MyMedR

Clinical and imaging features predictive of orbital granulomatosis with polyangiitis and the risk of systemic involvement

Tan LT, Davagnanam I, Isa H, Taylor SR, Rose GE, Verity DH, et al.

Ophthalmology, 2014 Jun;121(6):1304-9.

PMID: 24560566 DOI: 10.1016/j.ophtha.2013.12.003

Granulomatosis with polyangiitis (GPA), previously Wegener's granulomatosis, requires prompt diagnosis and systemic review to exclude life-threatening disease. However, early diagnosis of orbital GPA may be difficult because anti-neutrophil cytoplasmic antibody (ANCA) and anti-PR3 antibody screening can be negative at presentation and orbital biopsies taken for diagnosis may not show the classic features of GPA. This study was designed to compare GPA with other causes of orbital inflammation and to identify the presenting clinical and imaging features most likely to predict GPA and its systemic spread.

Matched MeSH terms: Tomography, X-Ray Computed

Pulmonary manifestation as initial presentation for systemic lupus erythematosus

Khor CG, Kan SL, Tan BE

Int J Rheum Dis, 2018 Jun;21(6):1322-1325.

PMID: 24495523 DOI: 10.1111/1756-185X.12302

We report a 29-year-old Malay man who had pulmonary manifestations as an initial presentation for systemic lupus erythematosus. He had prolonged hospitalization and was treated with intensive care therapy with immunosuppressants.

Matched MeSH terms: Tomography, X-Ray Computed

Fulltext Robot-assisted radiofrequency ablation of primary and secondary liver tumours: early experience

Abdullah BJ, Yeong CH, Goh KL, Yoong BK, Ho GF, Yim CC, et al.

Eur Radiol, 2014 Jan;24(1):79-85.

PMID: 23928933 DOI: 10.1007/s00330-013-2979-7

OBJECTIVE: Computed tomography (CT)-compatible robots, both commercial and research-based, have been developed with the intention of increasing the accuracy of needle placement and potentially improving the outcomes of therapies in addition to reducing clinical staff and patient exposure to radiation during CT fluoroscopy. In the case of highly inaccessible lesions that require multiple plane angulations, robotically assisted needles may improve biopsy access and targeted drug delivery therapy by avoidance of the straight line path of normal linear needles.

METHODS: We report our preliminary experience of performing radiofrequency ablation of the liver using a robotic-assisted CT guidance system on 11 patients (17 lesions).

RESULTS/CONCLUSION: Robotic-assisted planning and needle placement appears to have high accuracy, is technically easier than the non-robotic-assisted procedure, and involves a significantly lower radiation dose to both patient and support staff.

KEY POINTS: • An early experience of robotic-assisted radiofrequency ablation is reported • Robotic-assisted RFA improves accuracy of hepatic lesion targeting • Robotic-assisted RFA makes the procedure technically easier with significant lower radiation dose.

Matched MeSH terms: Tomography, X-Ray Computed

Fulltext Two variants of fat embolism syndrome evolving in a young patient with multiple fractures

Bajuri MY, Johan RR, Shukur H

BMJ Case Rep, 2013;2013.

PMID: 23576653 DOI: 10.1136/bcr-2013-008631

Fat embolism syndrome (FES) is a continuum of fat emboli. Variants of FES: acute fulminant form and classic FES are postulated to represent two different pathomechanisms. Acute fulminant FES occurs during the first 24 h. It is attributed to massive mechanical blockage pulmonary vasculature by the fat emboli. The classic FES typically has a latency period of 24-36 h manifestation of respiratory failure and other signs of fat embolism. Progression of asymptomatic fat embolism with FES frequently represents inadequate treatment of hypovolaemic shock. We present a rare case of two variants of FES evolving in a patient with multiple fractures to emphasis the importance of adequate and appropriate treatment of shock in preventing the development of FES. Since supportive therapy which is a ventilatory support remains as the treatment of FES, it is appropriate to treat FES in the intensive care unit setting.

Matched MeSH terms: Tomography, X-Ray Computed

Grisel's syndrome: a rare complication of tonsillectomy

Sia KJ, Tang IP, Kong CK, Nasriah A

J Laryngol Otol, 2012 May;126(5):529-31.

