10.4197/Med. 23.4.5 Abstract Since the introduction of therapeutic plasma exchange for the management of thrombotic thrombocytopenic purpura, the prognosis of this disease improved signifi cantly. Some patients suff er from refractory disease and adjunctive therapy needs to be considered. In addition, alternative explanations for thrombocytopenia may be present. In this report we discuss a patient who presented with typical fi ndings of thrombotic thrombocytopenic purpura and responded initially to therapeutic plasma exchange and steroids. Shortly afterwards, his platelet count deteriorated and he was found to have acute pulmonary embolism. Prior to the pulmonary embolism, the patient had received venous thromboembolism prophylaxis in the form of low molecular weight heparin and had a history of previous exposure to unfractionated heparin. Testing for heparin-induced thrombocytopenia antibodies was positive and the patient was started on an alternative anticoagulant. Despite these early interventions the patient did not survive. It is essential that physicians be aware of such possible associations to request appropriate investigations and start appropriate
{"title":"Heparin-Induced Thrombocytopenia Complicating Thrombotic Thrombocytopenic Purpura","authors":"Galila Zaher, M. Badawi","doi":"10.4197/med.24-1.5","DOIUrl":"https://doi.org/10.4197/med.24-1.5","url":null,"abstract":"10.4197/Med. 23.4.5 Abstract Since the introduction of therapeutic plasma exchange for the management of thrombotic thrombocytopenic purpura, the prognosis of this disease improved signifi cantly. Some patients suff er from refractory disease and adjunctive therapy needs to be considered. In addition, alternative explanations for thrombocytopenia may be present. In this report we discuss a patient who presented with typical fi ndings of thrombotic thrombocytopenic purpura and responded initially to therapeutic plasma exchange and steroids. Shortly afterwards, his platelet count deteriorated and he was found to have acute pulmonary embolism. Prior to the pulmonary embolism, the patient had received venous thromboembolism prophylaxis in the form of low molecular weight heparin and had a history of previous exposure to unfractionated heparin. Testing for heparin-induced thrombocytopenia antibodies was positive and the patient was started on an alternative anticoagulant. Despite these early interventions the patient did not survive. It is essential that physicians be aware of such possible associations to request appropriate investigations and start appropriate","PeriodicalId":287732,"journal":{"name":"Journal of King Abdulaziz University-medical Sciences","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130580061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lipid peroxidation is the mediator of several pathophysiological events such atherosclerosis, neurodegenerative disease and others. It is induced by reactive oxygen species that react with biological substrates, leading to cell damage. It is thought that Nicotinamide Adenine Dinucleotide Phosphate Hydrogen oxidases, as well as mitochondria dysfunction and other sources, are at the centre of these events, so it becomes an important therapeutic target. In order to retard this damage and the progression of the disease, the natural and synthetic antioxidant vitamin E (Tocopherol) has been studied extensively. In this study, we briefly address current knowledge on the function of vitamin E and try to emphasize its antioxidant properties versus its other properties. The purpose of this study is to design and synthesize a new vitamin E analogue that is placed outside cells. The precursor to a new vitamin E analogue bearing two charges is prepared from the reaction of the corresponding (6acetoxy-2,5,7,8- tetramethylchroman-2-yl) acyl chloride compound that was directly treated with an aniline-2,5-disulfonic acid tetrabutylammonium salt. The latter, a newly prepared compound, is considered a target. The new tocopherol analogue of the product was expected to exhibit protection of lipid membrane from the oxidative damage behavior of reactive oxygen species.
