MyMedR

Distribution of cord inflammation in cases with clinical suspicion of chorioamnionitis

Wong YP, Tan GC, Khong TY

Malays J Pathol, 2024 Apr;46(1):41-49.

INTRODUCTION: Identification of acute funisitis, a sign of foetal inflammatory response (FIR), is crucial as their presence is associated with ominous neonatal outcomes. Recommendation on which part of umbilical cord should be sampled to facilitate optimal identification of acute funisitis is limited.

METHODS: This is a retrospective cross-sectional study over a seven-month duration recruiting all patients with clinical suspicion of chorioamnionitis and/or maternal intrapartum pyrexia. The distribution and the degree of cord inflammation were assessed. The cases were also evaluated for maternal inflammatory response (MIR) and chorionic vasculitis (CV).

RESULTS: Of the 191 placentas, 88 (46.1%) had some degree of cord inflammation. Forty-nine (55.7%) had a differential in cord inflammation, with distal cord section (n = 38) demonstrating significant greater inflammation than that of proximal cord section (n = 11) (p<0.001). There were 20 cases with phlebitis only and 8 cases demonstrated arteritis only in either proximal or distal cord sections. Increasing magnitude of cord inflammation was significantly associated with increasing severity of MIR and the rate of CV (p<0.001). CV was observed in 25 (24.3%) cases showing absence of cord inflammation, while 12 (13.6%) cases with cord FIR demonstrated no CV.

DISCUSSION: Inflammatory reaction can occur variably throughout the length of the umbilical cord and chorionic plate vessels, with greater inflammation seen in the distal cord section. We affirm the current Amsterdam recommendation of submitting at least two cross sections of the cord representing proximal and distal sites and two sections from placental parenchyma to facilitate the identification of FIR.

Matched MeSH terms: Inflammation/pathology; Placenta/pathology

Fulltext Human Mesenchymal Stem Cell-Derived Miniature Joint System for Disease Modeling and Drug Testing

Li Z, Lin Z, Liu S, Yagi H, Zhang X, Yocum L, et al.

Adv Sci (Weinh), 2022 Jul;9(21):e2105909.

PMID: 35436042 DOI: 10.1002/advs.202105909

Diseases of the knee joint such as osteoarthritis (OA) affect all joint elements. An in vitro human cell-derived microphysiological system capable of simulating intraarticular tissue crosstalk is desirable for studying etiologies/pathogenesis of joint diseases and testing potential therapeutics. Herein, a human mesenchymal stem cell-derived miniature joint system (miniJoint) is generated, in which engineered osteochondral complex, synovial-like fibrous tissue, and adipose tissue are integrated into a microfluidics-enabled bioreactor. This novel design facilitates different tissues communicating while still maintaining their respective phenotypes. The miniJoint exhibits physiologically relevant changes when exposed to interleukin-1β mediated inflammation, which are similar to observations in joint diseases in humans. The potential of the miniJoint in predicting in vivo efficacy of drug treatment is confirmed by testing the "therapeutic effect" of the nonsteroidal anti-inflammatory drug, naproxen, as well as four other potential disease-modifying OA drugs. The data demonstrate that the miniJoint recapitulates complex tissue interactions, thus providing a robust organ chip model for the study of joint pathology and the development of novel therapeutic interventions.

Matched MeSH terms: Adipose Tissue/pathology; Knee Joint/pathology

Fulltext Cancer Metastases to the Hand: A Systematic Review and Meta-analysis

Dow T, Davis C, ElAbd R, Lalonde D, Williams J

Hand (N Y), 2024 Sep;19(6):865-874.

PMID: 36856295 DOI: 10.1177/15589447231153175

BACKGROUND: Metastatic lesions to the hand or wrist are rare and can mimic inflammatory and benign processes such as gout and infections. This often leads to misdiagnosis, underreporting, and delays in treatment. The purpose of this study was to examine all known cases of metastasis to the hand or wrist available in the literature and to analyze demographic trends, metastasis characteristics, and clinical course, and provide recommendations for management.

METHODS: An online systematic review of MEDLINE, Embase, PubMed, and the Cochrane Library from inception to January 7, 2022, was completed. Studies outlining the care of a patient with acrometastases of the hand were included. Data extracted included age, sex, site of primary tumor and metastasis, presence of other metastases, time from primary diagnosis to acrometastasis diagnosis, misdiagnosis, treatment, and survival.

