A 33-year-old Malay lady presented to us with 1-month history of globus sensation in the throat. Clinically, she had a 3cmx2cmx1cm sessile soft mass arising from the right tongue base and was treated as hypertrophied lingual tonsil. Biopsy of the mass was done when the patient developed bleeding and was reported as diffuse non-Hodgkin's B-cell lymphoma. Globus sensation is a common complaint in the ORL clinic. It is important to be able to decide if further investigation is warranted to differentiate a malignant from a benign lesion as at times, a malignant lesion can masquerade as a harmless lesion.
Matched MeSH terms: Lymphoma, Large B-Cell, Diffuse/therapy
Decision-making on behalf of an incapacitated patient at the end of life is a complex process, particularly in family-centric societies. The situation is more complex when attempts are made to accommodate Eastern concepts of end-of-life care with more conventional Western approaches. In this case report of an incapacitated 74-year-old Singaporean man of Malay descent with relapsed Stage 4 diffuse large B cell lymphoma who was without an established lasting power of attorney, we highlight the difficult deliberations that ensue when the patient's family, acting as his proxy, elected to administer lingzhi through his nasogastric tube (NGT). Focusing on the questions pertaining to end-of-life decision-making in Asia, we consider the issues surrounding the use of NGT and lingzhi in palliative care (PC) and the implementation of NGT for administering lingzhi in a PC setting, particularly in light of a dearth of data on such treatment measures among PC patients.
Matched MeSH terms: Lymphoma, Large B-Cell, Diffuse/therapy