1.Lymphocytic Mastitis Mimicking Breast Carcinoma, Radiology and Pathology Correlation: Review of Two Cases
Sharifah Majedah Idrus Alhabshi ; Kartini Rahmat ; Caroline Judy Westerhout ; Nani Harlina Md Latar ; Patricia Ann Chandran ; Suraya Aziz
Malaysian Journal of Medical Sciences 2013;20(3):83-87
Lymphocytic mastitis, or diabetic mastopathy, is an unusual finding in early-onset and long-standing diabetes. It can presents as a non-tender or tender palpable breast mass. Mammogram and ultrasound frequently demonstrate findings suspicious of malignancy, thus biopsy and histological confirmation is usually required. We reviewed two cases of lymphocytic mastitis with characteristics findings on mammogram, ultrasound, and histopathology. Diagnoses were confirmed with excision biopsy.
Breast Neoplasms
;
Diabetes Mellitus
2.Role of high resolution ultrasound in ulnar nerve neuropathy
Radhika Sridharan ; Lee Yee Ling ; Low Soo Fin ; Fazalina Mohd Fadzilah ; Sharifah Majedah Idrus Alhabshi ; Suraya Aziz ; Rajesh Singh ; Jamari Sapuan ; Tan Hui Jan ; Norlinah Mohamed Ibrahim
The Medical Journal of Malaysia 2015;70(3):158-161
SUMMARY
Aim: This study was conducted to measure the cross
sectional area (CSA) of the ulnar nerve (UN) in the cubital
tunnel and to evaluate the role of high-resolution
ultrasonography in the diagnosis of ulnar nerve neuropathy
(UNN).
Materials and Methods This was a cross sectional study with
64 arms from 32 patients (34 neuropathic, 30 nonneuropathic).
Diagnosis was confirmed by nerve conduction
study and electromyography. The ulnar nerves were
evaluated with 15MHz small footprint linear array transducer.
The ulnar nerve CSA was measured at three levels with arm
extended: at medial epicondyle (ME), 5cm proximal and 5cm
distal to ME. Results from the neuropathic and nonneuropathic
arms were compared. Independent T-tests and
Pearson correlation tests were used. P value of less than
0.05 was considered significant.
Results: Mean CSA values for the UN at levels 5cm proximal
to ME, ME and 5cm distal to ME were 0.055, 0.109, 0.045 cm2
respectively in the neuropathic group and 0.049, 0.075, 0.042
cm2 respectively in the non-neuropathic group. The CSA of
the UN at the ME level was significantly larger in the
neuropathic group, with p value of 0.005. However, there was
no statistical difference between the groups at 5cm proximal
and distal to the ME, with p values of 0.10 and 0.35
respectively.
Conclusion: There is significant difference in CSA values of
the UN at ME between the neuropathic and non-neuropathic
groups with mean CSA value above the predetermined
0.10cm2 cut-off point. High-resolution ultrasonography is
therefore useful to diagnose and follow up cases of elbow
UNN.
Ulnar Nerve
3.Comparison on the use of semi-automated and automated core biopsy needle in ultrasound guided breast biopsy
Radhika Sridharan ; Shereen Mohd Yunos ; Suraya Aziz ; Rizuana Iqbal Hussain ; Sharifah Majedah Idrus Alhabshi ; Suria Hayati Md Pauzi ; Saladina Jaszle Jasmin ; Zulfiqar Mohd Annuar
The Medical Journal of Malaysia 2015;70(6):325-333
Objective: The aim of this study was to compare the use of
semi-automated (Medax Velox 2; Poggio Rusco, Italy) and
automated (Bard Magnum Biopsy Instrument; Covington,
GA, USA) core biopsy needles, for ultrasound guided breast
biopsy.
Materials and Methods: A 14G semi-automatic spring loaded
core biopsy needle with a 22-mm-throw (Medax Velox 2;
Poggio Rusco, Italy) and 14-gauge automated needle device
with a 22-mm-throw biopsy gun (Bard-Magnum Biopsy
Instrument, Covington, GA, USA) were used for breast
biopsies under ultrasound guidance on alternate months
during the study period between July 2009 and May 2011.
One hundred and sixty lesions were biopsied and
specimens were sent for histological evaluation.
Results: The automated needle obtained a higher number of
histology reports at 84% (67/80) as compared with the semiautomated
needle at 60% (48/80) (Fisher exact test, p
value=0.023). Inadequate samples with the automated
needle were much less at 9% (7/60) than with the semiautomated
needle at 23% (18/60) (Fisher exact test, p
value=0.028). The semi-automated needle showed slightly
less fragmented samples. However, the number of
fragmented samples with definitive diagnosis was slightly
higher with the automated compared with the semiautomated
needle, at 16% (13/80) and 13% (10/80)
respectively. Compared with histology of 29 lesions that
were excised, the semi-automated needle had higher
sensitivity (100%) but lower specificity (75%) and accuracy
(90%) compared with the automated needle (88% sensitivity,
100% specificity, 95% accuracy).
Conclusion: Definitive diagnosis from the study samples
slightly favours the use of automated core biopsy needle as
compared to semi-automated core biopsy needle.
4.Positive Predictive Value of Sonographic BI-RADS Final Assessment Categories for Breast Lesions
Nursyahirah @Sheila Salinah Md Bohari ; Norzailin Abu Bakar ; Sharifah Majedah Idrus Alhabshi ; Nur Yazmin Yaacob
Malaysian Journal of Medicine and Health Sciences 2021;17(No.2):91-97
Introduction: We want to evaluate the sensitivity, specificity, positive (PPV) and negative predictive values (NPV)
of BI-RADS ultrasound, as well as PPV and NPV of BI-RADS ultrasound lexicon. Methods: A total of 517 ultrasound-guided breast biopsy cases were performed within three years. A total of 324 cases remained after 193 cases
were excluded from this study. The sensitivity, specificity, accuracy, PPV and NPV of overall BI-RADS and PPV for
each BI-RADS categories were calculated from the data when compared with histopathological examination (HPE)
finding. One observer evaluated four criteria of BI-RADS ultrasound lexicon; margin, echogenicity, posterior artefact
and internal echo from static sonographic images to determine the PPV and NPV of sonographic BI-RADS lexicon
based on HPE correlation. Results: There were 236 (72.8%) benign and 88 (27.1%) malignant lesions. The overall
BI-RADS has a sensitivity of 93.18%, specificity of 66.95%, accuracy of 74.07% with PPV and NPV of 51.25% and
96.34% respectively. The PPV of each BI-RADS categories were; BI-RADS 2 (9.09%), BI-RADS 3 (3.27%), BI-RADS 4
(39.02%) and BI-RADS 5 (91.89%). The highest predictive value for malignancy was irregular margin (52.3%) and for
benign was well-defined margin (89.7%). Criteria for margin and posterior artefact had a significant association with
HPE (p<0.0001) in differentiating between malignant and benign breast lesions in breast ultrasound. Conclusion:
Overlapping benign and malignant sonographic breast lesion descriptors tend to influence radiologist’s decision to
overcall final BI-RADS categories. The margin and posterior artefact are the important criteria in BI-RADS lexicon in
differentiating benign and malignant breast lesion.