Displaying all 10 publications

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  1. Low SF, Hanafiah M, Nurismah MI, Suraya A
    BMJ Case Rep, 2013;2013.
    PMID: 24057334 DOI: 10.1136/bcr-2013-200790
    The patella is an uncommon site for all primary and metastatic bone tumours and primary intra-osseous tumours of the patella are very rare. A majority of the patella tumours are benign. We report a patient with a sudden onset swelling and pain of the right knee following a staircase fall. The plain radiograph showed an expansile multiseptated patella lesion and it was further assessed with an MRI. The radiological findings and the initial histopathological features from a limited sample were suggestive of a primary aneurysmal bone cyst. However, the final histopathological diagnosis from a more adequate specimen was a giant cell tumour with a secondary aneurysmal bone cyst.
  2. Nurismah MI, Noriah O, Suryati MY, Sharifah NA
    Asian Pac J Cancer Prev, 2008 Oct-Dec;9(4):699-702.
    PMID: 19256762
    The traditional classification of infiltrating breast carcinomas into ductal and lobular can be diagnostically challenging in a small proportion of cases with equivocal histological features and in in-situ lesions with overlapping features. Distinguishing between the infiltrating ductal (IDC) and lobular (ILC) carcinomas is clinically important because of the different pattern of systemic metastases and prognostic evaluation. E-cadherin is a potentially useful immunohistochemical marker which may serve to differentiate between the two tumour types. We therefore studied E-cadherin expression in 32 cases of breast carcinomas comprising 16 IDCs and 16 ILCs. The correlation between E-cadherin expression and the histological grade of IDCs was also analysed. Our results showed complete loss of E-cadherin expression in all ILCs, while the IDCs consistently showed variable E-cadherin positivity. No significant correlation was found between E- cadherin expression and the histological grade of IDCs. We conclude from this study that E-cadherin is a useful marker to differentiate between IDC and ILC of the breast. A larger study of IDCs is now needed to further evaluate the correlation between E-cadherin and tumour grade to estimate its prognostic potential.
  3. Ng SP, Leong CF, Nurismah MI, Shahila T, Jamil MA
    Med J Malaysia, 2006 Aug;61(3):363-5.
    PMID: 17240592 MyJurnal
    A 20 year-old woman presented with features of a twisted ovarian cyst and had an emergency laparotomy Intraoperative findings revealed bilateral, solid ovarian tumors and a left oophorectomy with biopsy of the contralateral ovary performed. Histopathology report confirmed Burkitt lymphoma of ovary. There was no other evidence of lymphoma elsewhere. The primary Burkitt lymphoma of the ovaries was successfully managed with six courses of highly toxic chemotherapy (Berlin-Frankfurt- Munster 1986 protocol). The patient has remained disease free for the last 36 months.
  4. Farihah AG, Nurismah MI, Husyairi H, Shahrun Niza AS, Radhika S
    Med J Malaysia, 2018 02;73(1):9-15.
    PMID: 29531197 MyJurnal
    AIM: This study aims to evaluate the reliability of the Ultrasound (U) Classification system in predicting thyroid malignancy by using pathology diagnosis as the reference standard.

    METHODS: It was a cross-sectional study carried out at Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Malaysia. Records of patients with focal thyroid nodules on ultrasound (US) for which US-guided fine needle aspiration cytology (FNAC) was performed and pathology results were available, from January 2014 to May 2016 were selected for review. Correlation of the U Classification with pathology results was assessed. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, predictive value, negative predictive value and accuracy were calculated in a conservative and non-conservative method. The threshold for statistical performance was set at 0.05. Each sonographic feature was also compared with its pathology results.

    RESULTS: A total of 91 patients with 104 nodules were eligible. 12 nodules out of 104 (11.5%) were malignant. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value, negative predictive value and accuracy were 100%, 91.3%, 11.5, 0.0, 60%, 100% and 92.3%, and 100%, 91.4%, 11.7%, 0.0, 78.6%, 100% and 93.5%, for the non-conservative and conservative method of calculations respectively.

