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Fulltext Neuroimaging features of tuberculous meningitis

Sobri M, Merican JS, Nordiyana M, Valarmathi S, Ai-Edrus SA

Med J Malaysia, 2006 Mar;61(1):36-40.
PMID: 16708732 MyJurnal

Tuberculous meningitis leads to a high mortality rate. However, it responds well to chemotherapy if the treatment is started early. Neuroimaging is one of the most important initial investigations. There were 42 patients diagnosed with tuberculous meningitis in Kuala Lumpur Hospital based on clinical criteria, cerebrospinal fluid analysis and response to anti-tuberculous treatment over a 7 year period. Relevant information was obtained from patients' medical case notes and neuroimaging findings were evaluated. Male to female ratio was 3:1. The three major ethnics and the immigrant groups in Malaysia were represented in this study. The majority of the cases involved the Malays followed by immigrants, Chinese and Indians. The patients' age ranged from 18 to 62 years old with the mean age of 34.4 years. There were 95.2% (n = 40) of patients who presented with various neuroimaging abnormalities and only 2 (4.8%) patients had normal neuroimaging findings. Hydrocephalus and meningeal enhancement were the two commonest neuroimaging features. Other features include infarction, enhancing lesion, tuberculoma, abcess, oedema and calcification. Contrasted CT scan is an adequate neuroimaging tool to unmask abnormal findings in tuberculous meningitis.

Matched MeSH terms: Meninges/physiopathology; Meninges/radionuclide imaging
Pathological changes in red tilapias (Oreochromis spp.) naturally infected by Streptococcus agalactiae

Zamri-Saad M, Amal MN, Siti-Zahrah A

J Comp Pathol, 2010 Aug-Oct;143(2-3):227-9.
PMID: 20334871 DOI: 10.1016/j.jcpa.2010.01.020

The pathological changes present in 300 red tilapias (Oreochromis spp.) naturally infected by Streptococcus agalactiae are described. The most consistent gross findings were marked congestion of internal organs, particularly the liver, spleen and kidneys. Other features included exophthalmos, softening of the brain and the occasional accumulation of fluid within the abdominal cavity. Microscopical examination confirmed the presence of marked congestion of the liver, spleen and kidneys. The endothelial cells lining major blood vessels of the liver and occasionally the spleen were swollen and vacuolated. There was evidence of vascular thrombosis with infarction of surrounding tissue. Bacterial colonies were noted within and immediately surrounding the affected blood vessels. The meninges were thickened by the infiltration of numerous heterophils. Similar infiltrates of heterophils and lymphocytes were observed in the lamina propria of the intestine. The kidneys were severely congested and haemorrhagic, with extensive interstitial nephritis.

Matched MeSH terms: Meninges/pathology
Fulltext Somatic mitochondrial DNA D-loop mutations in meningioma discovered: A preliminary data

Mohamed Yusoff AA, Mohd Khair SZN, Wan Abdullah WS, Abd Radzak SM, Abdullah JM

J Cancer Res Ther, 2020 12 22;16(6):1517-1521.
PMID: 33342822 DOI: 10.4103/jcrt.JCRT_1132_16

Background and Objective: Meningiomas are among the most common intracranial tumors of the central nervous system. It is widely accepted that the initiation and progression of meningiomas involve the accumulation of nucleus genetic alterations, but little is known about the implication of mitochondrial genomic alterations during development of these tumors. The human mitochondrial DNA (mtDNA) contains a short hypervariable, noncoding displacement loop control region known as the D-Loop. Alterations in the mtDNA D-loop have been reported to occur in most types of human cancers. The purpose of this study was to assess the mtDNA D-loop mutations in Malaysian meningioma patients.
Materials and Methods: Genomic DNA was extracted from 21 fresh-frozen tumor tissues and blood samples of the same meningioma patients. The entire mtDNA D-loop region (positions 16024-576) was polymerase chain reaction amplified using designed primers, and then amplification products were purified before the direct DNA sequencing proceeds.
Results: Overall, 10 (47.6%) patients were detected to harbor a total of 27 somatic mtDNA D-loop mutations. Most of these mtDNA mutations were identified in the hypervariable segment II (40.7%), with 33.3% being located mainly in the conserved sequence block II of the D310 sequence. Furthermore, 58 different germline variations were observed at 21 nucleotide positions.
Conclusion: Our results suggest that mtDNA alterations in the D-loop region may be an important and early event in developing meningioma. Further studies are needed, including validation in a larger patient cohort, to verify the clinicopathological outcomes of mtDNA mutation biomarkers in meningiomas.

Matched MeSH terms: Meninges/pathology
Fulltext Extranodal natural killer/T-cell lymphoma presenting as orbital cellulitis

Zuhaimy H, Aziz HA, Vasudevan S, Hui Hui S

GMS Ophthalmol Cases, 2017;7:Doc04.
PMID: 28194321 DOI: 10.3205/oc000055

Objective: To report an aggressive case of extranodal natural killer/T-cell lymphoma (NKTCL) of the ethmoid sinus presenting as orbital cellulitis Method: Case report Results: A 56-year-old male presented with right eye redness, reduced vision, and periorbital swelling for 5 weeks duration associated with a two-month history of blocked nose. The visual acuity of the right eye was 6/18. The eye was proptosed with periorbital oedema and conjunctival chemosis. The pupil was mid-dilated but there was no relative afferent pupillary defect. The fundus was normal. The extraocular movements were restricted in all directions of gaze. Nasal endoscopy revealed pansinusitis that corresponded with CT scan orbit and paranasal sinuses findings. Despite treatment, he showed no clinical improvement. Ethmoidal sinus biopsies performed revealed extranodal NKTCL. Further imaging showed involvement of the right orbital contents and its adnexa with intracranial extension into the right cavernous sinus and meninges over right temporal fossa. The patient underwent chemotherapy. However he succumbed to his illness two months after the diagnosis. Conclusion: Extranodal NKTCL is a great mimicker. This case demonstrated how an acute initial presentation of extranodal NKTCL can present as orbital cellulitis with pansinusitis.

Matched MeSH terms: Meninges