{"title":"New Vitamin E Analogues","authors":"Asma A. Nashawi, R. Hartley","doi":"10.4197/MED.23-4.4","DOIUrl":"https://doi.org/10.4197/MED.23-4.4","url":null,"abstract":"Lipid peroxidation is the mediator of several pathophysiological events such atherosclerosis, neurodegenerative disease and others. It is induced by reactive oxygen species that react with biological substrates, leading to cell damage. It is thought that Nicotinamide Adenine Dinucleotide Phosphate Hydrogen oxidases, as well as mitochondria dysfunction and other sources, are at the centre of these events, so it becomes an important therapeutic target. In order to retard this damage and the progression of the disease, the natural and synthetic antioxidant vitamin E (Tocopherol) has been studied extensively. In this study, we briefly address current knowledge on the function of vitamin E and try to emphasize its antioxidant properties versus its other properties. The purpose of this study is to design and synthesize a new vitamin E analogue that is placed outside cells. The precursor to a new vitamin E analogue bearing two charges is prepared from the reaction of the corresponding (6acetoxy-2,5,7,8- tetramethylchroman-2-yl) acyl chloride compound that was directly treated with an aniline-2,5-disulfonic acid tetrabutylammonium salt. The latter, a newly prepared compound, is considered a target. The new tocopherol analogue of the product was expected to exhibit protection of lipid membrane from the oxidative damage behavior of reactive oxygen species.","PeriodicalId":287732,"journal":{"name":"Journal of King Abdulaziz University-medical Sciences","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132389664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The development of the specialty of emergency medicine demands a concurrent development of research in the field; training emergency departments are expected to take the lead in research production. This study aims to evaluate the research production of 14 Saudi Emergency Medicine training departments, from January 2000 to June 2016. From April to July 2016, we searched for articles published by first authors affiliated with Saudi Emergency Medicine training centers. We searched for original articles using the following search engines: PubMed, Web of Science, Embase, Ovid, Scopus, Inspec, Agency for Healthcare Research and Quality, and Cochrane Central Registers. Based on previous literature, we used certain metrics to evaluate the articles: journal’s impact factor, number of citations by Web of Science, number of citations by Google Scholar, and Altmetric score. Out of 9520 publications screened, only 76 articles were included for evaluation. The average number of publications per year was 4.7. However, it increased from two publications in year 2000 to 14 publications in 2015. Most of the publications (n = 65, 86%) were in journals with no or low IF (IF < 2). Although, there is progressive improvement in the quantity and quality of research from Saudi Emergency Medicine training departments, there should be more eff ort to reach to a higher level of research production.
急诊医学专业的发展需要该领域的研究同步发展;培训有望使急诊科在科研生产方面处于领先地位。本研究旨在评价2000年1月至2016年6月期间沙特14个急诊医学培训部门的研究成果。2016年4月至7月，我们检索了隶属于沙特急救医学培训中心的第一作者发表的文章。我们使用以下搜索引擎搜索原创文章:PubMed、Web of Science、Embase、Ovid、Scopus、Inspec、Agency for Healthcare Research and Quality和Cochrane Central Registers。基于之前的文献，我们使用了一定的指标来评估文章:期刊的影响因子、Web of Science的引用次数、Google Scholar的引用次数和Altmetric分数。在筛选的9520份出版物中，只有76篇文章被纳入评估。平均每年发表4.7篇。然而，它从2000年的两种出版物增加到2015年的14种出版物。大多数出版物(n = 65, 86%)发表在没有或低影响因子(IF < 2)的期刊上。尽管沙特急诊医学培训部门的研究在数量和质量上都在逐步提高，但仍需付出更多努力以达到更高的研究产出水平。
{"title":"Research Production of Current Saudi Emergency Medicine Training Centers in the New Millennium: A Descriptive Study","authors":"Loui K Alsulimani, Anas A. Khan, Ahmed M Bokhari","doi":"10.4197/MED.23-4.1","DOIUrl":"https://doi.org/10.4197/MED.23-4.1","url":null,"abstract":"The development of the specialty of emergency medicine demands a concurrent development of research in the field; training emergency departments are expected to take the lead in research production. This study aims to evaluate the research production of 14 Saudi Emergency Medicine training departments, from January 2000 to June 2016. From April to July 2016, we searched for articles published by first authors affiliated with Saudi Emergency Medicine training centers. We searched for original articles using the following search engines: PubMed, Web of Science, Embase, Ovid, Scopus, Inspec, Agency for Healthcare Research and Quality, and Cochrane Central Registers. Based on previous literature, we used certain metrics to evaluate the articles: journal’s impact factor, number of citations by Web of Science, number of citations by Google Scholar, and Altmetric score. Out of 9520 publications