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  1. Effects of androgenic gland ablation on male primary and secondary sexual characteristics in the Malaysian prawn, Macrobrachium rosenbergii (de Man) (Decapoda, Palaemonidae), with first evidence of induced feminization in a nonhermaphroditic decapod
    Nagamine C, Knight AW, Maggenti A, Paxman G
    Gen Comp Endocrinol, 1980 Aug;41(4):423-41.
    PMID: 7409450
    Matched MeSH terms: Feminization/pathology*; Testis/pathology; Vas Deferens/pathology
  2. Fulltext Elephantiasis nostras verrucosa: a rare complication of lower limb lymphoedema
    Kar Keong N, Siing Ngi AT, Muniandy P, Voon Fei W
    BMJ Case Rep, 2017 Aug 28;2017.
    PMID: 28847994 DOI: 10.1136/bcr-2017-221492
    We reported a case of a 49-year-old man who had chronic lymphoedema of bilateral lower limbs for 30 years, but he did not seek treatment. His disease was complicated with irreversible changes of elephantiasis nostras verrucosa and had recurrent admissions due to infection. He was not keen for surgical intervention. This case report illustrated a rare and non-reversible complication of a common skin disease, lymphoedema and also the importance of identifying and treating it early.
    Matched MeSH terms: Elephantiasis/pathology; Skin Diseases/pathology; Lower Extremity/pathology*
  3. Fulltext Metastasis within a metastasis to the thyroid: A rare phenomenon
    Wong YP, Affandi KA, Tan GC, Muhammad R
    Indian J Pathol Microbiol, 2017 9 25;60(3):430-432.
    PMID: 28937391 DOI: 10.4103/IJPM.IJPM_287_16
    Metastatic disease involving the thyroid gland is uncommon. Solitary thyroid metastases from various primary sites particularly kidney, lung, and breast had been previously described. To the best of our knowledge, metastases from two topographically separate primary malignancies to the thyroid have never been documented hitherto. This is the first reported case of cancer-to-cancer metastasis involving an invasive breast carcinoma metastasized within a metastatic renal cell carcinoma in the nonneoplastic thyroid in a 58-year-old woman. Distinguishing a secondary thyroid metastases from a primary thyroid malignancy is utmost crucial as treatment differs. The possibility of tumor metastases from two separated primaries should always be considered in a tumor exhibiting malignant cell populations with two distinctive histomorphological appearances. The role of immunohistochemistry stains in equivocal cases cannot be overemphasized.
    Matched MeSH terms: Breast Neoplasms/pathology*; Carcinoma, Renal Cell/pathology*; Thyroid Neoplasms/pathology*
  4. Orbital multiple myeloma: a diagnostic challenge
    Tai E, Sim SK, Haron J, Wan Hitam WH
    BMJ Case Rep, 2017 Aug 07;2017.
    PMID: 28790098 DOI: 10.1136/bcr-2017-220895
    Orbital involvement in multiple myeloma is unusual. We describe the case of an 85-year-old woman who presented with right eye proptosis, reduced visual acuity and diplopia. Computed tomography showed a lobulated, enhancing soft tissue mass arising from the right greater wing of the sphenoid with intraconal, lacrimal gland and ocular muscle involvement. Histopathology revealed predominantly atypical plasma cells in a background of reactive lymphocytes, with monoclonality towards kappa light chain protein, suggestive of multiple myeloma. This case illustrates the diagnostic imaging challenge of orbital multiple myeloma.
    Matched MeSH terms: Multiple Myeloma/pathology; Orbital Neoplasms/pathology; Sphenoid Bone/pathology
  5. Prospective diagnostic study on the use of narrow-band imaging on suspicious lesions during colonoscopy examination
    Yaacob H, Ikhwan SM, Hashim MN, Syed Abd Aziz SH, Wan Zain WZ, Tuan Sharif SE, et al.
    Asian J Endosc Surg, 2018 Nov;11(4):318-324.
    PMID: 29424061 DOI: 10.1111/ases.12463
    INTRODUCTION: Colonoscopy is the gold standard to detect colorectal neoplasm. Narrow-band imaging (NBI) has a good diagnostic accuracy to differentiate between neoplastic and non-neoplastic colorectal lesions. This study explores the diagnostic validity of NBI colonoscopy as well as its associated factors related to neoplastic and non-neoplastic colorectal lesions.

