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Biomedical subjects

N A Sharifah

Publications and source records attributed to N A Sharifah.

15 recordsLinked to original sources
PubMed2005

Complex karyotypic abnormalities in a case of acute myeloid leukaemia--M4Eo.

A 25-year-old man was referred to Hospital UKM with a 2-week history of fever, productive cough and loss of appetite. Physical examination revealed an ill-looking, tachypnoeic young man. No obvious lymphadenopathy or organomegaly was noted. Examination of the respiratory system revealed right pleural effusion. Full blood picture demonstrated leukocytosis with 90% blasts, and bone marrow examination confirmed the diagnosis of acute myeloid leukemia (AML) French-American-British (FAB) classification of M4 with eosinophilia. His chromosome karyotyping showed complex karyotypic abnormalities. Cytological examination of the pleural fluid demonstrated numerous blast cells indicating leukemic infiltration of the lungs, which is a rare presentation in AML. He was then started on induction chemotherapy with intravenous daunorubicin and cytarabine. In the midst of treatment, he developed an episode of seizure and cerebro-spinal fluid cytology confirmed central nervous system (CNS) leukaemic infiltration. Additional intrathecal methotraxate was given. Repeat bone marrow examination done on day 15 of chemotherapy showed persistence of excess blasts indicating refractory AML. He was then reinduced with high dose cytarabine but to no avail. The disease progressed and he succumbed about 8 weeks after the initial diagnosis was made. We highlight here a case of AML-M4Eo with complex karyoyptic abnormalities presenting with leukaemic infiltration of the lungs and CNS which had imparted a bad prognosis for this subtype of AML, AML-M4Eo.

Adult↗
PubMed2004

Ultrasound in the assessment of the palpable breast mass.

The aim of the study was: to obtain the profile of patients (with regards to age and family history of breast cancer) with a palpable breast mass. To determine the validity of ultrasound in the assessment of the palpable breast mass by determining the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of ultrasound in distinguishing a malignant mass. To determine the most discriminating ultrasound characteristics for differentiating benign and malignant masses. Seventy patients who had fine needle aspiration cytology of a palpable breast mass were subjected to an ultrasound assessment of the mass. The ultrasound findings were classified as benign, indeterminate or malignant. These findings were then compared with either the cytology or histology results in cases that eventually had surgical excision. The age of the patients ranged from 15 to 66 years old The majority was in the third and fourth decades with an average age of 25 years. The 8 patients with a proven malignant breast mass were aged between 39 and 66 years old. They did not have any family history of breast cancer. Only 4 patients had a family history of breast carcinoma and all proved to have a benign breast lesion. Ultrasound had a sensitivity of 100%, specificity of 85.7%, positive predictive value of 50%, negative predictive value of 100% and accuracy of 87.5% for distinguishing a malignant mass. For benign masses: 93.7% had well-defined margins, 81.3% had homogenous internal echoes, 91.7% had depth-width ratio of less than 1.0 and 89% were compressible. For malignant masses: 87.5% had either ill-defined or irregular margins, 87.5% had inhomogenous internal echoes and mixed posterior echoes, and 100% were incompressible. The majority of patients with a palpable breast mass were aged below 40 years old. Most of the patients with a malignant breast mass were aged 40 years and older. Neither a positive nor a negative family history of breast cancer had any significance on outcome. Ultrasound had high sensitivity, specificity and accuracy in distinguishing a malignant mass. The most discriminating benign ultrasound characteristic was compressibility. The most discriminating malignant ultrasound characteristic was ill-defined and irregular margins.

Adolescent↗
PubMed2004

Research on cancer diagnosis in Malaysia: current status.