screened, only 76 articles were included for evaluation. The average number of publications per year was 4.7. However, it increased from two publications in year 2000 to 14 publications in 2015. Most of the publications (n = 65, 86%) were in journals with no or low IF (IF < 2). Although, there is progressive improvement in the quantity and quality of research from Saudi Emergency Medicine training departments, there should be more eff ort to reach to a higher level of research production.","PeriodicalId":287732,"journal":{"name":"Journal of King Abdulaziz University-medical Sciences","volume":"321 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121837601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Microsurgical denervation of the spermatic cord has been described as a treatment modality for patients with chronic scrotal content pain. The aim of our study is to evaluate a modified technique by performing denervation of the spermatic cord without a surgical microscope in patients with chronic scrotal content pain as a simplified modality. This retrospective study included 20 patients who underwent denervation of spermatic cord without using surgical microscope for treatment of intractable chronic scrotal content pain. Post denervation pain was assessed 6 months after the surgery. Twelve (60%) patients reported complete alleviation of the symptoms, four (20%) patients noticed more than 50% improvement in their symptom, two (10%) patients had less than 50% improvement, and two (10%) patients reported no changes in their complaint. In conclusion, denervation of the spermatic cord without using surgical microscope is simple and feasible and shows comparable results to microsurgical denervation in treating patients with chronic scrotal content pain. Further studies are needed to confirm the efficacy of this modality.
{"title":"Surgical Denervation of Spermatic Cord for Chronic Scrotal Content Pain: A Modified Technique","authors":"E. Ahmed, A. Al-Sayyad","doi":"10.4197/med.23-4.3","DOIUrl":"https://doi.org/10.4197/med.23-4.3","url":null,"abstract":"Microsurgical denervation of the spermatic cord has been described as a treatment modality for patients with chronic scrotal content pain. The aim of our study is to evaluate a modified technique by performing denervation of the spermatic cord without a surgical microscope in patients with chronic scrotal content pain as a simplified modality. This retrospective study included 20 patients who underwent denervation of spermatic cord without using surgical microscope for treatment of intractable chronic scrotal content pain. Post denervation pain was assessed 6 months after the surgery. Twelve (60%) patients reported complete alleviation of the symptoms, four (20%) patients noticed more than 50% improvement in their symptom, two (10%) patients had less than 50% improvement, and two (10%) patients reported no changes in their complaint. In conclusion, denervation of the spermatic cord without using surgical microscope is simple and feasible and shows comparable results to microsurgical denervation in treating patients with chronic scrotal content pain. Further studies are needed to confirm the efficacy of this modality.","PeriodicalId":287732,"journal":{"name":"Journal of King Abdulaziz University-medical Sciences","volume":"56 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127567686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The current study aims to assess the sensitivity and specifi city of magnetic resonance imaging by reference to arthroscopy in the preoperative diagnosis of knee pathologies. In this retrospective study, pre-operative knee magnetic resonance imaging reports of 70 patients were reviewed by a blinded musculoskeletal radiologist and compared with the respective arthroscopic fi ndings recorded in the operative notes. Pre-operative magnetic resonance imaging demonstrated a sensitivity level of 92.7% and 61.3% and specifi city level of 33.3% and 53.9% in detecting pathologies of the medial and lateral menisci, respectively. With respect to the cases of complete anterior cruciate ligament tear, sensitivity was 76.7% with 92.5% specifi city. On the other hand, magnetic resonance imaging demonstrated 100% sensitivity and 90.7% specifi city in the diagnosis of posterior cruciate ligament partial tear. Relatively better sensitivity in detecting cruciate ligaments pathology and better specifi city in detecting menisci pathology was reported using magnetic resonance imaging. Almost 25% of complete anterior cruciate ligament injuries may remain undetected in preoperative magnetic resonance imaging reports, while they represent the most prevalent knee injury. Magnetic resonance imaging should be used with caution in knee pathology and arthroscopy continues to be the gold standard.
