• Asian Pacific Journal of Cancer Prevention
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• v.16 no.15
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• pp.6541-6544
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• 2015

Background: Laryngeal malignancy is a common malignancy of the head and neck region. Affected patients usually present with features that are characteristic of certain subsites. The larynx is oncologically divided into three: supraglottis, glottis and subglottis. Studies from Western countries have shown that the glottis is the commonest subsite to harbour laryngeal malignancy. However, the supraglottis has been reported to be the commonest subsite in developing countries, including examples in the Indian subcontinent. To our knowledge, no study has been carried out in western Nepal about the epidemiology of laryngeal cancer to date. The purpose of this study was to analyse the epidemiology of laryngeal cancer in relation to its risk factors, age distribution,and preferred subsites and to see if there is any recent change in the subsite wise distribution of laryngeal malignancy in western Nepal. Materials and Methods: Patients of all ages and both sexes with suspected laryngeal malignancy were enrolled in the initial study. Detailed history taking and clinical examination was performed to find out the involved subsite in relation to the clinical features. Direct laryngoscopy was performed to further confirm the subsite and to take biopsy from the growth under general anesthesia. After confirmation of malignancy from the biopsy report, patients were finally included in the study. Data were analysed and observations were made to find out the distribution of laryngeal malignancy in different subsites. Results: The supraglottic larynx was the commonest subsite to harbor laryngeal malignancy. Smoking and alcohol were found to be the common risk factors. The mean age of the patients was in their sixties. Conclusions: Laryngeal malignancy is common in elderly individuals. Supraglottic laryngeal malignancy is the commonest laryngeal malignancy in people who smoke and drink alcohol in Nepal. Avoidance of alcohol use and smoking will be a milestone to reduce the incidence of laryngeal cancers and associated mortality.

• Annals of Clinical Neurophysiology
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• v.25 no.2
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• pp.84-92
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• 2023

Background: Clinical spectrum of immunoglobulin M (IgM) monoclonal gammopathy varies from IgM monoclonal gammopathy of unknown significance (IgM-MGUS) to hematological malignancies. We evaluated the clinical features, electrophysiological characteristics, and prognosis of patients with peripheral neuropathy associated with IgM monoclonal gammopathy (PN-IgM MG). Methods: We retrospectively evaluated 25 patients with PN-IgM MG. Peripheral neuropathy was classified as axonal, demyelinating, or undetermined, based on electrophysiological studies. We classified the enrolled patients into the IgM-MGUS and malignancy groups, and compared the clinical and electrophysiological features between the groups. Results: Fifteen patients had IgM-MGUS and 10 had hematologic malignancies (Waldenström's macroglobulinemia: two and B-cell non-Hodgkin's lymphoma: eight). In the electrophysiological evaluation, the nerve conduction study (NCS) criteria for demyelination were met in 86.7% of the IgM-MGUS group and 10.0% of the malignancy group. In particular, the distal latencies of the motor NCS in the IgM-MGUS group were significantly prolonged compared to those in the malignancy group (median, 9.1 ± 5.1 [IgM-MGUS], 4.2 ± 1.3 [malignancy], p = 0.003; ulnar, 5.4 ± 1.9 [IgM-MGUS], 2.9 ± 0.9 [malignancy], p = 0.001; fibular, 9.3 ± 5.1 [IgM-MGUS], 3.8 ± 0.3 [malignancy], p = 0.01; P-posterior tibial, 8.3 ± 5.4 [IgM-MGUS], 4.4 ± 1.0 [malignancy], p = 0.04). Overall treatment responses were significantly worse in the malignancy group than in the IgM-MGUS group (p = 0.004), and the modified Rankin Scale score at the last visit was higher in the malignancy group than in the IgM-MGUS group (2.0 ± 1.1 [IgM-MGUS], 4.2 ± 1.7 [malignancy], p = 0.001), although there was no significant difference at the initial assessment. Conclusions: The risk of hematological malignancy should be carefully assessed in patients with PN-IgM MG without electrophysiological demyelination features.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.12
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• pp.6087-6091
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• 2012

Context: Patients diagnosed with a cancer have a life time risk of developing another de novo malignancy depending on various inherited, environmental and iatrogenic risk factors. Of late the detection of new primary has increased mainly due to refinement in both diagnostic and treatment modalities. Cancer victims are surviving longer and thus are more likely to develop a new metachronous malignancy. Aims: To report our observed trend of increase in prevalence of both synchronous and metachronous second malignant neoplasms among cancer victims and to review the relevant literature. Settings and Design: A hospital based retrospective collection of prospective data of patients diagnosed with second denovo malignancy. Materials and Method: The study was conducted over a 5 year period from July 2008 to June 2012. All patients diagnosed with a histologically proven second malignancy as per Warren Gate's criteria were included. Various details regarding sex, age at presentation, synchronous or metachronous, treatment and outcome were recorded. Conclusions: The occurrence of multiple primary malignancies is not rare. Awareness of the possibility alerts the clinician in evaluation of patients with a known malignancy presenting with unusual sites of metastasis. Individualizing the treatment according to the stages of the primaries will result in durable cancer control particularly in synchronous double malignancy.

