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A large unilateral submandibular mass

Rajandram RK, Sha PP, Hussaini HM, Jabar NA

Oral Surg Oral Med Oral Pathol Oral Radiol, 2014 Apr;117(4):402-6.
PMID: 23183027 DOI: 10.1016/j.oooo.2012.08.456
Matched MeSH terms: Biopsy
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to this procedure are haemorrhage and implantation of tumour cells in the needle tract after the biopsy needle is withdrawn.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*
A novel 2-step approach combining the NAFLD fibrosis score and liver stiffness measurement for predicting advanced fibrosis

Chan WK, Nik Mustapha NR, Mahadeva S

Hepatol Int, 2015 Oct;9(4):594-602.
PMID: 25788185 DOI: 10.1007/s12072-014-9596-7

BACKGROUND: The non-alcoholic fatty liver disease (NAFLD) fibrosis score (NFS) is indeterminate in a proportion of NAFLD patients. Combining the NFS with liver stiffness measurement (LSM) may improve prediction of advanced fibrosis. We aim to evaluate the NFS and LSM in predicting advanced fibrosis in NAFLD patients.
METHODS: The NFS was calculated and LSM obtained for consecutive adult NAFLD patients scheduled for liver biopsy. The accuracy of predicting advanced fibrosis using either modality and in combination were assessed. An algorithm combining the NFS and LSM was developed from a training cohort and subsequently tested in a validation cohort.
RESULTS: There were 101 and 46 patients in the training and validation cohort, respectively. In the training cohort, the percentages of misclassifications using the NFS alone, LSM alone, LSM alone (with grey zone), both tests for all patients and a 2-step approach using LSM only for patients with indeterminate and high NFS were 5.0, 28.7, 2.0, 2.0 and 4.0 %, respectively. The percentages of patients requiring liver biopsy were 30.7, 0, 36.6, 36.6 and 18.8 %, respectively. In the validation cohort, the percentages of misclassifications were 8.7, 28.3, 2.2, 2.2 and 8.7 %, respectively. The percentages of patients requiring liver biopsy were 28.3, 0, 41.3, 43.5 and 19.6 %, respectively.
CONCLUSIONS: The novel 2-step approach further reduced the number of patients requiring a liver biopsy whilst maintaining the accuracy to predict advanced fibrosis. The combination of NFS and LSM for all patients provided no apparent advantage over using either of the tests alone.

Matched MeSH terms: Biopsy
A preliminary investigation of chitosan film as dressing for punch biopsy wounds in rats

Khan TA, Peh KK

J Pharm Pharm Sci, 2003 Jan-Apr;6(1):20-6.
PMID: 12753727

To investigate the wound healing efficacy of two chitosan films, Chit-AA and Chit-LA, in comparison with a commercial preparation, Omiderm, using punch biopsy wounds in rats.

Matched MeSH terms: Biopsy
Fulltext A rare case of Tuberculous Prostatitis

Nurul Yaqeen Esa, Mohammad Hanafiah, Marymol Koshy, Hilmi Abdullah, Ahmad Izuanuddin Ismail, Mohamed Fauzi Abdul Rani

Journal of Clinical and Health Sciences, 2016;1:33-36.

Tuberculous prostatitis is an uncommon form of tuberculosis infection. It is commonly seen in immunocompromised patients and in those of middle or advanced age. The diagnosis is often not straight forward due to the nature of its presentation. We report a case of tuberculous prostatitis in a young, healthy and immunocompetent patient, who initially presented with respiratory features, followed by episodes of seizures and testicular swelling. He was finally diagnosed with tuberculous prostatitis after prostatic biopsy. This case illustrates that in a high TB prevalence environment, when symptoms warrant, there should be a high clinical suspicion coupled with a thorough approach in order to arrive at a correct diagnosis of TB prostatitis.

