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Fulltext Artificial weathering as a function of CO2 injection in Pahang Sandstone Malaysia: investigation of dissolution rate in surficial condition

Jalilavi M, Zoveidavianpoor M, Attarhamed F, Junin R, Mohsin R

Sci Rep, 2014;4:3645.
PMID: 24413195 DOI: 10.1038/srep03645

Formation of carbonate minerals by CO2 sequestration is a potential means to reduce atmospheric CO2 emissions. Vast amount of alkaline and alkali earth metals exist in silicate minerals that may be carbonated. Laboratory experiments carried out to study the dissolution rate in Pahang Sandstone, Malaysia, by CO2 injection at different flow rate in surficial condition. X-ray Powder Diffraction (XRD), Scanning Electron Microscope (SEM) with Energy Dispersive X-ray Spectroscopy (EDX), Atomic Absorption Spectroscopy (AAS) and weight losses measurement were performed to analyze the solid and liquid phase before and after the reaction process. The weight changes and mineral dissolution caused by CO2 injection for two hours CO2 bubbling and one week' aging were 0.28% and 18.74%, respectively. The average variation of concentrations of alkaline earth metals in solution varied from 22.62% for Ca(2+) to 17.42% for Mg(2+), with in between 16.18% observed for the alkali earth metal, potassium. Analysis of variance (ANOVA) test is performed to determine significant differences of the element concentration, including Ca, Mg, and K, before and after the reaction experiment. Such changes show that the deposition of alkali and alkaline earth metals and the dissolution of required elements in sandstone samples are enhanced by CO2 injection.

Matched MeSH terms: X-Rays
Fractures of the femoral neck

Monro JK

Journal of the Malaya Branch of the British Medical Association, 1940;3:422.

Matched MeSH terms: X-Rays
Mineral and physiochemical evaluation of cockle shell (Anadara granosa) and other selected molluscan shell as potential biomaterials

Bharatham H, Md Zuki Abu Bakar Zakaria, Perimal EK, Loqman Mohamad Yusof, Muhajir Hamid

Sains Malaysiana, 2014;43:1023-1029.

Molluscan shells are attracting research interest due to the diverse application properties possessed. As shells are very similar to bones, this study was conducted to analyze the mineral and physiochemical composition of Cockle (Anadara granosa) shell and three other types of molluscan shell, namely Strombus canarium, Oliva sayana and Terebra dislocata as potential biomaterial for bone tissue engineering applications. Approximately 200 g of shells from each species were processed and powdered for the purpose of this study. Carbon was analyzed using the carbon analyzer while minerals and heavy metals through ICP-MS. The phase purity and crystallographic structures of the powders were identified using X-Ray Diffractometer (XRD) while the chemical functionality was determined using the Fourier transform infrared (FTIR) spectrophotometer. The analysis showed that Cockle shells contained higher content of calcium and carbon including varying amount of other minor elements comparatively. However, all four types of shell powders were found to contain below detectable levels of toxic elements. Physiochemical analysis on phase purity and crystallographic structures showed similar characteristics of carbonate group present in all four shell types. A predominantly aragonite form of calcium carbonate was detected in both XRD diffractogram and FTIR spectra for all samples. Our findings demonstrated that different types of molluscan shells have almost similar mineral and physiochemical characteristics and a predominantly aragonite form of calcium carbonate that provides a strong basis for their use as a potential bone tissues engineering material.

Matched MeSH terms: X-Rays
Preparation, characterization and properties of core-shell cobalt ferrite/polycaprolactone nanomagnetic biomaterials

Khoo KS, Nur Farhana Amari, Tan CY, Shahidan Radiman, Redzuwan Yahaya, Muhamad Samudi Yasir

Sains Malaysiana, 2013;42:167-173.

Combination of magnetic and biocompatible materials to form core-shell nanomaterials has been widely used in medical fields. These core-shell magnetic biomaterials have a great potential for magnetic fluid hyperthermia (MFH) treatment to remedy cancer. The aims of this study were to investigate the production of core-shell cobalt ferrite/polycaprolactone (CoFe2O4/PCL) nanomaterials with different ratios of cobalt ferrite to caprolactone, to study the effects of using polymer in reducing the agglomerations between particles and to determine the structure, morphology, thermal and magnetic properties of these core-shell nanomaterials. The core-shell nanomaterials were produced by in situ polymerization method. The formation of the CoFe2O4/PCL was investigated by means of Fourier transform infrared spectroscopy (FTIR), x-ray diffractometer (XRD) and transmission electron microscopy (TEM). Its thermal properties were determined by using thermogravimetric analyzer (TGA). The vibrating sample magnetometer (VSM) was used to reveal the magnetic properties. The results for the XRD and FTIR spectra demonstrated the formation of cobalt ferrite and polycaprolactone in core-shell nanomaterials. From the TEM results, it was seen that the core-shell CoFe2O4/PCL nanomaterials were best formed at a ratio of CoFe2O4 to monomer caprolactone mixtures of 1:4.