PMID: 22361094 DOI: 10.1017/S0022215112000175

To discuss the pathophysiology of atlanto-axial subluxation as a rare complication of tonsillectomy, and to discuss the important radiological findings for diagnosis and treatment planning.

Matched MeSH terms: Tomography, X-Ray Computed

Fulltext Solid-pseudopapillary carcinoma: a case study and literature review

Mat Zin AA, Shakir KA, Aminuddin AR, Mahedzan MR, Irnawati WA, Andee DZ, et al.

BMJ Case Rep, 2012;2012.

PMID: 22927280 DOI: 10.1136/bcr-2012-006495

Solid-pseudopapillary tumour (SPT) is a rare exocrine tumour of the pancreas and is considered to have low malignant potential. Few morphological criteria are used to predict malignant behaviour such as equivocal perineural invasion, angioinvasion and invasion to surrounding tissue, and should be designated as solid-pseudopapillary carcinoma (SPC). We report a case of SPC. Clinical and radiological findings are typical for SPT with no metastatic disease. There is no tumour recurrence after 4&emsp14;months postresection. Clinical history and radiological findings were retrieved from the patient's record sheet and Viarad system. H&E staining and few immunoproxidase staining were reviewed by several pathologists. The histological findings are typical for SPT, with additional perineural invasion. There is no angioinvasion or capsular invasion identified. This is our first experience in diagnosing and managing SPC. We look forward to seeing the patient's disease status during her next routine follow-up. We expect good disease-free survival and very low risk of tumour recurrence, in view of only one risk factor (perineural invasion) and uninvolved surgical margins by the tumour.

Matched MeSH terms: Tomography, X-Ray Computed

Fulltext Hemorrhagic cardiac tamponade: rare complication of radiofrequency ablation of hepatocellular carcinoma

Loh KB, Bux SI, Abdullah BJ, Raja Mokhtar RA, Mohamed R

Korean J Radiol, 2012 Sep-Oct;13(5):643-7.

PMID: 22977334 DOI: 10.3348/kjr.2012.13.5.643

Local treatment for hepatocellular carcinoma (HCC) has been widely used in clinical practice due to its minimal invasiveness and high rate of cure. Percutaneous radiofrequency ablation (RFA) is widely used because its treatment effectiveness. However, some serious complications can arise from percutaneous RFA. We present here a rare case of hemorrhagic cardiac tamponade secondary to an anterior cardiac vein (right marginal vein) injury during RFA for treatment of HCC.

Matched MeSH terms: Tomography, X-Ray Computed

Fulltext Bilateral adrenal histoplasmosis: endoscopic ultrasound-guided fine needle aspiration as a method of diagnosis and assessment

Khairul Azhar J, Jacqueline HSG, Tony LKH, Tan BH, Steven JM

Med J Malaysia, 2011 Dec;66(5):504-6.

PMID: 22390113

We report a case of a healthy 78-year-old indonesian man who presented with chronic weight loss, poor appetite and lethargy. CT abdomen showed bilateral adrenal masses. EUS-guided FNA was performed on the left adrenal gland. Histopathology report was Histoplasma Capsulatum. He recovered well with antifungal treatment without any complication. In this case, we found that the role of EUS -guided FNA was not only limited to diagnosis but also helped in the prognosis of the disease since the method was able to assess the general anatomy of the adrenal gland better than other imaging modalities due to its close proximity and direct visualization.

Matched MeSH terms: Tomography, X-Ray Computed

Fulltext An atypical case of retropharyngeal abscess with long blind tract treated with Ryle's tube drainage

Tang ML, Lee SC, Phoon MP

Med J Malaysia, 2011 Dec;66(5):501-3.

PMID: 22390112

A 10 year-old Iban girl presented with severe odynophagia for 4 days and subcutaneous emphysema. Clinically, her neck was tender with crepitus. Lateral neck radiograph showed multiple linear radiolucent shadows at retropharyngeal space. Flexible nasopharyngolaryngoscope revealed a tunnel behind upper oesophagus with slough and there was pooling of saliva at pyriform sinus. Feeding via nasogastric tube was started and empirical treatment for fungal and bacterial infection was commenced. Subsequent computed tomography of neck and thorax showed a 15-long blind tract at subglottic region posterior to oesophagus (prevertebral region), extending to superior mediastinum just before carina at T3/T4 level, represent abscess. Hourly suctioning of the remaining abscess in the blind tract with 10ml-syringe was done.