    CONCLUSION: The U Classification is reliable in predicting thyroid malignancy. More evidence is nevertheless necessary for widespread adaptation and use.

  5. Siti Sarah M, Nor Aini U, Nurismah MI, Hafiza A, Khalidah M, Mokhtar AB, et al.
    Clin Ter, 2014;165(1):35-9.
    PMID: 24589949 DOI: 10.7471/CT.2014.1659
    Paraproteinemia is one of the diagnostic features of multiple myeloma. A commonly used method is the detection of paraprotein by agarose gel electrophoresis (AGE) followed by by immunofixation electrophoresis (IFE) to confirm monoclonality. Due to their smaller size, immunoglobulin A (IgA) and light chain only paraproteins may appear at the beta or even alpha 2 protein fractions. Here, we discuss a case report of a 47-year-old man who presented with pathological fracture of third thoracic (T3) vertebra. Serum protein electrophoresis (SPE) was initially reported as no paraprotein detected. However, a bone biopsy was reported to show plasma cell proliferation with light chain restriction. A repeat sample for protein electrophoresis together with IFE revealed lambda light chain paraprotein co-migrating at the beta region. The beta band plus paraprotein was quantitated as 4.3 g/L (7.0%), which was within normal limits of the beta protein fraction. Hence, it has to be remembered that if the SPE is negative, it does not necessarily mean that the paraprotein is absent in cases which are highly suspicious.
  6. Razif SM, Sulaiman S, Hanie SS, Aina EN, Rohaizak M, Fuad I, et al.
    Med J Malaysia, 2011 Aug;66(3):220-6.
    PMID: 22111444 MyJurnal
    Breast cancer is the most common cancer among Malaysian women. This study aimed to determine the reproductive for premenopausal breast cancer risk in Kuala Lumpur, Malaysia. A case-control study was conducted in 216 histopathologically confirmed cases of premenopausal breast cancer and 216 community-based controls that were matched by age within a 5-year period and ethnicity. The results of this study showed that premenopausal breast cancer risks were strongly related to parity, number of live births and family history of breast cancer. Premenopausal women with these known reproductive and family history risk factors should take extra measures to undergo appropriate screening method for early detection of breast cancer.
  7. Sharifah NA, Seeni A, Nurismah MI, Clarence-Ko CH, Hatta AZ, Ho NP, et al.
    Asian Pac J Cancer Prev, 2009 Apr-Jun;10(2):303-6.
    PMID: 19537900
    Cervical cancer is the second most common female malignancy in Malaysia. Despite advances in treatment, the overall survival for this disease has not changed in the last decade. Infection by certain types of HPV is recognized as a causal and necessary factor for its development. This study was carried out to determine the prevalence of HPV infection in abnormal cervical smears in Malaysian patients using archival cervical smears retrieved from the Cytopathology Unit, Universiti Kebangsaan Malaysia Medical Centre (UKMMC) between the years 1992-1995. DNA was extracted from 38 abnormal smears comprising 25 intraepithelial lesions and 13 cervical carcinomas and 10 normal smears. Amplification of HPV genes was carried out using the polymerase chain reaction (PCR) technique. HPV genotypes were determined using direct sequencing and the results were compared to the database from Genebank. DNA was successfully extracted from all 48 cervical smears. High-risk HPV (HR-HPV) genotypes were detected in 95% of the abnormal smears. Eight high-risk oncogenic types were identified: 16, 18, 31, 51, 52, 56, 58 and 66. All (100%) cervical cancer smears showed presence of HR-HPV compared to 92% of the cervical intraepithelial lesions. Among the eight HR-HPV genotypes identified, HPV 16 and 52 were the commonest (23.7% each) HPV genotypes encountered and among the CIN lesions, HPV 16 (28%) was the most frequent. We conclude that HPV 16 is the most prevalent HPV genotype present in abnormal cervical smears in Malaysian patients, and that the use of archival material to assess the presence of HPV is potentially worthwhile, and can be utilized for longitudinal studies of HPV presence and persistence.
  8. Lukman MR, Jasmi AY, Sarinah B, Nurismah MI, Aishah MA
    Asian J Surg, 2005 Jul;28(3):227-9.
    PMID: 16024322
    Extragonadal teratomas and germ cell tumours are uncommon. Most teratomas of the head and neck present in the paediatric age group. Occurrence of such tumours in an adult is extremely rare and, to date, less than 40 cases have been reported in the literature. We report a case of a young man presenting with impending airway obstruction secondary to a malignant teratoma of the neck.
  9. Tan KP, Mohamad Azlan Z, Rumaisa MP, Siti Aisyah Murni MR, Radhika S, Nurismah MI, et al.
    Med J Malaysia, 2014 Apr;69(2):79-85.
    PMID: 25241817 MyJurnal
    AIM: This study was performed to determine the accuracy of ultrasound (USG) as compared to mammography (MMG) in detecting breast cancer.