Matched MeSH terms: X-Rays
Fulltext PVC as a potential filter material for ionising radiation

Laila Kalidah Junet, Zafri Azran Abdul Majid, Muhammad Syahmi Che Othaman

International Journal of Allied Health Sciences, 2017;1(2):101-107.
MyJurnal

Aluminum (Al) is a standard material that has been used as a filter for ionising radiation however for polyvinyl chloride (PVC) there is no solid evidence to support but has been recommended. PVC has been selected as a potential filter material due to it is a long lasting constructing material and very durable, which can be used in a variety of application. The purpose of this study was to observe the effect of PVC on entrance surface dose (ESD) values as compare to the standard X-ray filter of Al. The effect of varying thickness of the materials and difference exposure settings were observed and compared to each other. From this study, the percentage difference for both PVC and Al thickness is less than ± 25.00 % shows that PVC has a potential to be used as one of the filter materials due to its ability to reduce the ESD value

Matched MeSH terms: X-Rays
Fulltext Pulmonary Embolism Masquerading as Severe Pneumonia: A Case Report

Payus AO, Rajah R, Febriany DC, Mustafa N

Open Access Maced J Med Sci, 2019 Feb 15;7(3):396-399.
PMID: 30834009 DOI: 10.3889/oamjms.2019.114

BACKGROUND: De novo pulmonary embolism (DNPE) is a term used when pulmonary embolism (PE) occur in the absence of deep vein thrombosis (DVT). Most DNPE cases occur in a patient who had a recent injury to the chest.
CASE PRESENTATION: However, here we report a case of DNPE with a slightly different presentation where there is no preceding trauma and has symptoms that mimic severe pneumonia. He presented with high fever, dyspnoea and pleuritic chest pain. Despite on 10 L of oxygen supplementation via high flow mask and already given bolus intravenous antibiotic, the patient still tachypnoeic and was persistently in type I respiratory failure. His chest X-ray showed consolidative changes. Upon further investigation revealed no evidence of DVT on Doppler ultrasound and normal D-dimer level. Due to the high index of suspicion by the attending physician, PE was suspected and later confirmed with computed tomography pulmonary angiography scan. He was successfully treated with anticoagulation therapy. The objective of this case report is to share the difficult experience of diagnosing PE when the presentation highly atypical and mimics severe pneumonia.
CONCLUSION: And with such a masquerading presentation, one can easily miss the diagnosis. To the best of our knowledge, there are very few similar cases reported.

Matched MeSH terms: X-Rays
Fulltext Synthesis and physicochemical analysis of polystyrene-anchored pd(II) metal complex

Siti Kamilah Che Soh, Siti Aminah Jusoh, Mustaffa Shamsuddin

Scientific Research Journal, 2014;11(2):0-0.
MyJurnal

A polystyrene (PS)-anchored Pd(II) metal complex was synthesized on cross-linked polymer by heating a mixture of chlorometylated polystyrene with phenyldithiocarbazate and carbon disulfide in the presence of potassium hydroxide (KOH) in dimethylformamide (DMF). The reaction mixture was heated at 80 °C to form the corresponding phenyldithiocarbazate-functionalized polymer. Then, it was treated with bis(benzonitrile)palladium(II) chloride. The properties of dark colored polymer, impregnated with the metal complex was then characterized by various spectroscopic technique such as Fourier Transform Infrared (FTIR), Scanning Electron Microscopy/Energy Dispersive X-ray (SEM/EDX), CHNS elemental analysis, BET surface area, X-ray Diffraction (XRD), Thermogravimetric (TGA) and Inductively Coupled Plasma-Optical Emission (ICP-OES) spectroscopy.

Matched MeSH terms: X-Rays
Fulltext Morphological and optical properties of graphene film synthesized from waste of industrial cooking oil, AYAMAS using DTCVD method

Mohd Muzamir Mahat, Nurfazianawatie Mohd Zin, Nurul Afaah Abdullah, Salifairus Mohammad Jafar, Mohd Firdaus Malek, M. Rusop, et al.

