A Story of Pathology and Cancer

The main purpose of this book is to introduce the history of pathology, the features of cancer from the pathological aspect and the role of pathology in the medical advances of cancer. However, it does not intend to provide an exhaustive discussion on cancer. It is a compilation of results to some of the research findings that has been undertaken so far

The Relationship between Odorrana hosii Skin Histology and Habitat Water Quality in Different Locations of Sarawak

Recent study has revealed that the poison gland in Odorrana hosii skin act as defensive mechanism and can help in wound healing management of a frog species. Since skin is the first organ that come into contact with the surrounding, the habitat of the species should be related to the properties of the frogs’ skin. Thus, we investigated the O. hosii skin histology in relation to water quality parameters at different localities in Sarawak. The goal of study is to uncover a link between O. hosii habitat and its skin histology at four different locations: Ranchan Recreational Park (RRP), Matang Wildlife Centre (MWC), Borneo Highlands (BH), and Santubong National Park (SNP). The water quality criteria for each area were pH, turbidity, temperature, and dissolved oxygen (DO). The results showed that DO concentration of the habitat is the most essential element in affecting the health of the amphibian skin, as well as the forested areas (MWC, SNP, and BH) that protect the skin from direct sunlight. The DO of the habitat differed significantly for the mean number of mucous and seromucous glands at 0.01 (α = 0.05) and 0.03 (α = 0.05), respectively. The number of mucous glands and DO were found to have a strong positive correlation at 0.701. However, the number of seromucous glands showed a strong negative correlation with DO at -0.623. O. hosii skin from the four different localities was found to have cutaneous gland variations that reflect the environment in the number of glands. Mucous glands play an important role in indicating the localities’ water quality, which reflects adaptation of O. hosii to its habitat. This highlights the importance of preserving natural habitats for this sensitive species. Keynote: Bornean frog, histology, Odorrana hosii, skin, water qualit

Metastatic erector spinae tumor underlying primary lung adenocarcinoma with paraneoplastic secreting beta-human chorionic gonadotropin hormone: A rare case report

Introduction: Beta-human chorionic gonadotropin (β-HCG) hormone is physiologically produced by syncytiotrophoblast cells in the placenta during pregnancy. It is also a specific marker for trophoblastic tumors of placenta and gestational tumors. In rare case, a rise in serum β-HCG may be due to ectopic secretion especially in epithelial carcinoma namely lung CA and other tumors. Here, we report a case of a middle-age woman presenting with rapid growing back swelling with amenorrhea and high serum β-HCG with underlying primary lung cancer. Discussion: 48 year-old single lady, ex-smoker and nulliparous presented with painful rapid growing back swelling for 3 months associated with marked loss of weight and appetite for 9 months. She was amenorrheic for 3 months. A firm mass located at left paraspinal area with 6x6cm in size, fixed to the underlying muscle and skin, irregular surface and border. Other systemic examinations was unremarkable. Serum β-HCG was high 1142mIU/ml. Transvaginal Ultrasonography was normal. Chest X-Ray showed consolidation over left middle zone of the lung. CT-TAP had left lung mass measuring 5.6x4.6x2.8cm with left hilar lymphadenopathy. MRI of whole spine revealed left erector spinae intramuscular lesion with adjacent inflammatory changes with no intraspinal extension. Tissue HPE showed fragments of fibrocollagenous tissue with malignant cell infiltration arranged in cords and glandular pattern. The malignant cells displayed mild pleomorphism with hyperchromatic nuclei and eosinophilic cytoplasm. Immunohistochemical study has positive CK7 and GATA3 with negative CK20 and TTF-1. These features are consistent with metastatic adenocarcinoma likely primary lung adenocarcinoma. Bronchoscopy-guided biopsy was performed and confirmed the diagnosis. She was then referred to oncology for further management. Conclusion: Ectopic secretion of β-HCG in lung carcinoma is not well understood and has not been well reported in literature. Therefore, such presentation may mimic various condition and this may result in delay of diagnosis. More studies are required for better understanding

The toxic effects of p-Cresyl Sulfate on bone metabolism

Background p-Cresyl Sulfate (pCS) is a uremic toxin that has been implicated in kidney disease, cardiovascular risks, endothelial dysfunction and neuropathies. In chronic kidney disease (CKD), pCS progressively accumulates in the body as the dysfunctional kidneys have a reduced ability to excrete toxins normally. pCS accumulated as a consequence of CKD cannot be removed from th body through dialysis, hence leading to further accumulation. This ultimately leads to bone loss which correlates with the worsening of CKD. As such, pCS could play a part in the development of bone loss with CKD. The objective of this review is to further understand the comprehensive effects pCS has on the bone

Extraskeletal soft tissue chondroma of right thumb : A rare case

Introduction: Extraskeletal soft tissue chondroma (ESSC) is a rare benign cartilaginous soft tissue tumour. It represents around 1.5% of all benign soft tissue tumours. ESSC is slow growing tumour arising from extra-osseous and extra-synovial location. Predominantly occurs in hands and feet especially in the fingers. We report a rare case of ESSC of right thumb treated with marginal excision. Discussion: A 31 years-old gentleman presented with progressively increasing painless swelling over his right thumb past 7 months. The swelling is 3x3cm in size, volar aspect of right thumb interphalangeal joint. Swelling was lobulated, firm in consistency, mobile and non-tender. No neurological involvement. Plain radiograph of the right thumb demonstrated well demarcated soft tissue swelling palmar side of right thumb with internal calcification and no underlying bony erosion. Marginal excision was performed. Intra operatively found that tumour is arising from flexor tendon sheath. Macroscopically tumour is greyish, firm, lobulated measuring 2.5x2x1.5cm. Histopathological examination revealed cartilaginous matrix with occasional binucleation of chondrocytes. There is presence of myxoid change areas, calcification and ossification. Conclusion: Clinical diagnosis might be challenging given the rarity of the disease. Combination of clinical, radiological and histopathology examination are necessary to diagnose ESSC. Marginal en-bloc excision is the first line of treatment to prevent local recurrenc

An Immunohistochemical Study of CD1a and CD83-Positive Infiltrating Dendritic Cell Density in Cervical Neoplasia

Cervical carcinoma is the second leading cancer in women in Malaysia, after breast cancer. Human papillomavirus (HPV) has been implicated in the development of dysplasia or cervical intraepithelial neoplasia and progression to squamous cell carcinoma. Because of the confinement of the human papillomavirus infection within the epithelial layer, the presence of dentritic cells or Langerhans cells in epithelial layer of the ectocervix is paramount in producing immune response. The mature dentritic cells express CD83 and high CD40/80/86, whereas the immature cells express CD1a and low CD40/80/86. By identifying CD1a and CD83, theoretically, both immature and mature dentritic cell populations can be studied. In view of the facts, we investigated the infiltrating cell density of mature and immature dentritic cells in cervical neoplasia