{"title":"Accuracy of Magnetic Resonance Imaging in Diagnosis of Internal Derangement of the Knee","authors":"M. Abbas, Abdullah A. Abulaban, Mamdooh M. Kotb","doi":"10.4197/MED.23-4.2","DOIUrl":"https://doi.org/10.4197/MED.23-4.2","url":null,"abstract":"The current study aims to assess the sensitivity and specifi city of magnetic resonance imaging by reference to arthroscopy in the preoperative diagnosis of knee pathologies. In this retrospective study, pre-operative knee magnetic resonance imaging reports of 70 patients were reviewed by a blinded musculoskeletal radiologist and compared with the respective arthroscopic fi ndings recorded in the operative notes. Pre-operative magnetic resonance imaging demonstrated a sensitivity level of 92.7% and 61.3% and specifi city level of 33.3% and 53.9% in detecting pathologies of the medial and lateral menisci, respectively. With respect to the cases of complete anterior cruciate ligament tear, sensitivity was 76.7% with 92.5% specifi city. On the other hand, magnetic resonance imaging demonstrated 100% sensitivity and 90.7% specifi city in the diagnosis of posterior cruciate ligament partial tear. Relatively better sensitivity in detecting cruciate ligaments pathology and better specifi city in detecting menisci pathology was reported using magnetic resonance imaging. Almost 25% of complete anterior cruciate ligament injuries may remain undetected in preoperative magnetic resonance imaging reports, while they represent the most prevalent knee injury. Magnetic resonance imaging should be used with caution in knee pathology and arthroscopy continues to be the gold standard.","PeriodicalId":287732,"journal":{"name":"Journal of King Abdulaziz University-medical Sciences","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115883833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ampullary and pancreatic carcinoma have high mortality rates particularly among the solid tumors. The median survival of untreated metastatic and locally advanced ampullary and pancreatic carcinoma are 3-5 and 6-10 months, respectively. The worldwide mortality due to these types of malignancies is increasing with more reported cases from the Middle East and North Africa. The incidence of ampullary carcinoma among pregnant females is rare. A limited number of cases have been reported. Here we report a case of a pregnant female detected with ampullary carcinoma, the course of the disease and pregnancy after pancreaticoduodenectomy (Whipple’s procedure).
{"title":"A Case of Pregnant Female Detected with Ampullary Carcinoma, the Course of the Disease and Pregnancy after Pancreaticoduodenectomy (Whipple’s Procedure)","authors":"N. Mansouri","doi":"10.4197/MED.23-4.5","DOIUrl":"https://doi.org/10.4197/MED.23-4.5","url":null,"abstract":"Ampullary and pancreatic carcinoma have high mortality rates particularly among the solid tumors. The median survival of untreated metastatic and locally advanced ampullary and pancreatic carcinoma are 3-5 and 6-10 months, respectively. The worldwide mortality due to these types of malignancies is increasing with more reported cases from the Middle East and North Africa. The incidence of ampullary carcinoma among pregnant females is rare. A limited number of cases have been reported. Here we report a case of a pregnant female detected with ampullary carcinoma, the course of the disease and pregnancy after pancreaticoduodenectomy (Whipple’s procedure).","PeriodicalId":287732,"journal":{"name":"Journal of King Abdulaziz University-medical Sciences","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133454830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sacral nerve stimulation is an FDA approved therapy for refractory overactive bladder, frequency urgency syndrome and nonobstructive urinary retention. It has been applied to other off label uses such as interstitial cystitis and chronic prostatitis for subjective patient symptomatic improvement. We report a 54 year old female who presented with vulvodynia and had been treated successfully with sacral neuromodulation.