Matched MeSH terms: Biopsy
Fulltext A rare case of Tuberculous Prostatitis

Nurul Yaqeen Esa, Mohammad Hanafiah, Marymol Koshy, Hilmi Abdullah, Ahmad Izuanuddin Ismail, Mohamed Fauzi Abdul Rani

Journal of Clinical and Health Sciences, 2016;1(2):33-36.
MyJurnal

Tuberculous prostatitis is an uncommon form of tuberculosis infection. It is commonly seen in immunocompromised patients and in those of middle or advanced age. The diagnosis is often not straight forward due to the nature of its presentation. We report a case of tuberculous prostatitis in a young, healthy and immunocompetent patient, who initially presented with respiratory features, followed by episodes of seizures and testicular swelling. He was finally diagnosed with tuberculous prostatitis after prostatic biopsy. This case illustrates that in a high TB prevalence environment, when symptoms warrant, there should be a high clinical suspicion coupled with a thorough approach in order to arrive at a correct diagnosis of TB prostatitis.

Matched MeSH terms: Biopsy
A rare case of persistent large cystic breast tumor mimicking as malignant cystic breast cancer

Teh MS, Teoh LY, See MH

J Cancer Res Ther, 2022;18(6):1804-1807.
PMID: 36412448 DOI: 10.4103/jcrt.JCRT_631_20

Breast cyst, especially galactocele is usually benign. Needle aspiration or surgical removal are both diagnostic and therapeutic. Mastectomy is not necessary even if the whole breast is affected, but surgeons need to be vigilant. We describe a rare case of persistent and large breast cyst.

Matched MeSH terms: Biopsy, Needle
Fulltext A rare case of solitary unifocal Langerhans cell histiocytosis with orbital extension: Diagnostic dilemma

Addenan M, May CM, Hooi TK, Ismail F, Kamalden TA

Oman J Ophthalmol, 2018 12 7;11(3):284-287.
PMID: 30505126 DOI: 10.4103/ojo.OJO_149_2017

Langerhans cell histiocytosis (LCH) is rarely encountered in ophthalmology practice. It is a spectrum of disorder characterized by accumulation of histiocytes in various tissues. Diagnosis is challenging as it may simulate periorbital hematoma, rhabdomyosarcoma, and neuroblastoma. We report a case of unifocal LCH with orbital extension. Diagnosis was obtained from incisional biopsy, and histopathological examination showed numerous histiocytes with eosinophilic infiltrations. The presence of Langerhans cells was confirmed by the presence of protein S-100, CD1a, and/or Langerin (CD207). Treatment depends on the degree of organ involvement. She responded well to cytotoxic drugs and steroids. This emphasized that prompt tissue diagnosis is crucial for early management.

Matched MeSH terms: Biopsy
Fulltext A rare presentation ofcCutaneous metastases in advanced lung adenocarcinoma

Liyana Dhamirah Aminuddin, Sabrina Ab Wahab, Suhaili Shariffudin, Tarita Tai

Journal of Clinical and Health Sciences, 2020;5(2):75-78.
MyJurnal

Patients with lung cancer may present with respiratory and systemic symptoms. However,
cutaneous metastases from primary lung cancer is a rare phenomenon, especially in women,
that signifies a poor prognosis. This paper reported a case regarding a 71-year-old woman
who was first presented with a cutaneous nodule over the year. Her condition was further
progressed to multiple lesions on the back and abdomen, dyspnoea, haemoptysis and weight
loss. The results of the skin lesion biopsy exhibited metastatic lung adenocarcinoma with
positive immunohistochemistry for thyroid transcription factor 1 (TTF1) and cytokeratin 7 (CK7). Computed tomography (CT) scan was conducted, and it revealed a left upper lobe lung
mass. The patient was subsequently scheduled for additional management, but she had
succumbed to complications of pulmonary embolism before the necessary interventions could
be provided. In this particular case presentation, the biopsy of cutaneous lesions obtained had
revealed an undiagnosed primary malignancy.

