MyMedR

Unexpected infant death secondary to a pulmonary infiltration due to acute myelocytic leukaemia

Ben Khelil M, Chkirbene Y, Mlika M, Haouet S, Hamdoun M

Malays J Pathol, 2017 Aug;39(2):193-196.

Acute myeloid leukaemia (AML) often presents with non-specific symptoms such as fatigue, anaemia or infection. Pulmonary involvement is uncommon in AML during the course of the disease and is usually caused by infection, haemorrhage, leukaemic pulmonary infiltrates and leukostasis. Lung localization of AML is very uncommon and potentially life threatening if not diagnosed and treated rapidly. The authors describe the sudden death of an asymptomatic five-month-infant because of a misdiagnosed lung localization of AML. Autopsy examination followed by histopathological studies showed an extensive leukostasis and extramedullary leukaemic infiltrating the lungs. Special stains and immunohistochemical studies revealed findings consistent with acute myelogenous leukaemia. This case suggests that underlying acute leukaemia should be considered as a cause of flu-like symptoms in infants. Medical personnel are urged to be alert to fever, sore throat, weakness and dyspnea that may be characteristic of serious systemic diseases.

Matched MeSH terms: Lung/pathology*; Leukemia, Myeloid, Acute/pathology*; Leukemic Infiltration/pathology*

Features of post-radioiodine whole body scan in non-invasive Follicular Thyroid Neoplasm with papillary-like nuclear features (NIFTP)

Wong TH, Tan TH, Chin SC, Lee BN

Med J Malaysia, 2018 06;73(3):181-182.

PMID: 29962506

Recently, encapsulated follicular variant of papillary thyroid carcinoma has been reclassified as non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) to emphasize the benign nature of this entity. In our institution, we have assessed 455 patients treated with radioiodine ablation for differentiated thyroid carcinoma and 20 of them were retrospectively found to fulfill the new NIFTP criteria. There was no evidence of metastasis on post radioiodine whole body scans for NIFTP cases and these patients were in remission subsequently. The benign features of these patients' whole body scans and good clinical outcome following treatment further support NIFTP as a low risk thyroid neoplasm.

Matched MeSH terms: Thyroid Gland/pathology; Thyroid Neoplasms/pathology; Adenocarcinoma, Follicular/pathology

Recent work on the typhus-like fevers of Malaya

Lewthwaite R, Savoor SR

Trans R Soc Trop Med Hyg, 1936;29:561-571.

DOI: 10.1016/S0035-9203(36)90038-X

Matched MeSH terms: Pathology

Thyroid storm: Is there a role for thyroid function test?

Tengku Ibrahim TZ, Thambiah SC, Samsudin IN, Nasuruddin AN, Zakaria MH

Malays J Pathol, 2019 Dec;41(3):355-358.

PMID: 31901922

INTRODUCTION: Thyroid storm (TS) is an endocrine emergency. Early diagnosis for prompt treatment is essential as it has a high mortality rate.

CASE REPORT: A 31-year-old lady with underlying hyperthyroidism, dilated cardiomyopathy with severe mitral regurgitation presented with shortness of breath. She was intubated and admitted due to decreasing Glasgow Coma Score. Her blood investigations revealed increased white cell count, raised free thyroxine with suppressed thyroid stimulating hormone, deranged liver, renal and coagulation profiles. As her condition did not improve with initial treatment, plasmapheresis was commenced on day 4. Biochemically, her thyroid function test (TFT) showed improvement; however, she succumbed due to multi-organ failure.

DISCUSSION: Plasmapheresis is considered in TS if there is no clinical improvement within 24-48 hours of initial treatment. The improvement in patient's TFT post plasmapheresis signifies its role in treating TS. Unfortunately, there was a delay in commencing plasmapheresis due to haemodynamic instability in this patient.