Cancer is a major morbidity and mortality concern in Malaysia. Based on National Cancer Registry data, the Malaysian population is estimated to bear a cancer burden of about 40,000 new cases per year, and a cumulative lifetime risk of about 1:4. Cancer research in Malaysia has to consider needs relevant to our population, and resources constraints. Hence, funding bodies prioritise cancers of high prevalence, unique to our community and posing specific clinical problems. Cancer diagnosis is crucial to cancer management. While cancer diagnosis research largely aims at improvements in diagnostic information towards more appropriate therapy, it also impacts upon policy development and other areas of cancer management. The scope of cancer diagnosis upon which this paper is based, and their possible impact on other R&D areas, has been broadly categorized into: (1) identification of aetiological agents and their linkages to the development of precancer and cancer (impact on policy development, cancer prevention and treatment), (2) cancer biology and pathogenesis (impact on cancer prevention, treatment strategies and product development), (3) improvements in accuracy, sensitivity and specificity in cancer detection, monitoring and classification (impact on technology development) and (4) prognostic and predictive parameters (impact on treatment strategies). This paper is based on data collected by the Working Group on Cancer Diagnosis Research for the First National Conference on Cancer Research Coordination in April 2004. Data was collated from the databases of Institutions/Universities where the authors are employed, the Ministry of Science, Technology and Innovation (MOSTI) and targeted survey feedback from key cancer researchers. Under the 7th Malaysia Plan, 76 cancer projects were funded through the Intensified Research in Priority Areas (IRPA) scheme of MOSTI, amounting to almost RM15 million of grant money. 47(61.8%) of these projects were substantially in cancer diagnosis, accounting for 65.6% (RM 9.7 million) of cancer project funds. The 8th Malaysia Plan saw a change in research strategy. The IRPA agency fielded several top-down projects which encouraged a multicentre and multidisciplinary approach. This resulted in larger funding per project i.e. RM32 million for 49 projects. There was also a surge of interest in drug development and natural products. Because of this shift in direction, cancer diagnosis projects constituted only 51% of IRPA-funded cancer projects. Nonetheless funding for cancer diagnosis research has exceeded that of the 7th Malaysia Plan, being RM12.5 million by March 2004. The majority of such research is carried out at the Universities, engaging a large number of young scientists and postgraduate students (51 MSc and 21 PhD). A lot of research findings presented at scientific meetings have not yet been published and there is a glaring shortage of patents and commercialization of research findings (such as creation of test kits). Because diagnosis is very much a part of clinical practice, many researchers felt satisfied and confident that their work will be translated into practice and will significantly improve diagnostic services in Malaysia. National guidelines and consensus development on at least three malignancies i.e. breast cancer, oral cancer and lymphoma, have substantial basis in local R&D work. Problems encountered in research included (1) insufficient funding to realize research objectives, (2) lack of local expertise (most research assistants are inexperienced BSc graduates with no or minimal research experience), (3) inadequate technical support from vendors during equipment failure, (4) inexperienced Institutional development units to assist in product development, (5) lack of venture capital for commercialization of findings, and (6) inadequate incentives to undertake research. Researchers pointed out that plans to promote research should include the establishment of (1) regional and national cancer tissue banks, (2) a National Cancer Research Institute, (3) a dedicated cancer research fund, (4) a registry of cancer researchers, (5) national research coordinators, (6) improved coverage by the National Cancer Registry, (7) more international collaboration, (8) a better career structure for researchers, (9) improved Institutional support for product realization, and (10) better recognition for cancer researchers.

Humans↗
PubMed2003

CD44s expression correlated with the International Neuroblastoma Pathology Classification (Shimada system) for neuroblastic tumours.

AIM: CD44 is a cell adhesion molecule that plays an important role in the cascade of metastasis and progression of human malignant tumours. A large family of variants or isoforms, generated by alternative splicing of a single gene, has been reported to be involved in the malignant process by conferring metastatic potential to non-metastatic cells. The objective of this study was to compare the expression of CD44 standard molecule with the International Neuroblastoma Pathology Classification (INPC) for neuroblastic tumours, a histological grading system based on the Shimada system for predicting the clinical outcome in neuroblastic tumours. METHODS: Paraffin blocks of primary neuroblastic tumour were graded according to the INPC system into favourable and unfavourable histological types. Tumour tissues were then analysed with immunostaining using monoclonal antibodies against the CD44 epitope. RESULTS: In this retrospective study, 32 cases of primary neuroblastic tumour were collected. Based on the INPC system, 13 cases (40.6%) had a favourable histology while 19 cases (59.4%) were of unfavourable histology. CD44 standard (CD44s) expression was detected in 69.2% of neuroblastic tumours with favourable histological type while 89.5% of tumours with unfavourable histological type did not express CD44s staining. Statistically, there was significant correlation between morphological grading of neuroblastic tumours based on the INPC and the presence of CD44 staining (Fisher's exact test, P<0.05). CONCLUSION: This study shows that there is a significant correlation between CD44s expression and tumour histology based on the INPC in which CD44s non-expression is correlated with an unfavourable histological type and the expression of CD44s with a favourable type. Therefore, the analysis of CD44s expression should be recommended as an additional biological marker in the initial routine staging of the disease.