    METHODS: This study enrolled 100 patients in a single-center tertiary teaching hospital. Patients presented for screening colonoscopy, and those with suspicious colorectal lesions were included in this study. During colonoscopy, the most suspicious lesion in each patient was analyzed using the NBI system based on Sano's classification. Each lesion was biopsied for histopathological analysis, the gold standard. Endoscopic images were captured electronically. The sensitivity, specificity, and diagnostic accuracy of NBI colonoscopy were assessed. Other associated factors related to neoplastic and non-neoplastic lesions were analyzed accordingly.

    RESULTS: The sensitivity and specificity of the NBI were 88.2% and 71.9%, respectively. The area under the receiver-operator curve was 0.801, indicating that NBI has a good ability to differentiate between disease and non-disease. There are significant associations between histopathological examination outcomes and both presenting symptoms, especially weight loss, and lesion site, even after other variables were controlled (P 

    Matched MeSH terms: Adenoma/pathology; Carcinoma/pathology; Colorectal Neoplasms/pathology
  6. Cyclooxygenase-2 (COX2) expression in adenocarcinoma surpasses that of squamous cell carcinoma in the uterine cervix
    Marutha Muthu AK, Cheah PL, Koh CC, Chew MF, Toh YF, Looi LM
    Malays J Pathol, 2017 Dec;39(3):251-255.
    PMID: 29279587 MyJurnal
    Over the years, adenocarcinoma (ADC), which has a worse prognosis than squamous cell carcinoma (SCC) of the cervix, has shown an increasing trend. Cyclooxygenase-2 (COX2) expression which has been associated with worse prognosis in several solid cancers was studied for its association with SCC and ADC of the cervix. 35 histologically re-confirmed SCC and 35 ADC were immunohistochemically stained for COX2 using a mouse monoclonal antibody to COX2 (1:100; Dako: Clone CX-294) on a Ventana Benchmark XT. The histoscore was computed as intensity of staining, semi-quantitated on a scale of 0-3 with 0 = negative, 1 = weak, 2 = moderate and 3 = strong staining intensity; multiplied by percentage of immunopositivity on a scale of 0-4 with 0 = <1%, 1 = 1-25%, 2 = 26-50%, 3 = 51-75% and 4 = ≥75% of immunopositive tumour cells. Histoscore 1-3/12 was considered as low and ≥4/12 as high COX2 expression. SCC affected Chinese more than Malays, while Malays had more ADC (p = 0.032). Mean age at presentation of SCC (57.5 years) was about a decade later than ADC at 47.9 years (p = 0.002). 30/35 (85.7%) of SCC and 34/35 (97.1%) of ADC expressed COX2. Histoscores of ADC (median = 4.0, IQR = 3.0-6.0) was significantly higher (p = 0.014) than those of SCC (median = 3.0, IQR = 2.0-3.0). High histoscores (≥4/12) were more frequent in ADC (55.9%) compared with SCC (26.7%) (p = 0.018), implicating COX2, either directly or indirectly, as a possible player in influencing the poorer outcome of ADC compared with SCC.
    Matched MeSH terms: Adenocarcinoma/pathology*; Carcinoma, Squamous Cell/pathology*; Uterine Cervical Neoplasms/pathology*
  7. Fulltext Evaluation of in silico predictors on short nucleotide variants in HBA1, HBA2, and HBB associated with haemoglobinopathies
    Tamana S, Xenophontos M, Minaidou A, Stephanou C, Harteveld CL, Bento C, et al.
    Elife, 2022 Dec 01;11.