• The Korean Journal of Cytopathology
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• v.2 no.1
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• pp.20-27
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• 1991

In order to evaluate the role of cytopathologic diagnosis of sputum, bronchial washing and bronchial blushing in the diagnosis of lung cancer, we performed this study. The patients included in this study had undergone sputum, bronchial washing and brushing cytology over the 20-month period of 1985 through 1987. The total number of specimens was 5,495 of 2,242 patients, including 4,830 sputa and 665 bronchial washing and brushings. The average number of sputa and bronchial washings and brushings per case was 2.4 and 1.2 respectively. Among them, about 10% were unsatisfactory specimen, and three-fourths were negative specimens. In sputum cytology, the diagnosis of "atypical cells" was given to 3%, "suspicious for malignancy" was given to 1 %, and "malignancy" was given to 13%. In bronchial washing and brushing cytology, the diagnosis of "atypical cells", "suspicious for malignancy" and malignancy" was given to 6%, 3%, and 20% respectively The cases diagnosed as "atypical cells" in cytology were actually malignancy in 95% and 84.8% of sputum and bronchial washing and brushings respectively, and the "suspicious for malignancy" were actually malignancy in 100% in both methods. The detection rates of malignancy were 504% and 55.2% in sputum and bronchial washing and blushing respectively, and the specificity was 100% in both methods. The accuracy of cell typing was 92% in sputum and 89.7% in bronchial washing and blushing.

• The Korean Journal of Cytopathology
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• v.19 no.2
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• pp.144-151
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• 2008

Fine needle aspiration (FNA) cytology is the decisive test in the pre-operative diagnostics of thyroid nodules. Here we share our institutional experience about thyroid aspiration and give suggestions for suspicious cytology results. Three hundred twenty-two cases in 270 patients (mean age 47.4 years, 243 women and 27 men) who underwent thyroidectomy were reviewed. Among the 322 cases, the FNA diagnosis of "positive for malignancy" was 87 cases (27.0%), "suggestive of malignancy" 30 cases (9.3%), "suspicious for malignancy" 61 cases (18.9%), "negative for malignancy" 102 cases (31.7%), and "unsatisfactory smear" 42 cases (13.0%). Eighty seven cases (100%) out of "positive for malignancy", 29 cases (96.7%) out of "suggestive of malignancy", and 39 cases (64.0%) out of "suspicious for malignancy" were papillary carcinoma (148 cases, 95.5%), or follicular carcinoma (2 cases, 1.3%), or metastatic carcinoma (1 case, 0.6%). Seventeen patients who had only negative or unsatisfactory cytology underwent thyroidectomy and nine cases (52.9%) were papillary carcinoma. We suggest that: the cytology diagnosis of "suggestive of malignancy" could be regarded as "positive for malignancy", the cytology diagnosis of "suspicious of malignancy" should be carefully correlated with clinico-radiologic manifestation, and even a negative or unsatisfactory smear should be carefully followed up.

• The Korean Journal of Pain
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• v.8 no.1
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• pp.135-138
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• 1995

We experienced two cases of malignancy diagnosed during the treatment of postherpetic neuralgia. One case was a lung cancer and the other case was a pancreatic cancer. Generally, herpes zoster frequently occurred in the patients who have immunosupressive disease, diabetes mellitus, malignancy and tuberculosis, etc. It is necessary to rule out malignancy in the patients who have herpes zoster, especially those patients whth severe eruptive cluster, persisting to the therapy or multifocal pain. So, we must carefully observe and follow up the patients to find out malignancy as well as to diminish the pain.

• Journal of Korean society of Dental Hygiene
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• v.13 no.3
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• pp.509-515
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• 2013

Objectives : This study was performed to evaluate the salivary secretion, salivary pH and cariogenic activity using unstimulated whole saliva in patients with hematologic malignancy. Methods : Nineteen patients (9 male, 10 female) who had hematologic malignancy and were treated with chemotherapy or bone marrow transplantation, and nineteen normal volunteers (7 male, 12 female) as control group were included. The mean age of patients group and control group was 45.1 and 46.7 years, respectively. Patients group was examined salivary secretion, salivary pH, and cariogenic activity using unstimulated whole saliva and was compared with control group. Results : In comparison with control group, salivary secretion, salivary pH and salivary buffer capacity were significantly lower in patients with hematologic malignancy (p<0.01). Both cariogenic activity(p<0.01) and the number of Lactobacilli(p<0.05) are higher in patients group than control group. Conclusions : These results suggest that the unstimulated whole salivary secretion, pH and buffer capacity were lower in patients with hematologic malignancy than control group. Cariogenic activity is higher in patients with hematologic malignancy than control group. Such salivary factor and cariogenic activity can increase the possibility of induction of dental caries.