Matched MeSH terms: Liver/pathology; Multiple Organ Failure/pathology*; Thyroid Crisis/pathology*

Fulltext Primary retroperitoneal serous adenocarcinoma: A case report of rare malignancy with literature review

Win TT, Aye SN, Abdul Hamad NS, Tuan Sharif SE

Indian J Cancer, 2021 1 7;58(2):262-266.

PMID: 33402586 DOI: 10.4103/ijc.IJC_528_19

The primary retroperitoneal serous adenocarcinoma (PRSAC) is a rare malignant tumor of the retroperitoneum. It shares the same pathological and biological behavior with ovarian serous carcinoma. Most of the cases develop as peritoneal adenocarcinoma and rarely occur in the retroperitoneum. It is reported as serous surface papillary carcinoma of the peritoneum and extraovarian peritoneal serous papillary carcinoma. We present a case of PRSAC in a 60-year-old woman. Only 11 cases of PRSAC have been reported from 1983 to 2019. Histopathological features with immunohistochemical expressions are important to diagnose PRSAC. The outcome and survival mainly depend on the possibility of surgical resection. Molecular genetics of PRSAC should also be studied in relation with its ovarian counterpart.

Matched MeSH terms: Ovarian Neoplasms/pathology*; Retroperitoneal Neoplasms/pathology*; Cystadenocarcinoma, Serous/pathology*

Fulltext Leonine facies

Low QJ, Cheo SW, Yap WYE

Indian J Dermatol Venereol Leprol, 2020 2 19;87(4):589-591.

PMID: 32068196 DOI: 10.4103/ijdvl.IJDVL_983_18

Matched MeSH terms: Facial Dermatoses/pathology*; Sebaceous Glands/pathology*; Skin Diseases, Genetic/pathology*

Fulltext 3D-Printed Coronary Plaques to Simulate High Calcification in the Coronary Arteries for Investigation of Blooming Artifacts

Sun Z, Ng CKC, Wong YH, Yeong CH

Biomolecules, 2021 09 03;11(9).

PMID: 34572520 DOI: 10.3390/biom11091307

The diagnostic value of coronary computed tomography angiography (CCTA) is significantly affected by high calcification in the coronary arteries owing to blooming artifacts limiting its accuracy in assessing the calcified plaques. This study aimed to simulate highly calcified plaques in 3D-printed coronary models. A combination of silicone + 32.8% calcium carbonate was found to produce 800 HU, representing extensive calcification. Six patient-specific coronary artery models were printed using the photosensitive polyurethane resin and a total of 22 calcified plaques with diameters ranging from 1 to 4 mm were inserted into different segments of these 3D-printed coronary models. The coronary models were scanned on a 192-slice CT scanner with 70 kV, pitch of 1.4, and slice thickness of 1 mm. Plaque attenuation was measured between 1100 and 1400 HU. Both maximum-intensity projection (MIP) and volume rendering (VR) images (wide and narrow window widths) were generated for measuring the diameters of these calcified plaques. An overestimation of plaque diameters was noticed on both MIP and VR images, with measurements on the MIP images close to those of the actual plaque sizes (<10% deviation), and a large measurement discrepancy observed on the VR images (up to 50% overestimation). This study proves the feasibility of simulating extensive calcification in coronary arteries using a 3D printing technique to develop calcified plaques and generate 3D-printed coronary models.

Matched MeSH terms: Calcinosis/pathology*; Coronary Vessels/pathology*; Plaque, Atherosclerotic/pathology*

Frank's sign - A dermatological link to coronary artery disease?

Lee KG

Med J Malaysia, 2017 06;72(3):195-196.

PMID: 28733570

Frank's sign, also known as diagonal earlobe crease (DELC), was observed to be an aural sign of coronary artery disease (CAD). Since then, there has been much interest in examining this unique and controversial association. This report describes a patient who has bilateral complete and deep diagonal ear lobe creases, presented with angina and diagnosed to have coronary artery disease on angiography. The characteristics of the sign and its association with atherosclerotic disease were discussed.

