Malaysian Journal of Pathology最新文献

Introduction: To determine the epidemiology of blood culture-positive late-onset sepsis (LOS, >72 hours of age) in 44 Malaysian neonatal intensive care units (NICUs).

Materials and methods: Study Design: Multicentre retrospective observational study using data from the Malaysian National Neonatal Registry.

Participants: 739486 neonates (birthweight ≥500g, gestation ≥22 weeks) born and admitted in 2015-2020.

Results: LOS developed in 2707 (0.4%) neonates. Median annual incidence (per 100 admissions) was 12.0 (range: 8.1-13.8) in extremely preterm (EPT, gestation <28 weeks), 5.3 (range: 5.0-6.8) in very preterm (VPT, gestation 28-<32 weeks), 0.5 (range: 0.4-0.7) in moderate/late preterm (gestation 32-<37 weeks) and 0.1 in term (gestation ≥37 weeks) neonates. Gram-negative bacteria accounted for 54.7% of pathogens isolated, gram-positive bacteria 39.3%, and fungal and other pathogens 6.0%. The six most common pathogens were coagulase-negative Staphylococcus (18.3%), Klebsiella spp. (18.3%), Staphylococcus aureus (9.9%), Pseudomonas spp. (8.9%), Acinetobacter spp. (7.7%) and Escherichia coli (5.9%). LOS-attributable mortality was 14.3% in EPT, 9.3% in VPT, 8.3% in LPT and 6.2% in term neonates. Multiple logistic regression analysis showed that EPT, small-for-gestation (SGA), conventional mechanical ventilation (CMV), high frequency ventilation (HFV), TPN and use of central venous lines (CVL) were significant independent risk factors associated with LOS in neonates <32 weeks' gestation. The significant independent risk factors associated with mortality in neonates with LOS were SGA, CMV, HFV, gram-negative sepsis, fungal sepsis, and pneumothorax.

Conclusion: Gram-negative bacteria were the commonest pathogens. Decreasing the usage of invasive ventilation, CVL and TPN may reduce the incidence and mortality of LOS, particularly in neonates <32 weeks gestation.

Trichoblastic carcinoma, trichoblastoma, trichoepithelioma, and basal cell carcinoma are histologically characterised by basaloid cell proliferation. In this report, we describe the case of a 76-year-old man who presented with trichoblastic carcinoma admixed with histological features of trichoblastoma, trichoepithelioma, and basal cell carcinoma. These tumours may not be situated separately but must be related to each other in terms of tumorigenesis. The correct biological behavior of trichoblastic carcinoma with other components is unknown and further careful follow-up after resection is required.

No abstract available.

Introduction: Endometrial cancer is one of the leading gynaecological malignancies in developed countries and becoming more prevalent in Malaysia. These have significant impact in women and management of this disease. If it occurs on young women, and as a whole becomes a burden on the national economy and world. This research aims to evaluate the clinical presentation and histopathological features of endometrial epithelial cancer among women treated in a University Hospital.

Materials and methods: Endometrial cancer cases were retrieved from the Pathology Department's Laboratory Information. The histopathology examination reports of the selected cases were reviewed, and the findings and diagnosis were recorded. The descriptive data was presented using pie charts, bar graphs, and tables.

Results: Endometrial cancer recorded the highest in 2022 and less than 15 of endometrial cancer cases were recorded in other years. Women with endometrial cancer diagnosed between the ages of 50 and 59 have the highest percentage (36.6%). It is the most prevalent high number (89%) among female Malay race people. Hypertension and diabetes were found in 52.5% and 37.8% of endometrial cancer patients, respectively. Endometrial cancer patients were also overweight or obese (68.2%). Endometrial cancers were of endometrioid subtypes with tumour grade 1 (71.6%) and early the stage 1 (57.6%). The myometrial invasion in 64.7% of endometrial cancer patients exhibited a superficial invasion depth of less than 50% (54.7%). Lymphovascular invasion was observed in 28.9% of diagnosed cases.

Conclusion: Despite belonging to the postmenopausal and overweight/obesity categories, Malay Kelantanese women diagnosed with endometrial cancer exhibited some favourable prognostic indicators.