    PMID: 36453528 DOI: 10.7554/eLife.79713
    Haemoglobinopathies are the commonest monogenic diseases worldwide and are caused by variants in the globin gene clusters. With over 2400 variants detected to date, their interpretation using the American College of Medical Genetics and Genomics (ACMG)/Association for Molecular Pathology (AMP) guidelines is challenging and computational evidence can provide valuable input about their functional annotation. While many in silico predictors have already been developed, their performance varies for different genes and diseases. In this study, we evaluate 31 in silico predictors using a dataset of 1627 variants in HBA1, HBA2, and HBB. By varying the decision threshold for each tool, we analyse their performance (a) as binary classifiers of pathogenicity and (b) by using different non-overlapping pathogenic and benign thresholds for their optimal use in the ACMG/AMP framework. Our results show that CADD, Eigen-PC, and REVEL are the overall top performers, with the former reaching moderate strength level for pathogenic prediction. Eigen-PC and REVEL achieve the highest accuracies for missense variants, while CADD is also a reliable predictor of non-missense variants. Moreover, SpliceAI is the top performing splicing predictor, reaching strong level of evidence, while GERP++ and phyloP are the most accurate conservation tools. This study provides evidence about the optimal use of computational tools in globin gene clusters under the ACMG/AMP framework.
    Matched MeSH terms: Pathology, Molecular
  8. Fulltext Sézary syndrome in a Malay--case report and literature review
    Yuen P, Chan HL, Lee YS
    Singapore Med J, 2001 May;42(5):224-7.
    PMID: 11513062
    Sézary syndrome is a rare form of primary cutaneous T cell lymphoma. It is a distinct systemic variant of mycosis fungoides, marked by erythroderma, lymphadenopathy and circulating cerebriform lymphocytes in the peripheral blood. We report a case of Sézary syndrome in a 61-year-old Malay man with a five-year history of indurated plaques, ulcers and tumours on the head and trunk, with characteristic findings on physical examination, skin biopsy, electron microscopy, immunophenotyping and peripheral blood film. A literature review on Sézary syndrome is presented.
    Matched MeSH terms: Face/pathology*; Sezary Syndrome/pathology*; Skin Ulcer/pathology*
  9. Fulltext Epidermal inclusion cyst of the breast: a rare benign entity
    Lam SY, Kasthoori JJ, Mun KS, Rahmat K
    Singapore Med J, 2010 Dec;51(12):e191-4.
    PMID: 21221490
    Epidermal inclusion cyst (EIC) arising from the breast is an uncommon benign condition. We report two cases of enlarging EIC of the breast in two women in their forties. The diagnosis of this condition may not be straightforward with imaging alone if an EIC presents as an enlarging lump in the breast and mimics a benign breast lesion, most commonly a fibroadenoma or malignant lesion with benign imaging features. Excision is usually recommended for a definite histopathological diagnosis and for the prevention of potential risks of malignant transformation. Asymptomatic stable lesions do not require treatment; biopsy is unnecessary, and follow-up imaging suffices if typical sonographic and clinical findings are found.
    Matched MeSH terms: Breast/pathology; Breast Diseases/pathology; Epidermal Cyst/pathology
  10. Fulltext A rare case of ambiguous genitalia
    Ng SF, Boo NY, Wu LL, Shuib S
    Singapore Med J, 2007 Sep;48(9):858-61.
    PMID: 17728969
    Genes on the Y chromosome are essential for normal sex determination and sex differentiation of male genitalia. However, genes on the X chromosome and other autosomes have been shown to be anti-testes and have a detrimental effect on this process. Addition of X chromosomes to the 46,XY karyotype results in seminiferous tubules dysgenesis, hypogonadism and malformed genitalia. We report a term male newborn with 49,XXXXY syndrome presenting with ambiguous genitalia, multiple extra-gonadal anomalies, facial dysmorphism, and radioulnar synostosis.
    Matched MeSH terms: Abnormalities, Multiple/pathology*; Genital Diseases, Male/pathology*; Sex Chromosome Disorders/pathology*
  11. Fulltext Acute presentation of tuberous sclerosis: case report
    Sathyamoorthy P
    Singapore Med J, 1993 Aug;34(4):358-60.
    PMID: 8266217
    Incomplete form of tuberous sclerosis (TS) may present with acute complications such as haematuria, retroperitoneal haemorrhage or pneumothorax. Such cases may pose diagnostic difficulty. A patient with incomplete form of TS without any cerebral impairment who presented as an acute surgical abdomen is reported. The diagnostic criteria of TS are reviewed. Visceral manifestations of TS including acute complications are discussed. The importance of recognising such presentations is stressed.