Antigens, Neoplasm↗
PubMed1999

Fine needle aspiration cytology of undifferentiated embryonal sarcoma of the liver: a case report.

The cytological features of a rare case of undifferentiated (embryonal) sarcoma of the liver are presented. The cytology smears showed singly dispersed polygonal and spindle cells as well as loose clusters of cells held together in myxoid material. Neoplastic cells were generally large with round, oval or lobulated nuclei. The cytoplasm was variable in amount with ill-defined borders. Occasional multinucleated cells were also present. Hyaline globules were present on sections of the cell block. Immunohistochemical studies performed showed positivity for vimentin, cytokeratin and alpha-1-antitrypsin (AAT) in the tumour cells.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1998

Huge adrenal haemangioma.

Adrenal tumours are either functioning or non-functioning. Non-functioning adrenal tumours are generally asymptomatic and usually of enormous proportions at the time of presentation. A case is presented here of a patient with a huge right adrenal haemangioma which was successfully treated surgically. This unusual tumour was 25 cm in diameter, was well encapsulated and weighed 4 kg. The literature pertaining to this interesting case is reviewed.

Adrenal Gland Neoplasms↗
PubMed1998

Primary squamous cell carcinoma of the thyroid--a case report.

A rare case of primary squamous cell carcinoma of the thyroid is reported herein. A 64-year-old Malay lady presented with a gradually enlarging thyroid nodule for the past 6 months and underwent total thyroidectomy. Histopathology revealed a squamous cell carcinoma of the thyroid with complete resection. Possible primary tumour elsewhere was excluded. Postoperative irradiation was given and patient is still alive after 2 years of follow-up.

Carcinoma, Squamous Cell↗
PubMed1995

Insulin-like growth factor II gene expression by congenital mesoblastic nephroma.

We studied the expression of insulin-like growth factor II (IGF2) and Wilms' tumor gene (WT1) in nine cases of congenital mesoblastic nephroma (CMN) and five cases of first trimester fetal kidneys by in situ hybridization. Our aim was to determine their site of expression and to correlate their histogenetic relationship to those of other childhood renal tumors. Our results showed that all nine cases of CMN (classic, mixed, and cellular) contained abundant IGF2 but not WT1 transcripts. The IGF2 transcripts were diffusely distributed over the tumor cells. These findings suggest that CMN is derived from primitive mesenchymal nephrogenic cells and have a potential to differentiate into a stromal cell lineage.

Female↗
PubMed1994

Fine needle aspiration cytology characteristics of renal tumors in children.

The cytologic findings observed in fine needle aspiration (FNA) biopsy smears from 27 cases of renal tumors in children are reported. The aspirates were from 16 cases of classical Wilms' tumor (WT), one anaplastic WT, 2 clear cell sarcomas of the kidney (CCSK), 2 malignant rhabdoid tumors of the kidney (MRTK) and 6 congenital mesoblastic nephromas (CMNs). The stromal component was present in 16 of the 17 cases (94%) of WT, and the epithelial component in 13 of the cases (76%). Blastema was noted in all 17 cases of WTs. Necrosis was present in 11 (65%) of the smears from WTs. Other features identified include tubular and glomerular differentiation (6 cases), rosette formation (2 cases), striated muscle differentiation (one case) and anaplasia (one case). Smears from malignant rhabdoid tumors of the kidney (MRTK) tended to be very cellular, comprizing cells with prominent esinophilic nucleoli. Cells from clear cell sarcoma of the kidney (CCSK) were usually arranged in smaller discrete groups with fragile cytoplasm. In congenital mesoblastic nephroma (CMN), the cells tend to be spindly and very cohesive. A definite tumor type was able to be made on 25 of the 27 cases (93%) of renal tumors.