Science Letters, 2020;14(2):24-33.
MyJurnal

The synthesis of graphene by double thermal chemical vapor deposition (DTCVD) using waste of industrial cooking oil (WICO) as a natural carbon source was investigated. The synthesis parameter (Argon gas flow rate) was varied between 50sccm to 300sccm by 50sccm increments. The function of Argon gas is to provide ambient condition, remove the atmospheric air from the tube and could improve the crystallinity of graphene during synthesis. WICO (from AYAMAS food processing) was placed in the first furnace (precursor furnace) and nickel was placed in the second furnace (deposition furnace). During the synthesis, elevated quantities of carbon from the source material are separated and precipitated on the Nickel surface. The sample were characterized by using Field Emission Scanning Electron Microscopy (FESEM), X-Ray Diffraction (XRD), Energy Dispersive X-ray (EDX), and Ultraviolet Visible (UV-Vis) spectroscopy. Based on FESEM images, at 250sccm, hexagonal graphene formation was observed. Besides, optical properties can be seen by UV-Vis and as the results show that 250sccm is the highest reflectivity value. Consequently, graphene synthesis from WICO using various Argon gas flow rate as precursor is successfully demonstrated.

Matched MeSH terms: X-Rays
Fulltext Prevalence and Factors Associated with Tuberculosis Treatment Success among TB/HIV Co-Infection in North-East Malaysia

Jalal TMT, Abdullah S, Wahab FA, Dir S, Naing NN

Malays J Med Sci, 2017 Dec;24(6):75-82.
PMID: 29379389 DOI: 10.21315/mjms2017.24.6.9

Background: One of the six strategies developed by WHO, in order to stop Tuberculosis (TB) is addressing TB/HIV high-risk groups. This study aimed to determine the prevalence of successful TB treatment and factors associated with TB treatment success among TB/HIV co-infection patients in North-East Malaysia.
Methods: A cross-sectional study was carried out in the a-year period from 2003 to 2012 by reviewing TB/HIV records in all hospitals and health clinics. The outcome of interest was treatment success as defined by Ministry of Health (MOH) when the patients was cured or completed TB treatment.
Results: Out of 1510 total TB/HIV co-infection cases, 27.9% (95% CI: 25.2, 30.6) of the patients were having treatment success. A majority of TB/HIV co-infection cases were male (91.1%). Fifty-eight percent the patients were drug addicts and 6% were having positive tuberculin tests. The multiple logistic regression revealed that male (OR: 0.39, 95% CI: 0.22, 0.71) and positive tuberculin test result (OR: 2.61, 95% CI: 1.63, 4.19) were significantly associated with the treatment success of TB/HIV co-infection patients. Other factors such as age, comorbid, sputum smear and x-ray findings were not significantly factors in this study.
Conclusion: Female patients and those with negative tuberculin test should be emphasised for successful tuberculosis treatment.

Matched MeSH terms: X-Rays
Fulltext Radiographic considerations in endodontics

Yusof, Z.Y.M., Nambiar, P.

Malaysian Dental Journal, 2007;28(1):51-58.
MyJurnal

Quality radiographs of diagnostic value are important in root canal treatment. The dentist who has knowledge and skills in the use of radiographs for diagnostic purposes has a professional responsibility to ensure that the radiographs are obtained with minimum risk of radiation dose to and for the benefit of the patient. This article reviews the effectiveness of radiography techniques required for successful root canal treatment with the patient’s interest in mind. Awareness of effectual radiographic techniques, their constraints and applicable techniques for improvements are discussed. It seeks to reduce potentially harmful ionising radiation dose to patients and optimise the use of X-rays to produce diagnostic radiographs during root canal treatment.

Matched MeSH terms: X-Rays
Fulltext Latest recommendations for dental radiography in general dental practice

Purmal, Kathiravan, Nambiar, Phrabhakaran

Malaysian Dental Journal, 2008;29(2):104-112.
MyJurnal

Radiology is important in the diagnostic assessment, treatment and monitoring progress of patients having dental and maxillofacial diseases. The central question in dental radiology is whether there is any risk with regard to low doses of radiation and what are the necessary protection needed to prevent any hazardous outcome with X-raying. With the emergence of the new millennium, major changes are happening in the field of science and technology. More efficient equipments are being discovered and more researches are being conducted to elicit better understanding of the radiation process and its effect on the human health. This article will review the latest guidelines for proper radiographic practice from the USA and Europe. It will address topics like the risks from dental radiography, selection criteria, protection for patients and staff, improvement to X-ray equipments, room dimensions and lead lining requirements. We have limited our research to intraoral, panoramic and cephalometric radiographs because these are the radiographs or images that are commonly taken in the general practice setting. (Copied from article).