Matched MeSH terms: Coronary Artery Disease/pathology*; Ear, External/pathology*; Atherosclerosis/pathology

Fulltext Difficult intubation stylohyoid ligament calcification

Aris AM, Elegbe EO, Krishna R

Singapore Med J, 1992 Apr;33(2):204-5.

PMID: 1621133

Intubation was difficult and traumatic in a 40-year-old patient presented for emergency oesophagoscopy because the diagnosis of stylohyoid ligament calcification was not suspected. High probability of stylohyoid ligament calcification should be suspected when there is difficulty in lifting the epiglottis and fibre-optic laryngoscopy is suggested as the best way to tackle this problem to prevent trauma and possible risk of regurgitation and aspiration especially in emergency situation.

Matched MeSH terms: Calcinosis/pathology*; Hyoid Bone/pathology*; Ligaments/pathology*

Fulltext Benign periarticular, bone and joint lipomatous lesions

Kheok SW, Ong KO

Singapore Med J, 2017 Sep;58(9):521-527.

PMID: 28948289 DOI: 10.11622/smedj.2017087

Benign periarticular, bone and joint lipomatous lesions are rare entities that are increasingly being identified using current imaging techniques. This pictorial review illustrates the wide range of imaging presentations of these lesions at various sites and their pathognomonic features. The main lesions reviewed include intraosseous lipoma, liposclerosing myxofibrous tumour, lipoma arborescens and intra-articular lipoma.

Matched MeSH terms: Bone and Bones/pathology; Bone Neoplasms/pathology; Lipoma/pathology

An epizootic of bovine malignant catarrh in Malaysia

Vanselow BA

Vet Rec, 1980 Jul 05;107(1):15-8.

PMID: 7434536

A severe epizootic of bovine malignant catarrh occurred from November 1976 until June 1977 in cattle at an agricultural institute in peninsular Malaysia. In a group of 82 Kedah-Kelantan cattle the morbidity rate was 47.6 per cent with a fatality rate of 89.7 per cent. In a group of 43 local Indian dairy cattle the morbidity rate was 23.3 per cent with a fatality rate of 100 per cent. Although evidence suggested that sheep acted as a common source of infection, the disease occurred in one animal which had no contact with sheep but had contact with infected cattle and carcases.

Matched MeSH terms: Brain/pathology; Malignant Catarrh/pathology; Spinal Cord/pathology

Linking Benzene, in Utero Carcinogenicity and Fetal Hematopoietic Stem Cell Niches: A Mechanistic Review

Yusoff NA, Abd Hamid Z, Budin SB, Taib IS

Int J Mol Sci, 2023 Mar 28;24(7).

PMID: 37047305 DOI: 10.3390/ijms24076335

Previous research reported that prolonged benzene exposure during in utero fetal development causes greater fetal abnormalities than in adult-stage exposure. This phenomenon increases the risk for disease development at the fetal stage, particularly carcinogenesis, which is mainly associated with hematological malignancies. Benzene has been reported to potentially act via multiple modes of action that target the hematopoietic stem cell (HSCs) niche, a complex microenvironment in which HSCs and multilineage hematopoietic stem and progenitor cells (HSPCs) reside. Oxidative stress, chromosomal aberration and epigenetic modification are among the known mechanisms mediating benzene-induced genetic and epigenetic modification in fetal stem cells leading to in utero carcinogenesis. Hence, it is crucial to monitor exposure to carcinogenic benzene via environmental, occupational or lifestyle factors among pregnant women. Benzene is a well-known cause of adult leukemia. However, proof of benzene involvement with childhood leukemia remains scarce despite previously reported research linking incidences of hematological disorders and maternal benzene exposure. Furthermore, accumulating evidence has shown that maternal benzene exposure is able to alter the developmental and functional properties of HSPCs, leading to hematological disorders in fetus and children. Since HSPCs are parental blood cells that regulate hematopoiesis during the fetal and adult stages, benzene exposure that targets HSPCs may induce damage to the population and trigger the development of hematological diseases. Therefore, the mechanism of in utero carcinogenicity by benzene in targeting fetal HSPCs is the primary focus of this review.