Matched MeSH terms: Biopsy
A retrospective analysis of oral and maxillofacial biopsied specimens in Malaysian newborns and infants

Binti Shuhairi NN, Bt Abdul Jalil A, Lau SH, Bt Mohd Ghazali S, Kee CC

Int J Paediatr Dent, 2021 Jul;31(4):496-503.
PMID: 32815206 DOI: 10.1111/ipd.12719

BACKGROUND: Globally, research on oral and maxillofacial lesions among newborns and infants remains limited.
AIM: To describe demographic patterns, histopathological findings, and locations of oral and maxillofacial lesions in newborns (birth-1 month) and infants (>1 month-2 years) reported over 51 years.
DESIGN: A retrospective cross-sectional study on histopathological records of newborns and infants was conducted. Patients' demographic characteristics (age, gender, and race), histopathological diagnosis, and lesion's location were gathered. Pearson's chi-square or Fisher's exact test was performed to determine associations between demographic characteristics and different categories of lesions.
RESULTS: Out of 66,546 specimens received, 0.44% (290 specimens) were from patients aged 2 years and younger (27 newborns and 263 infants). The most common category was inflammatory/reactive (44.2%), followed by tumour/tumour-like (42.0%), cystic/pseudocystic (6.6%), and miscellaneous lesions (5.5%). Mucous extravasation cysts (23.4%) and Langerhans cell histiocytosis (7.2%) were the most common histopathological diagnoses. Tumour/tumour-like lesions were significant in newborns (P = .021), and majority were congenital epulis (40.7%). Inflammatory/reactive lesions were significantly higher in male (P = .025) and infants (P =

Matched MeSH terms: Biopsy
Fulltext A review of epidemiological studies of oral cancer and precancer in Malaysia

Zain, R.B., Ghazali, N.

Ann Dent, 2001;8(1):-.
MyJurnal

This paper attempts to review epidemiological studies of oral cancer and precancer in Malaysia. The defmitions of prevalence, incidence, risk habits and oral cancer and precancers were discussed to better understand' the different types of studies conducted, which would be important in making comparisons between studies. Currently, epidemiological data on oral cancer in Malaysia are sketchy. The only incidence data for oral cancer in Malaysia was reported by Hirayama in 1966, 35 years ago. He estimated that 3.1 new cases per 100,000 population were diagnosed for the year 1963. A number of histopathological data of oral and maxillofacial biopsies were reported. Oral cancer accounted for one-fifth of all oral biopsies. A national study on oral mucosal lesions in Malaysia carried out in 1993/4 reported that there was a variation seen in the occurrence of oral premalignancy among the ethnic groups. The Indians and the indigenous people of Sabah and Sarawak were identified as high risk groups for oral cancer and precancer. It was also observed that both of the ethnic groups chewed betel quid. In conclusion, the epidemiological studies have provided useful data, which may be used in planning for future oral health programmes and research towards enhancing Malaysia's on-going effort in preventing the occurrence of these diseases.

Matched MeSH terms: Biopsy
Fulltext A review of parotid tumours and their management: a ten-year-experience

Shashinder S, Tang IP, Velayutham P, Prepageran N, Gopala KG, Kuljit S, et al.

Med J Malaysia, 2009 Mar;64(1):31-3.
PMID: 19852317 MyJurnal

To review the demographics, management and outcome of patients undergoing parotidectomy at a tertiary center. A total of 76 patients who underwent parotidectomies from January 1996 to December 2005 at the ORL department of our center were reviewed. All clinical, operative, postoperative, histology data were gathered and reviewed. Fine-needle aspiration cytology (FNAC) was diagnostic in 90% of patients with a sensitivity of 76% and specificity of 96%. Twenty-one patients had malignant tumours and the rest had benign or inflammatory lesions. There were a total of 48 superficial and 28 total parotidectomies performed. Facial nerve palsy occurred in 30 (39%) patients with 4% permanent palsy and 35% temporary palsy. The recurrence rate of pleomorphic adenoma was 2.6%. FNAC and CT scan were performed prior to the surgery were useful guidance in planning the operation but clinical judgment is more important. The most common surgery performed was superficial parotidectomy and the most common cause was due to pleomorphic adenoma. The incidence of complications and recurrence of tumour are comparable to other international studies. Prior knowledge of anatomy and careful planning is needed to decrease the incidence of facial nerve palsy.

