Feb;45(1):71-3.

PMID: 11259979 DOI: 10.1046/j.1440-1673.2001.00883.x

A patient with nasopharyngeal carcinoma developed clubbing and hypertrophic osteoarthropathy 6 months before radiological detection of secondary deposits in the lung. Another patient with nasopharyngeal carcinoma developed digital clubbing and hypertrophic osteoarthropathy 6 months after the discovery of lung metastases. Development of a paraneoplastic syndrome in the form of hypertrophic osteoarthropathy and digital clubbing is very rare. This manifestation of nasopharyngeal cancers is presented, with a short review of its biology and pathogenesis.

Matched MeSH terms: Nasopharyngeal Neoplasms/diagnosis

Fossa of Rosenmuller and nasopharyngeal carcinoma

Prasad U

Med J Malaysia, 1979 Mar;33(3):222-5.

PMID: 522726

Matched MeSH terms: Nasopharyngeal Neoplasms/diagnosis*

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