Matched MeSH terms: Fetus/pathology; Hematopoietic Stem Cells/pathology; Carcinogenesis/pathology

Fulltext Evaluating Nuclear Membrane Irregularity for the Classification of Cervical Squamous Epithelial Cells

Tang JR, Mat Isa NA, Ch'ng ES

PLoS One, 2016;11(10):e0164389.

PMID: 27741266 DOI: 10.1371/journal.pone.0164389

Pap test involves searching of morphological changes in cervical squamous epithelial cells by pathologists or cytotechnologists to identify potential cancerous cells in the cervix. Nuclear membrane irregularity is one of the morphological changes of malignancy. This paper proposes two novel techniques for the evaluation of nuclear membrane irregularity. The first technique, namely, penalty-driven smoothing analysis, introduces different penalty values for nuclear membrane contour with different degrees of irregularity. The second technique, which can be subdivided into mean- or median-type residual-based analysis, computes the number of points of nuclear membrane contour that deviates from the mean or median of the nuclear membrane contour. Performance of the proposed techniques was compared to three state-of-the-art techniques, namely, radial asymmetric, shape factor, and rim difference. Friedman and post hoc tests using Holm, Shaffer, and Bergmann procedures returned significant differences for all the three classes, i.e., negative for intraepithelial lesion or malignancy (NILM) versus low grade squamous intraepithelial lesion (LSIL), NILM versus high grade squamous intraepithelial lesion (HSIL), and LSIL versus HSIL when the span value equaled 3 was employed with linear penalty function. When span values equaled 5, 7, and 9, NILM versus LSIL and HSIL showed significant differences regardless of the penalty functions. In addition, the results of penalty-driven smoothing analysis were comparable with those of other state-of-the-art techniques. Residual-based analysis returned significant differences for the comparison among the three diagnostic classes. Findings of this study proved the significance of nuclear membrane irregularity as one of the features to differentiate the different diagnostic classes of cervical squamous epithelial cells.

Matched MeSH terms: Cervix Uteri/pathology; Epithelial Cells/pathology*; Nuclear Envelope/pathology*

Melioidotic osteomyelitis in an imported primate

Britt JO, Howard EB, Kean CJ, Jones J

J Am Vet Med Assoc, 1981 Dec 1;179(11):1303-5.

PMID: 7328029

Matched MeSH terms: Melioidosis/pathology; Monkey Diseases/pathology*; Osteomyelitis/pathology

Residual post-treatment rhabdomyosarcoma in bone marrow: A reminder of the continued importance of morphology

Abobarin-Aofolaju O, Kaumeyer B, Kahwash SB

Malays J Pathol, 2024 Aug;46(2):339-340.

PMID: 39207013

No abstract available.

Matched MeSH terms: Bone Marrow/pathology; Neoplasm, Residual/pathology; Bone Marrow Neoplasms/pathology

Fulltext Skeletal, dentoalveolar, and soft tissue cephalometric measurements of Malay transfusion-dependent thalassaemia patients

Toman HA, Nasir A, Hassan R, Hassan R

Eur J Orthod, 2011 Dec;33(6):700-4.

PMID: 21282284 DOI: 10.1093/ejo/cjq147

Thalassaemia is a public health problem in Malaysia. It is known to cause skeletal deformity. The purpose of this study was to compare the skeletal, dentoalveolar, and soft tissue features of Malay transfusion-dependent thalassaemia (TDT) patients with a Malay control group. Lateral cephalometric radiographs of 30 Malay (14 males and 16 females aged 6.4-21.8 years) TDT patients and 60 normal Malays matched for chronological age and gender were analysed and compared using an independent t-test. The TDT group showed a similar sagittal relationship to the control group but with a significantly increased (P < 0.01) mandibular plane inclination. They also showed a significantly shorter (P ≤ 0.001) mandibular body, ramus length, and posterior face height and consequently a smaller ratio of posterior to anterior face height (P < 0.01). The upper and lower lips were significantly procumbent (P < 0.001) in the TDT group together with a significantly smaller nasolabial angle (P < 0.05). Dentoalveolar measurements showed less proclined maxillary teeth in the TDT group compared with the controls (P < 0.05). The cephalometric features of Malay TDT patients were characterized by a mild Class II skeletal pattern, prominent vertical growth direction of the mandible, and protruded upper and lower lips.