Matched MeSH terms: Biopsy, Fine-Needle
Fulltext A survey of radiation dose to patients and operators during radiofrequency ablation using computed tomography

Saidatul A, Azlan C, Megat Amin M, Abdullah B, Ng Kh

Biomed Imaging Interv J, 2010 Jan-Mar;6(1):e1.
PMID: 21611060 MyJurnal DOI: 10.2349/biij.6.1.e2

Computed tomography (CT) fluoroscopy is able to give real time images to a physician undertaking minimally invasive procedures such as biopsies, percutaneous drainage, and radio frequency ablation (RFA). Both operators executing the procedure and patients too, are thus at risk of radiation exposure during a CT fluoroscopy.This study focuses on the radiation exposure present during a series of radio frequency ablation (RFA) procedures, and used Gafchromic film (Type XR-QA; International Specialty Products, USA) and thermoluminescent dosimeters (TLD-100H; Bicron, USA) to measure the radiation received by patients undergoing treatment, and also operators subject to scatter radiation.The voltage was held constant at 120 kVp and the current 70mA, with 5mm thickness. The duration of irradiation was between 150-638 seconds.Ultimately, from a sample of 30 liver that have undergone RFA, the study revealed that the operator received the highest dose at the hands, which was followed by the eyes and thyroid, while secondary staff dosage was moderately uniform across all parts of the body that were measured.

Matched MeSH terms: Biopsy
Fulltext A thyroid mass that moves with tongue protrusion: An ectopic thyroid gland

Yaroko AA, Mohamad I, Abdul Karim AH, Wan Abdul Rahman WF

Malays Fam Physician, 2014;9(2):61-3.
PMID: 25883768 MyJurnal

Thyroglossal duct cyst (TDC) is a developmental anomaly that usually appears in early childhood. The common presentation is midline swelling of the neck, which moves with both tongue protrusion and deglutition. Diagnosis is usually clinical and radiological. Fine needle aspiration cytology (FNAC) can be used as a tool for the exclusion of malignancy in adult patients. In some cases thyroid scan is done to rule out the presence or absence of the normal thyroid gland. A complete work-up is mandatory before cyst removal given that it contains only thyroid tissue. We report the case of a 32-year-old woman with only thyroid tissue in thyroglossal duct cyst.

Matched MeSH terms: Biopsy, Fine-Needle
ALK-positive anaplastic large cell lymphoma with a monomorphic small-cell pattern masquerading as inflammatory gastric lesions

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; Biopsy, Needle
Fulltext Abdominal subcutaneous fat aspiration--an alternative method to diagnose amyloidosis

Ong SG, Rajasingam R

Med J Malaysia, 2007 Mar;62(1):68-9.
PMID: 17682576

A middle aged lady presented with clinical manifestations of primary amyloidosis which included amyloid cardiomyopathy. There was failure to confirm the diagnosis of amyloidosis with biopsies from rectal and tongue tissues. Fat tissue obtained from abdominal subcutaneous fat aspiration eventually demonstrated the presence of amyloid.

Matched MeSH terms: Biopsy, Needle
Fulltext Absence of nucleotide alteration in region of exon 34 of NOTCH1 and NOTCH2 receptor genes analysed in oral cancer samples: a preliminary observation

Nor Nasyitah Ismail, Khairani Idah Mokhtar

Archives of Orofacial Sciences, 2010;5(1):17-23.
MyJurnal

Oral cancer is one of the common cancer cases identified in the developing countries. Genetic mutation and overexpression of certain genes and proteins have been associated in the development of this cancer. Notch signalling pathway is normally involved in controlling the development process of vertebrates and invertebrates; however, deregulation of this pathway was found to be responsible in the formation of certain cancers including oral cancers. Activation of this pathway requires binding of the ligands to its receptors. Four NOTCH receptors (NOTCH 1, 2, 3 and 4) have been identified in mammals. Disruptions within these molecules might interfere with the normal functions of Notch signalling pathway. Hence, this study was conducted to detect mutations of NOTCH1 and NOTCH2 receptor genes which might be occurring in the oral cancer cases obtained from the local population. DNA extracted from fresh-frozen tissue biopsy of the tongue and buccal mucosa from 10 confirmed cases of oral cancer were subjected for polymerase chain reaction (PCR) amplification using the specific sets of primers. The PCR products were sent for sequencing before final results were analysed.
Due to time and cost limitation, only two out of four NOTCH receptor genes; NOTCH1 and NOTCH2, were used in this analysis. The results revealed absence of nucleotide changes for both NOTCH receptor genes amplified from these oral cancer samples. More samples and further analysis looking into other regions in these genes are required to conclude the involvement of NOTCH receptor genes mutation in causing oral cancer.