    Matched MeSH terms: Kidney Neoplasms/pathology; Tuberous Sclerosis/pathology*; Angiomyolipoma/pathology
  12. Fulltext Xanthogranulomatous pyelonephritis in a Malaysian population
    Koh KB
    Singapore Med J, 1993 Aug;34(4):341-2.
    PMID: 8266209
    Xanthogranulomatous pyelonephritis is a clinico-pathological entity that is gaining awareness amongst urologists worldwide. It is an unusual chronic inflammatory lesion involving the kidney that destroys renal parenchyma and may mimic renal carcinoma. It is usually seen in middle-aged women and is associated with urinary tract infections and urinary calculi. Most reports and reviews of this condition come from the West; this study reviews the incidence and presentation of the condition in a Malaysian population.
    Matched MeSH terms: Granuloma/pathology; Pyelonephritis/pathology; Xanthomatosis/pathology
  13. Fulltext Pathogenic Role of Exosomes in Epstein-Barr Virus (EBV)-Associated Cancers
    Teow SY, Liew K, Khoo AS, Peh SC
    Int J Biol Sci, 2017;13(10):1276-1286.
    PMID: 29104494 DOI: 10.7150/ijbs.19531
    Exosomes are 40- to 100-nm membrane-bound small vesicles that carry a great variety of cellular cargoes including proteins, DNA, messenger RNAs (mRNAs), and microRNAs (miRNAs). These nanovesicles are detected in various biological fluids such as serum, urine, saliva, and seminal fluids. Exosomes serve as key mediators in intercellular communication by facilitating the transfer and exchange of cellular components from cells to cells. They contain various pathogenic factors whereby their adverse effects have been implicated in multiple viral infections and cancers. Interestingly, accumulating evidences showed that exosomes derived from tumour viruses or oncoviruses, exacerbate virus-associated cancers by remodelling the tumour microenvironment. In this review, we summarize the contributing factors of Epstein-Barr virus (EBV) products-containing exosomes in viral pathogenesis and their potential implications in EBV-driven malignancies. Understanding the biological role of these exosomes in the disease would undoubtedly boost the development of a more comprehensive strategy to combat EBV-associated cancers and to better predict the therapeutic outcomes. Furthermore, we also highlight the potentials and challenges of EBV products-containing exosomes being employed as diagnostic markers and therapeutic targets for EBV-related cancers. Since these aspects are rather underexplored, we attempt to underline interesting areas that warrant further investigations in the future.
    Matched MeSH terms: Carcinoma/pathology*; Nasopharyngeal Neoplasms/pathology*; Epstein-Barr Virus Infections/pathology*
  14. Fulltext Mucoepidermoid carcinoma of the nasal septum (case report)
    Alazzawi S, Sivalingam S, Raman R, Mun KS
    Ann Saudi Med, 2015 10 29;35(5):400-2.
    PMID: 26506975 DOI: 10.5144/0256-4947.2015.400
    We report an extremely rare case of mucoepidermoid carcinoma of the nasal septum. A patient with a history of right-sided nasal obstruction presented to our clinic. Clinical examination revealed a mass in the right nasal cavity originating from the nasal septum. Biopsy revealed a high-grade mucoepidermoid carcinoma. The patient was treated with surgical resection only. Surgery alone might be suitable for small tumors when direct inspection of the surgical site is feasible to detect early recurrence.
    Matched MeSH terms: Nose Neoplasms/pathology; Nasal Obstruction/pathology; Carcinoma, Mucoepidermoid/pathology
  15. Fulltext Understanding Glioblastoma Biomarkers: Knocking a Mountain with a Hammer
    Hassn Mesrati M, Behrooz AB, Y Abuhamad A, Syahir A
    Cells, 2020 05 16;9(5).