{"title":"Vulvodynia Treated by Sacral Nerve Stimulation: Case Report","authors":"M. Banakhar","doi":"10.4197/med.23-4.6","DOIUrl":"https://doi.org/10.4197/med.23-4.6","url":null,"abstract":"Sacral nerve stimulation is an FDA approved therapy for refractory overactive bladder, frequency urgency syndrome and nonobstructive urinary retention. It has been applied to other off label uses such as interstitial cystitis and chronic prostatitis for subjective patient symptomatic improvement. We report a 54 year old female who presented with vulvodynia and had been treated successfully with sacral neuromodulation.","PeriodicalId":287732,"journal":{"name":"Journal of King Abdulaziz University-medical Sciences","volume":"106 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124995867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Citation Al Ageeli EI. Further delineation of speckled lentiginous nevus syndrome. JKAU Med Sci 2016; 23 (3): 57-61. DOI: 10.4197/Med. 23.3.7 Abstract Speckled lentiginous nevus syndrome is a recently described condition, characterized by unilateral neurocutaneous manifestations consisting of: speckled lentiginous nevus, hyperhidrosis, muscular weakness and dysesthesia. Skeletal anomalies such as scoliosis, limb asymmetry, and psychiatric manifestations have been also reported. Herein, we report a case of speckled lentiginous nevus syndrome with skeletal anomalies and a pseudo-marfanoid phenotype.
{"title":"Further Delineation of Speckled Lentiginous Nevus Syndrome","authors":"E. Ageeli","doi":"10.4197/med.23-3.7","DOIUrl":"https://doi.org/10.4197/med.23-3.7","url":null,"abstract":"Citation Al Ageeli EI. Further delineation of speckled lentiginous nevus syndrome. JKAU Med Sci 2016; 23 (3): 57-61. DOI: 10.4197/Med. 23.3.7 Abstract Speckled lentiginous nevus syndrome is a recently described condition, characterized by unilateral neurocutaneous manifestations consisting of: speckled lentiginous nevus, hyperhidrosis, muscular weakness and dysesthesia. Skeletal anomalies such as scoliosis, limb asymmetry, and psychiatric manifestations have been also reported. Herein, we report a case of speckled lentiginous nevus syndrome with skeletal anomalies and a pseudo-marfanoid phenotype.","PeriodicalId":287732,"journal":{"name":"Journal of King Abdulaziz University-medical Sciences","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120959594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Citation Alturkustani MA. Rare variants of ependymoma: a report of four cases and a review of the literature. JKAU Med Sci 2016; 23 (3): 39-50. DOI: 10.4197/Med. 23.3.5 Abstract Ependymomas are brain tumors that have a wide spectrum of morphological patterns. Rare or unusual patterns of ependymoma can resemble other neoplasms and result in erroneous diagnosis, and management. Four out of 22 ependymoma cases in the pathology archive of King Abdulaziz University Hospital in the last decade had these patterns. The fi rst case was of ependymoma with multinodular growth and diff erent types of ependymal diff erentiation, including subependymoma, classic ependymoma, and astroblastoma. Dysplastic neurons were associated with the neoplastic growth. This combination can be interpreted as ganglioglioma (i.e., with ependymoma representing the glial component, World Health Organization grade I) or alternatively as ependymoma with dysplastic neurons (World Health Organization grade II). The second case was of a rare variant of intracranial extra-axial ependymoma with lobular and papillary architecture. The third case was of a previously unreported combination of clear cell and giant cell ependymoma. The fourth case was of epithelioid ependymoma with fi brillary background and a peculiar arrangement of the tight clustered epithelioid cells. This report expands the morphological spectrum of ependymoma by introducing diff erent, previously unreported combinations of patterns that were observed in individual tumors, as well as rare locations and architectures.