RESULTS: Between 1889 and present, 871 lesions were described in 676 patients who met the inclusion criteria. There was no predilection for hand dominance or site of previous trauma. The mean age among patients was 59.5 (1.5-91) years, and male sex was more common (64.6%). The most common primary cancer source was the lung (39.2%), followed by the kidney (10.8%). The distal phalanx was the most frequently cited tumor location (33.7%). Mean survival after diagnosis of acrometastasis was 6.3 months (0.25-50) ± 11.5 months.

CONCLUSION: Acrometastasis remains an uncommon presentation of metastatic disease with poor prognosis. Treatment currently focuses on pain management and optimizing functional outcomes. Our review led to the development of 7 treatment recommendations when managing these patients.

Matched MeSH terms: Kidney Neoplasms/pathology; Lung Neoplasms/pathology

Changes in cell density and morphology of selected cells of the ageing human dental pulp

Daud S, Nambiar P, Hossain MZ, Rahman MR, Bakri MM

Gerodontology, 2016 Sep;33(3):315-21.

PMID: 25266855 DOI: 10.1111/ger.12154

OBJECTIVES: The aim of this study was to determine the changes in cell density and morphology of selected cells of the ageing human dental pulp.

BACKGROUND: Changes in cell density and morphology of dental pulp cells over time may affect their capability to respond to tooth injury.

MATERIALS AND METHODS: One hundred thirty-one extracted teeth were obtained from individuals between the ages of 6 and 80 years. The apical 1/3 of the root region was removed from all teeth prior to routine processing for producing histological slides. The histology slides were used to study the changes in cell density and morphology of selected pulp cells; odontoblasts, subodontoblasts and fibroblasts in the crown and root regions of the dental pulp. Student's t-test and one-way anova were used for statistical analyses.

RESULTS: In all age groups, the cell density for all types of cells was found to be higher in the crown than in the root (p

Matched MeSH terms: Dental Pulp/pathology*; Tooth Root/pathology; Tooth Crown/pathology

Testicular microlithiasis in a unilateral undescended testis: a rare phenomenon

Sharma S, Manchanda V, Gupta R

Malays J Pathol, 2013 Dec;35(2):181-3.

PMID: 24362482

Testicular microlithiasis (TM) is a rare benign condition with presence of multiple small microcalcifications in the seminiferous tubules. Though the aetiology is unknown, TM has been described in association with a variety of urological conditions. We report the clinico-pathological features of a 12-year-old male child who underwent orchidectomy for undescended testis. Histopathological examination of the excised testis showed multiple small intratubular calcifications without any evidence of testicular neoplasia. TM is an unusual phenomenon that should be kept in mind while evaluating testicular biopsies. Though it behaves in a benign manner in most of the cases, patients with positive family history of testicular cancer should be followed-up for testicular tumour.

Matched MeSH terms: Calculi/pathology*; Cryptorchidism/pathology*; Testicular Diseases/pathology*

Fulltext Lung adenocarcinoma with ipsilateral pleural and breast metastases

Liam CK, Pang YK, Kow KS

J Thorac Oncol, 2014 Jan;9(1):e8-9.

PMID: 24346108 DOI: 10.1097/01.JTO.0000438376.45132.9c

Matched MeSH terms: Adenocarcinoma/pathology*; Lung Neoplasms/pathology*; Lymph Nodes/pathology*

Fulltext Keratinous inclusion cyst of oesophagus: unusual finding

Wan Abdul Rahman WF, Mutum SS, Fauzi MH

BMJ Case Rep, 2013;2013.

PMID: 23878290 DOI: 10.1136/bcr-2013-010172

Cysts of the oesophagus are unusual findings and they are classified according to the embryological site of origin. It may represent inclusion cysts, retention cysts and developmental cysts. We present a case of keratinous inclusion cyst of the lower oesophagus in a 71-year-old Malay woman who presented with dyspepsia and severe epigastric pain. An oesophago-gastro-duodenoscopy demonstrated a sliding hiatus hernia with whitish ulcer-like lesion at the lower oesophagus. Biopsy from the lesion revealed a keratinous inclusion cyst. The patient was given pantoprazole and put on regular follow-up for monitoring any other development.

Matched MeSH terms: Epidermal Cyst/pathology; Esophageal Diseases/pathology; Esophagus/pathology

Mechanisms of cataractogenesis in the presence of magnesium deficiency

Agarwal R, Iezhitsa IN, Agarwal P, Spasov AA

Magnes Res, 2013 Jan-Feb;26(1):2-8.