Biopsy, Needle↗
PubMed1994

Malignant rhabdoid tumor of the kidney expresses insulin-like growth factor II transcripts.

Insulin-like growth factor II (IGF-II) is thought to play a major role in fetal growth and development. High levels have been demonstrated in blastemal cells of both normal fetal kidney and Wilms' Tumor (WT). In this report, 2 cases of malignant rhabdoid tumor of the kidney (MRTK) were studied to detect the expression of IGF-II mRNA by in situ hybridization using 35S labelled RNA riboprobes. Results showed highly strong and specific IGF-II mRNA expression by tumor cells.

Child↗
PubMed1993

Ultrasound guided percutaneous biopsies of suspected mediastinal lesions.

Realtime ultrasonography with general purpose sector transducer was used to guide 87 percutaneous biopsies on 82 patients with lesions suspected to be mediastinal masses on plain chest radiographs. In seven patients who had dyspnea the biopsies were done in erect or semi-erect sitting positions. Definitive diagnosis was obtained from 66 lesions (80.5%) where 46 (70.0%) were mediastinal and the remaining 20 lesions (30.0%) arising from the lung. Of the 46 mediastinal lesions where specific diagnosis were made, 42 (91.0%) were anterior and four (0.9%) posterior mediastinal lesions. The majority of these anterior mediastinal masses were lymphomatous nodes followed by germ cell tumours whereas all four posterior mediastinal masses were neurogenic. Of the lung lesions, 19 were primary malignancies. The remaining lung lesion which was located posteriorly was cryptococcus infection. One patient developed massive hemothorax, but subsequently recovered. No significant complications were encountered in the remaining patients. Surgery was carried on 11 patients. There is correlation between definitive diagnosis from percutaneous biopsy and final diagnosis after surgery in 80% of patients. It is proposed that all percutaneous biopsies for thoracic masses which abut the chest wall and cause mediastinal widening on a plain chest radiograph be guided by ultrasound. It can be effectively accomplished with ease and safety even without the use of dedicated biopsy ultrasound probes or biopsy attachments, and on patients in erect or semi-erect positions.

Adolescent↗
PubMed1993

Fine needle aspiration cytology of the breast: an analysis of 1,094 aspirates.

Our experience with 1,094 consecutive fine needle aspirations (FNAs) of the breast in 918 cases is presented. Correlation between the FNA cytology and subsequent histology of the lesions was available in 211 cases. FNA had a sensitivity rate of 87.3%, a specificity rate of 99.3% and a positive predictive value of 98.2%. A false negative diagnosis rate of 5.1% occurred. The overall diagnostic accuracy rate was 95.7%.

Biopsy, Needle↗
PubMed1993

Painful thyroiditis in postpartum period.

Destructive thyroiditis commonly occurs during the postpartum period, with a prevalence rate of 5% to 16%, and is mainly due to postpartum autoimmune thyroiditis (PPT) and, very rarely, to subacute thyroiditis. The thyroiditis is similar to Hashimoto's thyroiditis and is generally painless in nature, although cases with painful thyroiditis have been described. We report a case of painful destructive thyroiditis occurring during the postpartum period, which was clinically and biochemically indistinguishable from the variant of painful PPT or subacute thyroiditis. Fine needle aspiration cytology showed multi-nucleated giant cells diagnostic of subacute thyroiditis.

Adult↗
PubMed1991

Comparative study of cytologic and colposcopic findings in preclinical cervical cancer.

Seventy-seven patients who had PAP smear cytology and colposcopic examination in a 2-year period between 1988 and 1989 were reviewed. Those with findings indicative or suspicious of malignancy were subjected to biopsy. All 50 patients thus biopsied were confirmed to have preclinical cancer on histological examination. Compared against histology, PAP smear cytology gave an accuracy rate of 90% (5 false negatives) and colposcopy gave an accuracy rate of 94% (3 false negatives). These results demonstrate that the two techniques are useful as screening tests for preclinical cervical cancer. The results are improved if they are used complementarily. However, there was poor specificity in the categorisation of cervical cancer by both methods. This was probably due to the subjectiveness of the two procedures. The study also raised the possibility of a higher incidence of preclinical cervical cancer in the Chinese ethnic group.

Adult↗