Matched MeSH terms: Biopsy
Fulltext Accuracy of fine needle aspiration cytology in solitary or dominant nodular goitre: a single centre study

Rohaizak, M., Aman Fuad, Y., Naqiyah, I., Saladina, J.J., Shahrun Niza, A.S.

International Medical Journal Malaysia, 2017;16(2):85-88.
MyJurnal

Background: Thyroid swelling or goitre is a common condition, either asymptomatic or symptomatic. The
diagnosis is usually established by ultrasound or fine needle aspiration cytology (FNAC) as a gold standard.
The sensitivity of the test is inversely related to increasing size of the nodule. The objective of this study is
to evaluate the accuracy of FNAC especially in cases of large goitre.

Material and methods: This is a
retrospective study on patients who underwent thyroidectomy between January 2000 to December 2007 for
solitary or dominant nodular goitre. The analysis was made only on those patients with complete data on
FNAC and histology.

Result: There were 235 patients, but only 161 patients were analysed after excluding
the suspicious and inadequate sample. The patients’ mean age was 42.1 year old (21 to 60). The size of the
thyroid nodule ranged from 2.1 to 5.0 cm (mean = 3.9 cm). The overall sensitivity was 67.4% and the overall
accuracy was 86.3%. The accuracy of FNAC according to the sizes above and below the value were as
follows; 2 cm (72.2% vs. 88.1%); 3 cm (88.0% vs. 87.4%) ; 4 cm (86.6% vs. 84.4%) ; 5 cm (87.3% vs. 78.8%).
This was most obvious in the sensitivity of the FNA which also showed reducing trend as the nodules
increased in size.

Conclusion: FNAC is an essential diagnostic tool in the management of nodular goitre.
Our study showed that the accuracy of FNAC decreased as the size of the nodule getting bigger. Cautious
approach should be taken in the management of large goitre and decision should not be based only on the
result of FNAC.

Matched MeSH terms: Biopsy, Fine-Needle
Fulltext Acute Marjolin's Ulcer in Chronic Foot Wounds with Previous Negative Biopsy: Report of Two Cases

Xu S, Kang Y, Soeharno H, Yeo N

Malays Orthop J, 2020 Nov;14(3):194-197.
PMID: 33403086 DOI: 10.5704/MOJ.2011.033

Marjolin's ulcer is a rare and often overlooked diagnosis which can be encountered by a variety of specialities. Majority of the literatures describe long latency period of 11 to 75 years. The authors present two unusual cases of rapid progression to Marjolin's ulcer in patients with previously negative biopsy 8- and 10-month prior. This highlights the importance for clinicians to have a high degree of suspicion when encountered with any non-healing wound, especially one who's symptomatology and morphological features have undergone an acute change. Even with previous negative biopsy, patients should still be followed-up closely and clinicians should not hesitate to perform re-biopsy if the suspicion arises.

Matched MeSH terms: Biopsy
Fulltext Acute Tonsillitis With Concurrent Kikuchi's Disease as a Cause of Persistent Lymphadenopathy

Sawali H, Sabir Husin Athar PP, Ami M, Shamsudin NH, Nair G

Malays J Med Sci, 2009 Oct;16(4):73-6.
PMID: 22135516

We present a young adult female with symptoms of acute tonsillitis and tender cervical lymphadenopathy. Despite a full course of oral antibiotics, she had persistent left lower cervical lymphadenopathy measuring 2.0 x 1.5 cm at 2 weeks post-treatment. Rigid and flexible scope examinations did not reveal any abnormalities in the nasopharynx, oropharynx or hypopharynx. Tuberculosis tests were negative and blood index results were normal. Fine needle aspiration cytology revealed a non-specific granulomatous inflammatory process. Excisional lymph node biopsy was performed, and the patient was diagnosed as having Kikuchi's Disease (KD). We would like to highlight the diagnostic challenges in detecting this condition and the importance of differentiating KD from tuberculosis and malignant lymphoma, the latter of which requires aggressive treatment.

Matched MeSH terms: Biopsy, Fine-Needle

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