Multiple myeloma (MM), a clonal B-cell neoplasia, is an incurable and heterogeneous disease where survival ranges from a few months to more than 10 years. The clinical heterogeneity of MM arises from multiple genomic events that result in tumour development and progression. Recurring genomic abnormalities including cytogenetic abnormalities, gene mutations and abnormal gene expression profiles in myeloma cells have a strong prognostic power. With the advancement in technologies and the development of novel drugs, the prognostic factors and treatment paradigms of MM have been fast evolving over the past few years. Following the introduction of new highthroughput cytogenomic technologies such as array comparative genome hybridisation (aCGH) or single nucleotide polymorphism array (SNP array) and molecular techniques such as gene expression profiling (GEP) and massively parallel genomic sequencing, the prediction of survival in MM no longer solely depends on conventional cytogenetics and interphase fluorescence in situ hybridisation (iFISH) analysis findings. These new technologies enable screening for all possible chromosomal aberrations and other genomic alterations, identifying each aberration on a case-bycase basis and discovering new aberrations that are relevant in unraveling the tumor cells' complex biology. This in turn allows a better understanding of the disease complexity and heterogeneity. The objective of this review on the genetic architecture of MM is to discuss the latest developments on the cytogenetic/cytogenomic-based risk classification of MM that are currently in use and their prognostic implications.

Chronic kidney disease (CKD) is a common clinical condition with significant health risks for patients and is widely recognised as a major public health concern. Laboratory medicine plays a crucial role in both diagnosing and managing CKD, as diagnosis and staging rely on estimated glomerular filtration rate (GFR) and evaluating albuminuria (or proteinuria). It was evident that the laboratory assessment of CKD in Malaysia is not standardised. In light of this, the Malaysian Association of Clinical Biochemistry CKD (MACB-CKD) Task Force issued a national recommendation for laboratory diagnosis of CKD in 2019. Recently, Kidney Disease: Improving Global Outcomes (KDIGO) updated its recommendations for the diagnosis, evaluation, management, and treatment of CKD. These guidelines incorporate the most recent evidence-based practices to support laboratory professionals in delivering optimal care for individuals with CKD, focusing on critical areas such as estimated GFR (eGFR), albuminuria assessment, and risk stratification. The latest National Institute for Health and Care Excellence (NICE) guidelines on CKD has also incorporated the Kidney Failure Risk Equation (KFRE) as a tool for predicting the likelihood of progression to end-stage kidney disease (ESKD) in CKD patients. Hence, the MACB-CKD Task Force has reviewed and updated its recommendations for laboratory reporting of eGFR and urine albumin in alignment with the latest guidelines.

Osteoarthritis (OA) is a prevalent degenerative joint disease characterised by cartilage and subchondral bone breakdown, impacting millions worldwide. This review provides an overview of the complex aetiology of OA, integrating biochemical, mechanical, and genetic factors. It also emphasises a multifaceted management approach, combining non-pharmacological, pharmacological, and surgical treatments. Non-pharmacological strategies include physical therapy and lifestyle changes, which are crucial for pain relief and functional improvement. Pharmacological options focus on non-steroidal anti-inflammatory agents and emerging disease-modifying drugs, while surgical interventions are reserved for advanced cases. The review also explores the potential of regenerative medicine and personalised treatments in revolutionising OA management. Additionally, it underscores the importance of advanced diagnostic tools in early disease detection and monitoring, paving the way for timely and effective interventions.

No abstract available.

No abstract available.

Introduction: ICAM-1 is an adhesion molecule expressed on the endothelial cells and is involved in regulating leukocyte recruitment to the site of inflammation. Elevated ICAM-1 mRNA expression was found in the serum of mothers with chorioamnionitis. This study aimed to determine the expression of ICAM-1 in the placenta and umbilical cord of pregnancy with chorioamnionitis, and its association with adverse neonatal outcome.

Materials and methods: This study comprised a total of 86 cases of which there were 35 cases of non-chorioamnionitis and 51 cases of chorioamnionitis consisting of acute subchorionitis/chorionitis (maternal inflammatory response (MIR) stage 1, n=17), acute chorioamnionitis (MIR stage 2, n=17) and acute necrotising chorioamnionitis (MIR stage 3, n=17). Formalin-fixed paraffin embedded placenta tissue blocks were retrieved from the histopathology archive. ICAM-1 immunohistochemistry was performed on all cases and their expressions were evaluated on cells of the umbilical vein, umbilical artery, foetal vessels and maternal vessels.

Results: The expression of ICAM-1 in umbilical vein was significantly associated with cases of foetal inflammatory response (p<0.001).

Conclusion: We found that ICAM-1 expression was upregulated in the endothelial cells of umbilical vein in acute chorioamnionitis with positive foetal inflammatory response. ICAM-1 might be involved in the pathogenesis of acute chorioamnionitis and funisitis. Further study using a larger cohort is needed to strengthen this observation.