1.Coughing on palpation: A rare complication of vagal schwannoma
Zabrina Marnel Samarakkody ; Khairil Amir Sayuti ; Anani Aila Mat Zin ; Wan Nor Najmiyah Wan Abdul Wahab ; Irfan Mohamad
Malaysian Family Physician 2018;13(3):40-43
Cervical vagal schwannoma is an uncommon, benign neoplasm. It is usually asymptomatic and
presents as a painless, palpable mass in the neck. However, large schwannomas can cause dysphagia,
dysphonia or dyspnea as a result of compression. We report a case of an extremely rare complication
of vagal schwannoma in which neck palpation induced the patient to cough. As the patient refused
any surgical intervention, conservative management was used.
2.Classifying DLBCL according cell of origin using Hans algorithm and its association with clinicopathological parameters: A single centre experience
Wan Nor Najmiyah Wan Abdul Wahab ; Azlan Husin ; Faezahtul Arbaeyah Hussain
The Medical Journal of Malaysia 2020;75(2):98-102
Introduction: In recent years, "double hit" and "double
protein" involving gene rearrangement and protein
expression of c-MYC and BCL2 and/or BCL6 are the most
used terms to describe poor prognostic factors in diffuse
large B-cell lymphoma (DLBCL). This study was to
determine the frequency of double or triple protein
expression by using immunohistochemistry (IHC) and
comparing the result with clinicopathological features and
cell of origin (COO) classification.
Methods: We conducted a cross-sectional study by using 29
archived formalin-fixed paraffin embedded tissue blocks of
DLBCL. All the samples were evaluated for the subgrouping
of COO DLBCL was determined by expression of CD10,
BCL6 and MUM1 based on Hans classification. In addition,
expressions of c-MYC, BCL2 and BCL6 were detected by
IHC.
Results: Among the 29 cases, MYC, BCL2 and BCL6 proteins
were detected in 72.4%, 62.1% and 62.1% of patients,
respectively. Concurrent expression (c-MYC positive/BCL2
positive and/or BCL6 positive) was present in 58.6% of
patients. 34.5% were categorised as germinal centre like
(GCB) subgroup and 65.5% were categorised as nongerminal centre like (non-GCB) subgroup. Among the
clinicopathological features, the double/triple protein
expression lymphoma was significantly associated with
elevated LDH level (p=0.018), IPI score (p=0.003), Ann Arbor
stage (p=0.011) and complete response rate (p=0.011).
Conclusion: Double/triple protein lymphoma was strongly
associated more adverse clinical risk factors. Thus,
analyses of MYC, BCL2 and BCL6 expression by IHC
represents a rapid and inexpensive approach to risk-stratify
patients with DLBCL at diagnosis.