• International Journal of Contents
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• v.5 no.1
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• pp.33-36
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• 2009

Since the diagnosis of malignancy and benign of thyroid gland diseases is difficult only by using ultrasonogram opinions, the combination of fine needle aspiration (FNA) has been generalized trend for precise pathological diagnosis. Therefore, the current study aimed to know about its availability. The study subjected 500 patients who received the FNA along with the ultrasonogram screening for thyroid gland from October, 2007 to April, 2008. As the equipments for the study, Philips HDI-3500 and Philips UITRAMARKer-9 (UM-9) were used to conduct the comparative analysis of pathological results that were obtained through the inspection of ultrasonogram screening and through ultrasonogram guided FNA. Among the 464 patients who were found to be benign from the ultrasonogram screening inspection, II cases of the FNA diagnosis results judged to be malignancy, and 13 cases of the FNA diagnosis resulted to be benign among 36 patients who were diagnosed to be malignancy. The cases observed as solid from the opinions of ultrasonogram screening were often found to be malignancy, and most of the malignancy results were observed to show the hypoechoic pattern. Among the patients diagnosed with malignancy from the diagnosis of FNA, the 32 patients were found to have the papillary carcinoma, and the benign type was observed to be goiter and hyperplasia in 263 patients, which took up 52.6%. The ultrasonogram screening test that is performed for the purpose of diagnosing thyroid gland diseases, it is distinctively an useful inspection to diagnosis the presence, size and shape of nodules. However, the results of performing of FNA for those of nodules which were observed to be benign from the ultrasonogram were often came up with malignancy and there were cases that the nodules diagnosed with malignancy were diagnosed as benign from the FNA diagnosis.

• Journal of Yeungnam Medical Science
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• v.35 no.1
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• pp.99-103
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• 2018

Mammary Paget's disease (MPD) is usually accompanied by underlying breast malignancy; however, a few cases have been reported as only skin lesions without any evidence of malignancy of the breast on imaging tests and microscopic examination of surgical specimen. Here, we describe a 47-year-old woman who visited our hospital who had an eczematous lesion on right nipple and areola for over 10 years. The lesion was diagnosed as Paget's disease by punch biopsy; however, imaging studies demonstrated no breast malignancy or lymph node metastasis. The patient underwent surgery of on the nipple and areola including underlying breast tissue. No underlying malignancy was found upon microscopic examination, except for Paget's disease. Immunohistochemical stains revealed that the tumor cells were positive for cytokeratin 7, and negativity for p63, cytokeratin 5/6, estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2. We report a case of MPD without underlying malignancy. To the best of our knowledge, this is the third case reported in Korea.

• The Korean Journal of Cytopathology
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• v.9 no.1
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• pp.15-20
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• 1998

Mutant form of the p53 gene product is abnormally accumulated in the nuclei of the tumor cells due to prolonged half life, and readily detected by immunohistochemical methods. To determine the positivity rate of p53 in body cavity fluid according the primary site and histological types of tumors and the utility of p53 immunostaining as an adjunct in the diagnosis of malignancy, we reviewed 69 effusions, including pleural effusion, ascitic fluid, and pericardial fluid, that were diagnosed as overt malignancy and 21 effusions of suspicious malignancy, immunohistochemistry was performed on paraffin-embedded cell blocks using a monoclonal antibody to p53 supressor gene product(Clone DO7) and a standard avidin-biotin complex technique with a citrate buffer antigen retrieval solution. The results were as follows; of the 46 pleural effusions with overt malignancy, 22 were immunopositive for p53 protein; of the 21 ascitic fluids with overt malignancy, 5 were positive for p53. Positivity rates according to the primary sites of tumors were 18 of 34(52.9%), 8 of 21(38.1%), 1 of 9(11.1%) cases of the tumors of the lung, GI tract, and ovary, respectively. According to the histologic types of lung cancer, 11 cases(61.6%) were positive out of 18 adenocarcinomas, 2 of 5 large cell undifferentiated carcinomas, and 1 of 2 small cell undifferentiated carcinomas. Of 21 cases of suspicious malignancy, 6 were positive for p53 and all of them(6/6) were confirmed as adenocarcinoma of the lung or GI tract. These findings indicate that p53 immunostaining using paraffin embedded cell block is useful diagnostic and prognostic marker in body fluid cytology although negative immunostaining does not exclude malignancy.