{"title":"Rare Variants of Ependymoma: A Report of Four Cases and a Review of the Literature","authors":"M. Alturkustani","doi":"10.4197/med.23-3.5","DOIUrl":"https://doi.org/10.4197/med.23-3.5","url":null,"abstract":"Citation Alturkustani MA. Rare variants of ependymoma: a report of four cases and a review of the literature. JKAU Med Sci 2016; 23 (3): 39-50. DOI: 10.4197/Med. 23.3.5 Abstract Ependymomas are brain tumors that have a wide spectrum of morphological patterns. Rare or unusual patterns of ependymoma can resemble other neoplasms and result in erroneous diagnosis, and management. Four out of 22 ependymoma cases in the pathology archive of King Abdulaziz University Hospital in the last decade had these patterns. The fi rst case was of ependymoma with multinodular growth and diff erent types of ependymal diff erentiation, including subependymoma, classic ependymoma, and astroblastoma. Dysplastic neurons were associated with the neoplastic growth. This combination can be interpreted as ganglioglioma (i.e., with ependymoma representing the glial component, World Health Organization grade I) or alternatively as ependymoma with dysplastic neurons (World Health Organization grade II). The second case was of a rare variant of intracranial extra-axial ependymoma with lobular and papillary architecture. The third case was of a previously unreported combination of clear cell and giant cell ependymoma. The fourth case was of epithelioid ependymoma with fi brillary background and a peculiar arrangement of the tight clustered epithelioid cells. This report expands the morphological spectrum of ependymoma by introducing diff erent, previously unreported combinations of patterns that were observed in individual tumors, as well as rare locations and architectures.","PeriodicalId":287732,"journal":{"name":"Journal of King Abdulaziz University-medical Sciences","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115429448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pathological diagnosis of follicular variant of papillary thyroid carcinoma has high inter and intra-observer variability among expert pathologists, aff ecting prognosis and management of the disease. A recent study applying strict diagnostic criteria and long-term follow up confi rmed the indolent behavior of a subtype of these tumors. They recommended a nomenclature change to noninvasive follicular thyroid neoplasm with papillary-like nuclear features, refl ecting the low risk of adverse outcomes. We searched the pathology archives of King Abdulaziz University Hospital from 2002-2016 for all cases diagnosed with “follicular variant of papillary thyroid carcinoma”. Clinical data, and imaging fi ndings were retrospectively reviewed. Available pathologyslides were reviewed using the proposed inclusion and exclusion diagnostic criteria. We confi rmed the diagnostic reproducibility of the suggested criteria. Ten out of 37 cases met the diagnostic criteria. Eightadditional patients could have had their diagnosis modifi ed if sufficient tissue samples were available. Follow up data confi rmed the indolent behavior in these cases with no recurrence or adverse outcome. We concluded that application of the new diagnostic criteria for this subtype is reasonable and has major ramifi cations for the diagnosis and management as this will spare unnecessary thyroidectomies, radioactive iodine therapy, and their complications.
{"title":"Effect of Implementing the New Diagnostic Criteria for Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features in King Abdulaziz University Hospital","authors":"Fatimah A. Alturkistani, M. Alturkustani","doi":"10.4197/MED.23-3.4","DOIUrl":"https://doi.org/10.4197/MED.23-3.4","url":null,"abstract":"Pathological diagnosis of follicular variant of papillary thyroid carcinoma has high inter and intra-observer variability among expert pathologists, aff ecting prognosis and management of the disease. A recent study applying strict diagnostic criteria and long-term follow up confi rmed the indolent behavior of a subtype of these tumors. They recommended a nomenclature change to noninvasive follicular thyroid neoplasm with papillary-like nuclear features, refl ecting the low risk of adverse outcomes. We searched the pathology archives of King Abdulaziz University Hospital from 2002-2016 for all cases diagnosed with “follicular variant of papillary thyroid carcinoma”. Clinical data, and imaging fi ndings were retrospectively reviewed. Available pathologyslides were reviewed using the proposed inclusion and exclusion diagnostic criteria. We confi rmed the diagnostic reproducibility of the suggested criteria. Ten out of 37 cases met the diagnostic criteria. Eightadditional patients could have had their diagnosis modifi ed if sufficient tissue samples were available. Follow up data confi rmed the indolent behavior in these cases with no recurrence or adverse outcome. We concluded that application of the new diagnostic criteria for this subtype is reasonable and has major ramifi cations for the diagnosis and management as this will spare unnecessary thyroidectomies, radioactive iodine therapy, and their complications.","PeriodicalId":287732,"journal":{"name":"Journal of King Abdulaziz University-medical Sciences","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122033382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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