    METHODS: This was a review of patients who had breast imaging and biopsy during an 18-month period. Details of patients who underwent breast biopsy were obtained from the department biopsy record books and imaging request forms. Details of breast imaging findings and histology of lesions biopsied were obtained from the hospital Integrated Radiology Information System (IRIS). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of USG and MMG were calculated with histology as the gold standard.

    RESULTS: A total of 326 breast lesions were biopsied. Histology results revealed the presence of 74 breast cancers and 252 benign lesions. USG had a sensitivity of 82%, specificity of 84%, PPV = 60%, NPV = 94% and an accuracy of 84%. MMG had a sensitivity of 49%, specificity of 89%, PPV = 53%, NPV = 88% and an accuracy of 81%. A total of 161 lesions which were imaged with both modalities were analyzed to determine the significance in the differences in sensitivity and specificity between USG and MMG. Sensitivity of USG (75%) was significantly higher than sensitivity of MMG (44%) (X(2)1=6.905, p=0.014). Specificity of MMG (91%) was significantly higher than specificity of USG (79%) (X(2)1=27.114, p<0.001). Compared with MMG, the sensitivity of USG was 50% (95% CI 10%-90%) higher in women aged less than 50 years (X(2)1=0.000, p=1.000) and 27% (95% CI 19%-36%) higher in women aged 50 years and above (X(2)1=5.866, p=0.015). Compared with MMG, the sensitivity of USG was 40% (95% CI 10%-70%) higher in women with dense breasts (X(2)1=0.234, p=0.628) and 27% (95% CI 9%-46%) higher in women with non-dense breasts (X(2)1=4.585, p=0.032).

    CONCLUSION: Accuracy of USG was higher compared with MMG. USG was more sensitive than MMG regardless of age group. However, MMG was more specific in those aged 50 years and older. USG was more sensitive and MMG was more specific regardless of breast density. In this study, 20% of breast cancers detected were occult on MMG and seen only on USG.
  10. Sharifah NA, Nurismah MI, Lee HC, Aisyah AN, Clarence-Ko CH, Naqiyah I, et al.
    Cancer Epidemiol, 2010 Aug;34(4):442-7.
    PMID: 20451485 DOI: 10.1016/j.canep.2010.04.010
    The incidence of breast cancer has been on the rise in Malaysia. It is suggested that a subset of breast cancer cases were associated with germline mutation in breast cancer susceptibility (BRCA) genes. Most of the BRCA mutations reported in Malaysia were point mutations, small deletions and insertions. Here we report the first study of BRCA large genomic rearrangements (LGRs) in Malaysia. We aimed to detect the presence of LGRs in the BRCA genes of Malaysian patients with breast cancer.
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