PMID: 23708888 DOI: 10.1684/mrh.2013.0336

Senile cataract is the most common cause of bilateral blindness and results from the loss of transparency of the lens. Maintenance of the unique tissue architecture of the lens is vital for keeping the lens transparent. Membrane transport mechanisms utilizing several magnesium (Mg)-dependent ATPases, play an important role in maintaining lens homeostasis. Therefore, in Mg-deficiency states, ATPase dysfunctions lead to intracellular depletion of K(+) and accumulation of Na(+) and Ca(2+). High intracellular Ca(2+) causes activation of the enzyme calpain II, which leads to the denaturation of crystallin, the soluble lens protein required for maintaining the transparency of the lens. Mg deficiency also interferes with ATPase functions by causing cellular ATP depletion. Furthermore, Mg deficiency enhances lenticular oxidative stress by increased production of free radicals and depletion of antioxidant defenses. Therefore, Mg supplementation may be of therapeutic value in preventing the onset and progression of cataracts in conditions associated with Mg deficiency.

Matched MeSH terms: Cataract/pathology; Lens, Crystalline/pathology; Magnesium Deficiency/pathology

Fulltext Recurrent glossal leiomyoma

Idayu MY, Irfan M, Othman NH

Med J Malaysia, 2012 Jun;67(3):329-30.

PMID: 23082428 MyJurnal

Oral leiomyomas are rare benign tumour of smooth muscle. The first case of oral leiomyoma was reported by Blanc in 1884 and since then more cases has been published following advancement in immunohistochemical study. This tumour has an excellent prognosis and recurrences are extremely rare. We report a case of a recurrent glossal leiomyoma in a patient with HIV infection and the lesion recurred one year after the first excision.

Matched MeSH terms: Leiomyoma/pathology; Neoplasm Recurrence, Local/pathology; Tongue Neoplasms/pathology

Motor vehicle-assisted ligature strangulation causing complete decapitation: an autopsy report

Samberkar PN

Am J Forensic Med Pathol, 2012 Mar;33(1):86-7.

PMID: 21455053 DOI: 10.1097/PAF.0b013e3182186d72

The victim, a 63-year-old prosperous businessman from Labasa, of the Northern Island (Vanua Levu) of Fiji Islands, was found completely decapitated in the early hours of morning in 2004. Initial police investigation did not reveal any history of any medical or family calamity. Further inquiry by the police revealed that on the previous day the deceased had visited all his friends and relatives, and his behavior was not out of the ordinary. The police suspected it to be a case of homicide. On visit to the scene, a completely decapitated body was found in a van on a downhill road. Tire marks were found on the road. A nylon rope was used for ligature strangulation. At autopsy, the decapitation wound of the head and the torso articulated well. The face was congested, and there was tongue bite. Wound margins were clear-cut, with well-demarcated abrasion and multiple imprints of the nylon rope on the neck. The upper one third of the larynx was attached to the head. No other injuries were found on the body. From the findings, it was obvious that asphyxiation was involved in the death before decapitation.

Matched MeSH terms: Asphyxia/pathology; Decapitation/pathology*; Forensic Pathology

Fulltext Histomorphology of aberrant crypt foci in colorectal carcinoma

Norlida AO, Phang KS

Malays J Pathol, 2010 Dec;32(2):111-6.

PMID: 21329182 MyJurnal

Colorectal carcinogenesis is a complex multistep process that includes changes in histomorphological appearance of the colonic mucosa and changes at molecular level. Aberrant crypt foci (ACF) was first described by Bird in 1987 on examination of methylene-blue-stained colonic mucosa of azoxymethane-treated mice under light microscopy. Since then ACF was considered as the earliest preneoplastic change that can be seen in the colonic mucosa. The aim of this study was to look at the histomorphology and distribution of ACF in colorectal carcinoma. 50 formalin-fixed archival colectomy specimens for colorectal carcinoma were examined under light microscopy after staining with 0.2% methylene blue. ACF was identified by larger and darker crypts with thickened epithelium, and often elevated from adjacent normal mucosa. ACF was found in 41 of 50 colectomy specimens examined. There were 328 ACF consisting of 36 (11.0%) ACF without hyperplasia or dysplasia, 263 (80.2%) ACF with hyperplasia and 29 (8.8%) ACF with dysplasia. Of these 29 ACF with dysplasia, 25 showed low grade dysplasia and four high grade dysplasia. The density of ACF was higher in the left colon, those older than 65 years of age and among males but these findings were statistically not significant. The crypt multiplicity of hyperplastic ACF (30.149, SD 28.395) was larger than dysplastic ACF (20.613, SD 40.128). The spectrum of histological changes observed probably represent the evolution of ACF in colorectal carcinogenesis.