Matched MeSH terms: X-Rays
Fulltext True mechanical behaviour and the associated structure morphology of Poly(Lactid Acid) polymer in strain induced crystallisation by in-situ time resolved x-ray diffraction and scattering technique

Muhammad Rawi Mohamed Zin, Mahendrasingam, Arumugam, Konkel, Chris, Narayanan, Theyencheri

Jurnal Sains Nuklear Malaysia, 2011;23(2):53-59.
MyJurnal

Changes in molecular structure configuration during strain induced crystallisation of an amorphous Poly(Lactic Acid) (PLA 4032D) polymer was monitored in-situ by simultaneously recording the wide angle x-ray scattering (WAXS) and small angle x-ray scattering (SAXS) patterns together with polymer deformation images and force data. The amorphous chain orientation from the beginning of deformation until the onset of crystallisation was studied from the WAXS patterns. The true mechanical behaviour described by the true stress-true strain curve related to an amorphous chain orientation exhibited a linear behaviour. Approaching critical amorphous orientation, the true stress-true strain curve deviated from linear into non-linear behaviour. After the onset of crystallization, when the deformed polymer became a semicrystalline state, the true mechanical behaviour exhibited true strain hardening which greatly affected by the formation of the morphology. The gradual true strain hardening was associated with the formation of micro-fibrillar structure containing thin crystallite morphology whilst sharp increased in true strain hardening was associated with the formation of stacked lamellar morphology in the form of macro-lattice structure. The study was accomplished by the application of high brilliance synchrotron radiation at beamline ID2 of ESRF, Grenoble in France and the usage of the high contrast resolution of WAXS and SAXS charge-couple device (CCD) camera as well as 40 milliseconds temporal resolution of data acquisition system.

Matched MeSH terms: X-Rays
Fulltext Automated bone age assessment: motivation, taxonomies, and challenges

Mansourvar M, Ismail MA, Herawan T, Raj RG, Kareem SA, Nasaruddin FH

Comput Math Methods Med, 2013;2013:391626.
PMID: 24454534 DOI: 10.1155/2013/391626

Bone age assessment (BAA) of unknown people is one of the most important topics in clinical procedure for evaluation of biological maturity of children. BAA is performed usually by comparing an X-ray of left hand wrist with an atlas of known sample bones. Recently, BAA has gained remarkable ground from academia and medicine. Manual methods of BAA are time-consuming and prone to observer variability. This is a motivation for developing automated methods of BAA. However, there is considerable research on the automated assessment, much of which are still in the experimental stage. This survey provides taxonomy of automated BAA approaches and discusses the challenges. Finally, we present suggestions for future research.

Matched MeSH terms: X-Rays
Fulltext The oldest nutritional deficiency disease: a case report of scurvy

Yap, Chiew Yee, Tam, Pui Ying, Ng, Su Wei

Malaysian Journal of Paediatrics and Child Health, 2016;22(101):0-0.
MyJurnal

Scurvy resulting from dietary deficiency of vitamin C is characterized by anaemia, tender limbs swelling and hemorrhagic manifestations such as petechiae and bruises. We report a case of scurvy in a 13 years old boy with cerebral palsy who presented with history of limbs bruising and swelling for 2 months. On examination, he was cachexic and pale with poor dentition and swollen gum. There were extensive bruises and swollen limbs as well. His platelet count and coagulation profile were normal. Limbs X-ray revealed classical scorbutic changes in the long bones. Serum ascorbic acid level was low

Matched MeSH terms: X-Rays
Synthesis and characterization of anthill-eggshell composite adsorbent for removal of hexavalent chromium from aqueous solution

Yusuff AS, Gbadamosi AO, Lala MA, Ngochindo JF

Environ Sci Pollut Res Int, 2018 Jul;25(19):19143-19154.
PMID: 29725925 DOI: 10.1007/s11356-018-2075-2