    PMID: 32429463 DOI: 10.3390/cells9051236
    Gliomas are the most frequent and deadly form of human primary brain tumors. Among them, the most common and aggressive type is the high-grade glioblastoma multiforme (GBM), which rapidly grows and renders patients a very poor prognosis. Meanwhile, cancer stem cells (CSCs) have been determined in gliomas and play vital roles in driving tumor growth due to their competency in self-renewal and proliferation. Studies of gliomas have recognized CSCs via specific markers. This review comprehensively examines the current knowledge of the most significant CSCs markers in gliomas in general and in glioblastoma in particular and specifically focuses on their outlook and importance in gliomas CSCs research. We suggest that CSCs should be the superior therapeutic approach by directly targeting the markers. In addition, we highlight the association of these markers with each other in relation to their cascading pathways, and interactions with functional miRNAs, providing the role of the networks axes in glioblastoma signaling pathways.
    Matched MeSH terms: Brain Neoplasms/pathology; Glioblastoma/pathology; Neoplastic Stem Cells/pathology
  16. Clinico-radiologic-pathologic conference. Abnormal findings on chest radiographs of an asymptomatic patient
    Staples CA, Brown MJ, Bai TR, Chan NH
    Can Assoc Radiol J, 1996 Apr;47(2):136-9.
    PMID: 8612087
    Matched MeSH terms: Calculi/pathology; Lung Diseases/pathology; Pulmonary Alveoli/pathology
  17. The Effect of Eye Patching on Clear Corneal Incision Architecture in Phacoemulsification: A Randomized Controlled Trial
    Ho FL, Salowi MA, Bastion MC
    Asia Pac J Ophthalmol (Phila), 2017;6(5):429-434.
    PMID: 28379650 DOI: 10.22608/APO.2016198
    PURPOSE: To investigate the effects of postoperative eye patching on clear corneal incision architecture in phacoemulsification.

    DESIGN: A single-center, randomized controlled trial.

    METHODS: A total of 132 patients with uncomplicated phacoemulsification were randomly allocated to the intervention or control group. The intervention group received postoperative eye patching for approximately 18 hours, whereas the control group received eye shield. The clear corneal incision architecture was examined postoperatively at 2 hours, 1 day, and 7 days after surgery using optical coherence tomography.

    RESULTS: Epithelial gaping was significantly reduced on postoperative day 1 in the intervention group (52.4%) compared with control (74.2%) (P = 0.01). No differences were found for other architectural defects. Descemet membrane detachment was associated with lower intraocular pressure on postoperative day 7 (P = 0.02). Presence of underlying diabetes mellitus did not seem to influence architectural defects.

    CONCLUSIONS: Postoperative eye patching facilitated epithelial healing and reduced the occurrence of epithelial gaping on postoperative day 1. It may play a role in protecting and improving corneal wounds during the critical immediate postoperative period.

    Matched MeSH terms: Cornea/pathology; Descemet Membrane/pathology; Epithelium, Corneal/pathology
  18. Fulltext Syrian hamsters (Mesocricetus auratus) oronasally inoculated with a Nipah virus isolate from Bangladesh or Malaysia develop similar respiratory tract lesions
    Baseler L, de Wit E, Scott DP, Munster VJ, Feldmann H
    Vet Pathol, 2015 Jan;52(1):38-45.
    PMID: 25352203 DOI: 10.1177/0300985814556189
    Nipah virus is a paramyxovirus in the genus Henipavirus, which has caused outbreaks in humans in Malaysia, India, Singapore, and Bangladesh. Whereas the human cases in Malaysia were characterized mainly by neurological symptoms and a case fatality rate of ∼40%, cases in Bangladesh also exhibited respiratory disease and had a case fatality rate of ∼70%. Here, we compared the histopathologic changes in the respiratory tract of Syrian hamsters, a well-established small animal disease model for Nipah virus, inoculated oronasally with Nipah virus isolates from human cases in Malaysia and Bangladesh. The Nipah virus isolate from Bangladesh caused slightly more severe rhinitis and bronchointerstitial pneumonia 2 days after inoculation in Syrian hamsters. By day 4, differences in lesion severity could no longer be detected. Immunohistochemistry demonstrated Nipah virus antigen in the nasal cavity and pulmonary lesions; the amount of Nipah virus antigen present correlated with lesion severity. Immunohistochemistry indicated that both Nipah virus isolates exhibited endotheliotropism in small- and medium-caliber arteries and arterioles, but not in veins, in the lung. This correlated with the location of ephrin B2, the main receptor for Nipah virus, in the vasculature. In conclusion, Nipah virus isolates from outbreaks in Malaysia and Bangladesh caused a similar type and severity of respiratory tract lesions in Syrian hamsters, suggesting that the differences in human disease reported in the outbreaks in Malaysia and Bangladesh are unlikely to have been caused by intrinsic differences in these 2 virus isolates.