Matched MeSH terms: Tomography, X-Ray Computed

Fulltext Visual outcome in open globe injuries

Thevi T, Mimiwati Z, Reddy SC

Nepal J Ophthalmol, 2012;4(2):263-70.

PMID: 22864032 DOI: http://dx.doi.org/10.3126/nepjoph.v4i2.6542

To determine the factors affecting the visual outcome in patients with open globe injuries of eye.

Matched MeSH terms: Tomography, X-Ray Computed

Tumour Lysis Syndrome: a Rare Complication of Trans-Arterial Chemo-Embolisation with Doxorubicin Beads for Hepatocellular Carcinoma

Katiman D, Manikam J, Goh KL, Abdullah BJ, Mahadeva S

J Gastrointest Cancer, 2012 Sep;43 Suppl 1:S187-90.

PMID: 22692948 DOI: 10.1007/s12029-012-9373-6

Matched MeSH terms: Tomography, X-Ray Computed

A parapharyngeal meningioma presenting as a neck mass and multiple cranial nerve palsies

Mohamad I, Abdullah B, Idris Z, Naik VR, Bhavaraju VM

Ceylon Med J, 2011 Jun;56(2):73-4.

PMID: 21789871

Matched MeSH terms: Tomography, X-Ray Computed

Pedunculated parietal pleural lesion: a rare presentation of bronchogenic cyst

Abdul Rahman MR, Yaman MN, Dimon MZ, Zabir AF, Min JO, Hamid HA

Ann Thorac Surg, 2011 Aug;92(2):714-5.

PMID: 21801925 DOI: 10.1016/j.athoracsur.2011.02.028

We present a 35-year-old man with a preoperative diagnosis of a right lower lobe cystic mass. Misled by a radiological suggestion of an intraparenchymal lesion, he had a thoracotomy and right lower lobectomy. An intraoperative finding of a pedunculated cyst arising from the parietal pleural with subsequent histopathology confirmation of a benign bronchogenic cyst, however, would have made a less invasive surgical excision more appropriate.

Matched MeSH terms: Tomography, X-Ray Computed

Synovial sarcoma: a rare presentation of parapharyngeal mass

Shaariyah MM, Mazita A, Masaany M, Razif MY, Isa MR, Asma A

Chin J Cancer, 2010 Jun;29(6):631-3.

PMID: 20507738

Synovial sarcoma is a rare soft tissue sarcoma of the head and neck region involving the parapharyngeal space. The diagnosis of synovial sarcoma can be very challenging to the pathologists. We present a rare case of parapharyngeal synovial sarcoma in a young female patient who had a two-month history of left cervical intumescent mass at level II. The fine needle aspiration cytology of the mass was proved inconclusive. Transcervical excision of the mass was performed and the first case of parapharyngeal sarcoma was identified in our center by fluorescence in situ hybridization (FISH) technique. Repeat imaging revealed residual tumor. The patient successfully underwent a second excision of the residual tumor and received adjuvant radiotherapy.

Matched MeSH terms: Tomography, X-Ray Computed

Fulltext Severe traumatic brain injury: outcome in patients with diffuse axonal injury managed conservatively in Hospital Sultanah Aminah, Johor Bahru--an observational study

Liew BS, Johari SA, Nasser AW, Abdullah J

Med J Malaysia, 2009 Dec;64(4):280-8.

PMID: 20954551

Patients with isolated severe head injury with diffuse axonal injury and without any surgical lesion may be treated safely without cerebral resuscitation and intracranial pressure (ICP) monitoring. Seventy two patients were divided into three groups of patients receiving treatment based on ICP-CPP-targeted, or conservative methods either with or without ventilation support. The characteristics of these three groups were compared based on age, gender, Glasgow Coma Scale (GCS), pupillary reaction to light, computerized tomography scanning according to the Marshall classification, duration of intensive care unit (ICU) stays, Glasgow Outcome Score (GOS) and possible complications. There were higher risk of mortality (p < 0.001), worse GCS improvement upon discharge (p < 0.001) and longer ICU stays (p = 0.016) in ICP group compared to Intubation group. There were no significant statistical differences of GOS at 3rd and 6th months between all three groups.