In this study, adsorption behavior of anthill-eggshell composite (AEC) for the removal of hexavalent chromium (Cr6+) from aqueous solution was investigated. The raw AEC sample was thermally treated at 864 °C for 4 h and characterized using Brunauer-Emmett-Teller (BET), scanning electron microscopy (SEM), Fourier transform infrared (FTIR) spectroscopy, X-ray diffraction (XRD), and X-ray fluorescence (XRF) techniques. The effects of adsorption process variables including initial Cr6+ concentration, contact time, and adsorbent dosage on the Cr6+ removal efficiency were investigated using central composite design (CCD) of response surface methodology (RSM). Equilibrium adsorption isotherm and kinetic were also studied. From the analysis of variance (ANOVA), the three variables proved to be significant and the optimum conditions for Cr6+ adsorption were obtained to be 150 mg/L initial Cr6+ concentration, 45.04-min contact time, and 0.5 g adsorbent dosage, which resulted in 86.21% of Cr6+ adsorbed. Equilibrium isotherm study showed that Freundlich model fitted well to the experimental data. The pseudo-second-order kinetic model appeared to better describe the experimental data. The study showed that mixed anthill-eggshell is a promising adsorbent for removing Cr6+ from aqueous solution.

Matched MeSH terms: X-Rays
Fulltext A case of miliary adenocarcinoma of lung masquerading as miliary tuberculosis

Nik Azlan, N.M.

Medicine & Health, 2020;15(1):274-279.
MyJurnal

Adenokarsinoma paru-paru miliari adalah sangat jarang dan agresif. Adenokarsinoma paru-paru biasanya menunjukkan sifat ketulan pada peparu yang berkaitan dengan kerosakan paru-paru dan efusi pleura. Adenokarsinoma ini jarang jarang berpunca daripada tapak selain daripada tapak primer, tidak seperti kanser-kanser lain contohnya kanser tiroid, koriokarsinoma dan sarcoma. Kami membentangkan di sini kes seorang suri rumah berusia 50 tahun yang mengadu batuk-batuk, hilang selera makan dan sukar untuk bernafas selama 1 bulan. Perawat perubatan primer telah merawat beliau sebagai jangkitan kuman pada paru-paru. Disebabkan keadaan yang tidak pulih dan semakin melarat, beliau dibawa ke Jabatan Kecemasan. Oksigen beliau dikesan sebanyak 93% atas udara bilik. Berdasarkan sejarah pesakit dan penemuan X-ray paru-paru, rawatan untuk tuberculosis miliari telah di beri walaupun ujian Mantoux dan kahak negatif. Berikutan peningkatan tanda-tanda dan intubasi, bronkoskopi kemudian mendedahkan diagnosis adenokarsinoma paru-paru. Sebagai pelajaran, penampilan miliari radiografi tidak dikelirukan kepada tuberkulosis sahaja, kerana sebab-sebab berbahaya yang lain perlu disiasat. Bronkoskop dengan analisis histopatologi diperlukan, terutamanya jika Mantoux dan sputum adalah negatif.

Matched MeSH terms: X-Rays
Fulltext A case of missed giant bullae emphysema diagnosed as pneumothorax

Ong, S.F., Nik Azlan, N.M.

Medicine & Health, 2017;12(1):90-93.
MyJurnal

We report a case of a giant bullous emphysema misdiagnosed as a pneumothorax. A 18-year-old chronic smoker presented with right sided chest pain and dyspnoea. Initial respiratory rate was 35 /min, blood pressure was 136/90 mmHg, heart rate 80/min and SpO2 was 98% on room air. Clinical examination revealed reduced right air entry and left trachea deviation. Chest X-ray helped to arrive at a diagnosis of pneumothorax. Needle aspiration was then performed followed by a chest tube thoracostomy because of no improvement. Massive amount of blood was drained and patient deteriorated further. CT thorax revealed a right haemopneumothorax with multiple bullaes. Patient was rushed to OT for emergency thoracotomy for stapling of the ruptured bullae. Giant bullous emphysema can mimic pneumothorax and physician must be vigilant if draining a suspected pneumothorax.
Keywords: emphysema, haemopneumothorax, thoracostomy, thorax

Matched MeSH terms: X-Rays
Fulltext Effectiveness of ultrasound as a triage tool in ruling out fractures among non-critical emergency department patients

Nik Muhamad, N.A., anesan Murthi, J., Nik Ismail, N.A.