    Matched MeSH terms: Lung/pathology; Respiratory System/pathology; Henipavirus Infections/pathology*
  19. Myocardial infarction in a large colony of nonhuman primates with coronary artery atherosclerosis
    Bond MG, Bullock BC, Bellinger DA, Hamm TE
    Am J Pathol, 1980 Dec;101(3):675-92.
    PMID: 7446712
    Relatively few cases of myocardial infarction associated with coronary artery atherosclerosis have been described previously in macaques. In this study the authors report the prevalence and characteristics of coronary artery atherosclerosis and myocardial infarction in 10 rhesus (Macaca mulatta) and two cynomolgus (Macaca fascicularis) macaques that were fed atherogenic diets for 16 months or longer. Our findings show clearly that myocardial infarction occurs in macaques with diet-induced atherosclerosis. The frequency seems to be related to the species, composition of the atherogenic diet, and length of time fed the atherogenic diet. The myocardial lesions are remarkably similar to those described in human beings in terms of location and gross and microscopic characteristics. The characteristics of coronary artery atherosclerosis, including the occurrence of thrombosis, severe stenosis, mineralization, atheronecrosis, and sterol clefts, especially in animals fed the atherogenic diets for longer periods of time, also closely resemble those of the arterial lesions found in human beings. The greatest prevalence of myocardial infarcts was found in rhesus monkeys fed a cholesterol-containing diet with 40% of calories supplied by peanut oil and in cynomolgus macaques from Malaya that were fed the same amount of cholesterol with 40% of calories from lard. Electrocardiographic abnormalities as well as the occurrence of unexpected and relatively sudden death in several of these nonhuman primates are also consistent with signs frequently observed in human beings.
    Matched MeSH terms: Arteriosclerosis/pathology; Coronary Vessels/pathology; Myocardial Infarction/pathology
  20. Fulltext Neuroendocrine Cell Hyperplasia of Infancy. Clinical Score and Comorbidities
    Liptzin DR, Pickett K, Brinton JT, Agarwal A, Fishman MP, Casey A, et al.
    Ann Am Thorac Soc, 2020 Jun;17(6):724-728.
    PMID: 32109152 DOI: 10.1513/AnnalsATS.201908-617OC
    Rationale: Neuroendocrine cell hyperplasia of infancy (NEHI) is an important form of children's interstitial and diffuse lung disease for which the diagnostic strategy has evolved. The prevalence of comorbidities in NEHI that may influence treatment has not been previously assessed.Objectives: To evaluate a previously unpublished NEHI clinical score for assistance in diagnosis of NEHI and to assess comorbidities in NEHI.Methods: We performed a retrospective chart review of 199 deidentified patients with NEHI from 11 centers. Data were collected in a centralized Research Electronic Data Capture registry and we performed descriptive statistics.Results: The majority of patients with NEHI were male (66%). The sensitivity of the NEHI Clinical Score was 87% (95% confidence interval [CI], 0.82-0.91) for all patients from included centers and 93% (95% CI, 0.86-0.97) for those with complete scores (e.g., no missing data). Findings were similar when we limited the population to the 75 patients diagnosed by lung biopsy (87%; 95% CI, 0.77-0.93). Of those patients evaluated for comorbidities, 51% had gastroesophageal reflux, 35% had aspiration or were at risk for aspiration, and 17% had evidence of immune system abnormalities.Conclusions: The NEHI Clinical Score is a sensitive tool for clinically evaluating NEHI; however, its specificity has not yet been addressed. Clinicians should consider evaluating patients with NEHI for comorbidities, including gastroesophageal reflux, aspiration, and immune system abnormalities, because these can contribute to the child's clinical picture and may influence clinical course and treatment.
    Matched MeSH terms: Hyperplasia/pathology; Lung Diseases, Interstitial/pathology; Lung Diseases, Interstitial/physiopathology; Neuroendocrine Cells/pathology
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