Matched MeSH terms: Adenocarcinoma/pathology*; Colorectal Neoplasms/pathology*; Aberrant Crypt Foci/pathology*

Syringocystadenoma papilliferum in an unusual location beyond the head and neck region: a case report and review of literature

Yap FB, Lee BR, Baba R

Dermatol. Online J., 2010;16(10):4.

PMID: 21062598

A case of syringocystadenoma papilliferum with multiple papulonodules in a linear fashion located in an unusual location of the right lower abdomen is presented. The presence of a large tumor at the inferior pole raised the suspicion of malignant transformation and the presence of discharge from the lesions raised the possibility of necrosis. However, histopathological examination showed the classical features of syringocystadenoma papilliferum without malignant transformation or tumor necrosis. The patient refused to undergo surgical excision of the nodules and subsequently was lost to follow-up. This case illustrates the atypical location of a rare disease and adds to the differential diagnosis of linear verrucous lesions on the abdomen. Review of all the cases with syringocystadenoma papilliferum outside the head and neck region in the English literature showed only one case of syringocystadenoma papilliferum arising on the abdomen; our patient is the second reported case with the unique feature of linear arrangement of lesions.

Matched MeSH terms: Cystadenoma/pathology*; Sweat Gland Neoplasms/pathology*; Syringoma/pathology*

Epithelial migration on the external ear canal wall in normal and pathologic ears

Revadi G, Prepageran N, Raman R, Sharizal TA

Otol Neurotol, 2011 Apr;32(3):504-7.

PMID: 21307812 DOI: 10.1097/MAO.0b013e31820d97e2

HYPOTHESIS: Epithelial migration on the external auditory canal (EAC) wall is abnormal in ears with keratosis obturans (KO).
BACKGROUND: Earlier studies of epithelial migration have focused on the tympanic membrane with scattered information available for epithelial migration on canal walls. This study was undertaken to observe the epithelial migration on the EAC wall in normal ears and in ears with KO.
METHODS: Twenty-five subjects with normal ears and 4 with KO were recruited for the study. Colored ink dots were placed around the tympanic annulus at the 12, 3, 6, and 9 o'clock positions. Migration patterns and the rate of travel of these ink dots were examined and photographed until the ink dots reached the bony cartilaginous junction.
RESULTS: Fifteen healthy subjects and 1 with bilateral KO completed the study. The ink dots migrated laterally, with a rate of migration in normal ears between 42 and 205 μm/d. The mean rates for each quadrant, measured clockwise from the 12 o'clock position, were 104.93, 89.80, 72.67, and 109.93 μm/d, respectively. The pathologic ears exhibited a rate between 88 and 140 μm/d, and at approximately 4 to 12 weeks after ink application, areas of abnormal desquamation were apparent at the inferior quadrant, leading to a halt in the migration of the ink dot once it reached these sites.
CONCLUSION: Epithelial migration occurred in an almost linear pattern in all quadrants, but the speed of migration was relatively slower in the anterior and inferior quadrants of a normal EAC. In the single KO patient, there were areas of normal migration and areas of abnormal keratin resurfacing at the inferior quadrant, which interfered with the migration of ink dots.

Matched MeSH terms: Cholesteatoma/pathology*; Ear Canal/pathology*; Epithelial Cells/pathology*

Fulltext Lymphatic channel density in colorectal adenocarcinoma

Naik VR, Jaafar H, Seng CE

Indian J Pathol Microbiol, 2010 Jan-Mar;53(1):12-4.

PMID: 20090214 DOI: 10.4103/0377-4929.59175

The purpose of this study was to count the number of lymphatic channels present in colorectal adenocarcinoma and correlate it with site, size, and stage of tumor, lymph node metastasis.

Matched MeSH terms: Adenocarcinoma/pathology*; Colorectal Neoplasms/pathology*; Lymphatic Vessels/pathology*

Necrobiotic xanthogranuloma of the parotid gland

Zainal A, Razif MY, Makhashen M, Swaminathan M, Mazita A

J Laryngol Otol, 2010 May;124(5):569-71.