Matched MeSH terms: Tomography, X-Ray Computed

Recurrence of multiple myeloma with soft tissue plasmacytoma presenting as unilateral proptosis

Pan SW, Wan Hitam WH, Mohd Noor RA, Bhavaraju VM

Orbit, 2011 Mar;30(2):105-7.

PMID: 21322793 DOI: 10.3109/01676830.2010.546553

To describe a rare case of soft tissue plasmacytoma of the orbit presenting with proptosis.

Matched MeSH terms: Tomography, X-Ray Computed

A recurrent nasopharyngeal carcinoma with lacrimal sac involvement: a case report

Tang IP, Periyannan P, Prepageran N, Shashinder S, Singh A, Bhagubhai PN

Eur J Cancer Care (Engl), 2011 Jan;20(1):93-5.

PMID: 20088917 DOI: 10.1111/j.1365-2354.2009.01147.x

We report a very rare case of recurrent nasopharyngeal carcinoma with local involvement of lacrimal sac. The patient was treated with chemotherapy and there was no recurrence noted after 1 year of follow-up.

Matched MeSH terms: Tomography, X-Ray Computed

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: Tomography, X-Ray Computed

Pediatric subperiosteal orbital abscess secondary to acute sinusitis: a 5-year review

Tan VES

Am J Otolaryngol, 2011 Jan-Feb;32(1):62-8.

PMID: 20031268 DOI: 10.1016/j.amjoto.2009.10.002

Objective: Subperiosteal orbital abscesses (SPOAs) secondary to acute sinusitis are rare occurrences in the pediatric age group, more so in the neonatal period. Here, a rare case of SPOA in a 38-day-old newborn later drained via endoscopic sinus surgery is included also. This review describes the demographic data, clinical history, treatment, microbiology results, complications, and outcome.
Methods: The admission records for all the patients who were admitted to the Pediatric Surgical Ward in Sarawak General Hospital, Kuching, Malaysia, between January 2004 and May 2009 were retrospectively reviewed. Records of patients who presented with preseptal cellulitis, orbital cellulitis, subperiosteal abscess (extraconal), orbital abscess (intraconal), and cavernous sinus thrombosis were closely studied. Ophthalmology consultations were obtained in all these cases. Ultimately, 3 patients having SPOA secondary to acute sinusitis were selected for this review.
Results: All patients were male with rapid onset of periorbital signs, absence of purulent rhinorrhea, and presence of significant thrombocytosis (exceeding 500 × 109/L). The 38-day-old newborn had mixed infection of methicillin-resistant coagulase-negative Staphylococcus bacteremia and local Acinetobacter eye infection with Staphylococcus aureus in the SPOA. All had medially located SPOA that was adequately drained via endoscopic sinus surgery, resulting in full recovery.
Conclusion: Newborns with preexisting risk factors and immature immunity are at risk of severe and rare infections. Contrast-enhanced paranasal sinus computed tomographic scan is mandatory and reliable to differentiate preseptal and postseptal orbital infection, as both conditions can present similarly and rapidly deteriorate. In the contrast-enhanced computed tomography–demonstrable SPOA, endoscopic sinus surgery drainage of the abscess proved to be safe and reliable as the main treatment modality. All patients recovered well without complications.

Matched MeSH terms: Tomography, X-Ray Computed

A new expandable cannula system for endoscopic evacuation of intraparenchymal hemorrhages

Waran V, Vairavan N, Sia SF, Abdullah B

J. Neurosurg., 2009 Dec;111(6):1127-30.

PMID: 19408977 DOI: 10.3171/2009.4.JNS081506

The authors describe a newly developed expandable cannula to enable a more efficient use of an endoscope in removing intraparenchymal spontaneous hypertensive intracerebral hematomas. The cannula is introduced like a conventional brain cannula, using neuronavigation techniques to reach the targeted hematoma accurately, and, once deployed, conventional microsurgical techniques are used under direct endoscopic visualization. This method was used in 6 patients, and, based on the results of intraoperative intracranial pressure monitoring and postoperative CT scanning, the authors were able to achieve good hematoma removal. They found that by using the expandable cannula, efficient endoscopic surgery in the brain parenchyma was possible.

Matched MeSH terms: Tomography, X-Ray Computed

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