Matched MeSH terms: Facial Bones/pathology*; Incisor/pathology; Lip/pathology; Malocclusion, Angle Class II/pathology; Mandible/pathology; Maxilla/pathology; Nasal Bone/pathology; Nose/pathology; Palate/pathology; Tooth/pathology*

Henipavirus encephalitis

Abdullah S, Tan CT

Handb Clin Neurol, 2014;123:663-70.

PMID: 25015510 DOI: 10.1016/B978-0-444-53488-0.00032-8

Matched MeSH terms: Brain/pathology

Fulltext The Malaysian Journal of Pathology - moving forward

Looi LM

Malays J Pathol, 2014 Apr;36(1):1.

PMID: 24763229

Matched MeSH terms: Pathology, Clinical*

An automated decision-support system for non-proliferative diabetic retinopathy disease based on MAs and HAs detection

Saleh MD, Eswaran C

Comput Methods Programs Biomed, 2012 Oct;108(1):186-96.

PMID: 22551841 DOI: 10.1016/j.cmpb.2012.03.004

Diabetic retinopathy (DR) has become a serious threat in our society, which causes 45% of the legal blindness in diabetes patients. Early detection as well as the periodic screening of DR helps in reducing the progress of this disease and in preventing the subsequent loss of visual capability. This paper provides an automated diagnosis system for DR integrated with a user-friendly interface. The grading of the severity level of DR is based on detecting and analyzing the early clinical signs associated with the disease, such as microaneurysms (MAs) and hemorrhages (HAs). The system extracts some retinal features, such as optic disc, fovea, and retinal tissue for easier segmentation of dark spot lesions in the fundus images. That is followed by the classification of the correctly segmented spots into MAs and HAs. Based on the number and location of MAs and HAs, the system quantifies the severity level of DR. A database of 98 color images is used in order to evaluate the performance of the developed system. From the experimental results, it is found that the proposed system achieves 84.31% and 87.53% values in terms of sensitivity for the detection of MAs and HAs respectively. In terms of specificity, the system achieves 93.63% and 95.08% values for the detection of MAs and HAs respectively. Also, the proposed system achieves 68.98% and 74.91% values in terms of kappa coefficient for the detection of MAs and HAs respectively. Moreover, the system yields sensitivity and specificity values of 89.47% and 95.65% for the classification of DR versus normal.

Matched MeSH terms: Diabetic Retinopathy/pathology*

Absence of the peroneus tertius muscle: cadaveric study with clinical considerations

Das S, Haji Suhaimi F, Abd Latiff A, Pa Pa Hlaing K, Abd Ghafar N, Othman F

Rom J Morphol Embryol, 2009;50(3):509-11.

PMID: 19690784

Peroneus tertius (PT) is a muscle of the anterior compartment of the leg. The PT muscle originates from the anterior surface of the fibula and the interosseous membrane and inserts into the medial side of the dorsal region of the fifth metatarsal bone. During routine dissection, we observed the absence of PT on the left lower limb of a cadaver. Usually, the PT is involved in dorsiflexion and eversion of the foot. In many cases, the absence of PT maybe asymptomatic and it may be incidentally detected during cadaveric dissections or autopsies. The existence of PT may help in the swing phase of bipedal walking. The PT may be used for tendon graft surgeries. The pull of the PT may be responsible for causing stress on the fifth metacarpal and account for all stress fractures in any individual. The absence of the PT may puzzle any transplant and foot surgeons performing graft operations. We as anatomists discuss the clinical implications of the absence of PT.

Matched MeSH terms: Foot/pathology

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