Medicine & Health, 2015;10(2):103-111.
MyJurnal

The popularity of ultrasound for acute diagnosis of fractures in the Emergency Department (ED) has increased over the recent years. This present study aimed to determine the sensitivity and specificity of ultrasound use for detection of fractures in a different environment, which is at the triage area of the ED. We compared the results of bedside ultrasound in detecting non-critical fractures to the current gold standard of X-rays in the triage area. The design was a single centered crosssectional study. From August 2014 till November 2014, a total of 46 patients were recruited, creating 75 image pairs. Following consent, a bedside ultrasound was performed and subsequently compared with X-ray reporting regarding the presence or absence of fractures. SPSS analysis was used to determine the sensitivity and specificity of ultrasound in diagnosing fracture as compared to X-rays. Ultrasound had a sensitivity of 72% (95% CI, 50.6% - 87.9%) and a specificity of 80% (95%CI: 66.3 - 90%) when compared to X-rays in fracture diagnosis. The kappa analyses showed moderate inter observer agreement (0.5) between ultrasound and X-rays in diagnosing fractures. This study suggests that the use of ultrasound as a triage tool yet has unacceptable sensitivity and needs further evaluation and consideration.

Matched MeSH terms: X-Rays
Fulltext Factors associated with unsuccessful treatment outcome of pulmonary tuberculosis in Kota Bharu, Kelantan

Nik Nor Ronaidi, N.M., Mohd, N.S., Wan Mohammad, Z., Sharina, D., Nik Rosmawati, N.H.

Malaysian Journal of Public Health Medicine, 2011;11(1):6-15.
MyJurnal

Treating tuberculosis (TB) remains a public health challenge in many developing countries. Treatment success rate in Malaysia is on declining pattern from 78% in 2000 to 48% in 2006. This study will determine factors associated with unsuccessful treatment among pulmonary TB patients. A retrospective cohort study was conducted on notified and treated pulmonary TB cases in Kota Bharu district Kelantan between January 2006 and December 2007. To identify the associated factors, univariate comparison and multiple logistic regressions were performed. Among the 765 patients identified, 472 (61.7%) cases fulfilled the criteria and were analyzed. There were 316 males and 156 females and their mean (SD) age was 45 (17.9) years. In univariable analysis, age, gender, educational level, employment status, family incomes as well as coexistence of extra-pulmonary TB, smoking, co-morbid disease (diabetes mellitus), HIV status, sputum cultures, chest X-ray findings and duration of delay for diagnosis were all found to have significant relationship with unsuccessful pulmonary TB treatment outcome. After adjusted for the confounders, the significant predictors for unsuccessful tuberculosis treatment were age (Adj. OR 1.09; 95% CI: 1.03-1.15), HIV positive (Adj. OR 23.04; 95% CI: 3.01-176.22) and advanced chest X-ray findings (Adj. OR 6.51; 95% CI: 1.50-28.23). A large proportion of unsuccessfully treated cases could be identified at entry
by screening for age, chest X-rays and HIV status and specially targeted measures could be taken. The use of directly observed treatment short-course (DOTS) should be given more focus and priority among this high risk group of patients.

Matched MeSH terms: X-Rays
Fulltext Importance of clinical and morphological correlations in diagnosing Langerhans cell histiocytosis

Seb, Omayma, Fauzana, K., Aisyah, M.R., Noraidah, M., Noor Hamidah, H.

Medicine & Health, 2018;13(1):220-226.
MyJurnal

Langerhans cell histiocytosis (LCH) is a clonal histiocytic disorder. The variable clinical manifestations from isolated bone lesion to multisystem disease can cause difficulties and delay in diagnosis. We report a 2 years and 8 months-old girl who presented with a 2 weeks history of persistent fever and weight loss associated with progressive abdominal distension. Physical examination revealed pallor, bilateral proptosis, seaborrheic dermatitis over the scalp and hepatosplenomegaly. Skull X-ray demonstrated multiple lytic lesions at the base and the skull vault. Bone marrow morphology showed numerous abnormal Langerhans cells (LCs) and foamy macrophages. The trephine immunohistochemistry (IHC) stains for CD1a, S-100 and CD68 were inconclusive. The diagnosis of multisystem Langerhans cell histiocytosis (MS-LCH) in this patient was based on the clinical presentation, radiological and morphological analysis. She subsequently received chemotherapy and currently she is on maintenance therapy with a good clinical response. LCH is a rare disease and although the IHC was inconclusive, the correlation of clinical, radiological and morphological data are essential for the diagnosis.

Matched MeSH terms: X-Rays

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