PMID: 19825226 DOI: 10.1017/S0022215109991563

To highlight the first reported case of necrobiotic xanthogranuloma of the parotid gland. We also review the clinical presentations and treatments for this rare condition.

Matched MeSH terms: Granuloma/pathology*; Parotid Diseases/pathology*; Xanthomatosis/pathology*

Fulltext Giant gluteal lipoma-like liposarcoma: a case report

Sultan M, Burezq H, Bang RL, El-Kabany M, Eskaf W

World J Surg Oncol, 2008;6:81.

PMID: 18664291 DOI: 10.1186/1477-7819-6-81

Liposarcoma is the second most common soft tissue sarcoma in adults with a peak incidence between the 4th and 6th decade of life and slight preponderance to the male gender. It originates from multipotential primitive mesenchymal cells, rather than mature adipose tissue.

Matched MeSH terms: Lipoma/pathology*; Liposarcoma/pathology*; Soft Tissue Neoplasms/pathology*

Choristoma of the base of the tongue

Naik VR, Wan Faiziah WA, Musa MY

Indian J Pathol Microbiol, 2009 1 13;52(1):86-7.

PMID: 19136792

Choristoma is a benign tumor where new bone formation occurs. It occurs exclusively in the flat bones of the skull and face. These are slow growing lesions that are usually completely asymptomatic and only present when there is a disruption in the function of the organ due to its large size as it grows. These choristomas can rarely occur in soft tissues especially in the head, eye, tongue, or extremities. Choristomas of the soft tissues are very rare. Only 61 cases of choristomas of the tongue have been reported in literature. Here we report a case of choristoma in the base of the tongue in a 25-year-old Malay female.

Matched MeSH terms: Choristoma/pathology*; Tongue/pathology*; Tongue Neoplasms/pathology*

Heterotopic ossification in skeletal muscle metastasis from colonic adenocarcinoma--a case report

Naik VR, Jaafar H, Mutum SS

Malays J Pathol, 2005 Dec;27(2):119-21.

PMID: 17191396

Colonic adenocarcinoma metastasising to the skeletal muscle is rare. A-56-yr-old Malay man was diagnosed to have adenocarcinoma of the right colon [Dukes B] for which a right hemicolectomy was performed, followed by radiotherapy and chemotherapy. Five years later the patient presented with a mass in the rectus abdominis muscle. The serum carcinoembryonic antigen was 71 ng/Ml. The mass was resected. Gross and microscopical examination showed multiple deposits of mucin-secreting adenocarcinoma with prominent heterotopic ossification in the stroma. The exact pathogenesis and significance of heterotopic ossification is not clear, but bone morphogenetic proteins may play an important role.

Matched MeSH terms: Colonic Neoplasms/pathology*; Ossification, Heterotopic/pathology*; Muscle, Skeletal/pathology*

Hanging without knot in the noose

Kumar V

J Forensic Leg Med, 2007 Jan;14(1):35-8.

PMID: 16530454

Death by hanging is believed to be a painless method of committing suicide. In most cases the noose has a knot and on this basis only it can be labeled as atypical or typical hanging. A 35 year Chinese man committed suicide by hanging with a ligature material made of electric wire where there was no knot present on the noose.

Matched MeSH terms: Asphyxia/pathology; Neck Injuries/pathology; Forensic Pathology

Fulltext Histoplasmosis of the larynx

Subramaniam S, Abdullah AHR, Hairuzah I

Med J Malaysia, 2005 Aug;60(3):386-8.

PMID: 16379201

Primary histoplasmosis of the larynx is not a common disease. Most cases of laryngeal histoplasmosis results from hematogenous spread of disseminated histoplasmosis usually originating from pulmonary infection by Histoplasma capsulatum. We report a 52-year-old male chronic smoker who had prolonged hoarseness and was initially diagnosed with laryngeal carcinoma. However, biopsy of the laryngeal mucosa confirmed the diagnosis of histoplasmosis. There were no signs of pulmonary or systemic involvement. Treatment with intravenous amphotericin B was given for a week and oral ketaconazole was given for a month with complete resolution of symptoms.

Matched MeSH terms: Histoplasmosis/pathology*; Laryngeal Diseases/pathology*; Larynx/pathology*

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