BackgroundHodgkin lymphoma (HL) is a type of lymphoma that arises from the B lymphocytes. The four main subtypes of HL are the nodular sclerosing, mixed cellularity, lymphocyte rich and the lymphocyte depleted. Nodular sclerosis subtype accounts for majority of all classical HL, whereas lymphocytic depletion type accounts for less than 1%. The main objective of reporting this case is to share with the medical fraternity a rare presentation of abdominal lymphocyte-depleted classical Hodgkin lymphoma.A 47-year-old gentleman of Malay ethnicity with no known pre-morbidities, presented to the haematology unit with a 2-month history of night fever, loss of weight, malaise, anorexia and abdominal swelling. Abdominal examination revealed a periumbilical and lower epigastric swelling measuring 6x6 cms. The swelling was non-tender, firm in consistency and smooth on palpation. The Contrast Enhanced Computed Tomography (CECT) imaging revealed an enlarged mesenteric mass measuring 5.8x6.9x5.7 cm and multiple enlarged aorta-caval lymph nodes. The mesenteric tumour histology and immunohistochemistry were consistent with lymphocyte depleted HL. He completed six cycles of intravenous ABVD polychemotherapy consisting of doxorubicin (Adriamycin) 25mg/m2, Bleomycin 10mg/m2, Vinblastine 6mg/m2 and Dacarbazine 375mg/m2. The Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG PET /CT) imaging post 2 cycles and 6 cycles of ABVD polychemotherapy showed complete metabolic response to chemotherapy.
ConclusionLymphocyte-depleted classical Hodgkin lymphoma (LDcHL) is a rare entity and is mostly diagnosed at a later stage rendering it a disease with poor prognostic outcomes. Early detection and prompt institution of therapy is crucial in the management of this disease.
The study aims to investigate the relationship between the work environment and work engagement at one multinational company on the west coast of Peninsular Malaysia. The work environment was measured by Work Environment Scale (Billing and Moos, 1982) and work engagement was assessed by Utrecht Work Engagement Scale (UWES) (Schaufeli and Bakker, 2003). A total of 103 employees from the customer relations department of the multinational company have been chosen as the respondents in this research. Structural equation modelling using SmartPLS has been adopted to analyze the collected data. The results reveal that the level of the work environment is at moderate while work engagement is at high. The findings from SmartPLS discover that there is a significant and positive relationship between the work environment and work engagement at the multinational company on the west coast of Peninsular Malaysia. A few recommendations were suggested such as the company can improve the low level of relationship dimension in the work environment by initiating team-based projects rather than individual-based projects. Suggestions were also provided for future research including combining the quantitative and qualitative approaches in conducting the research.
Atypical lung carcinoid tumour, which is highly malignant has not been described widely in the literature. We report a middle-age woman who initially referred for possible lung malignancy. She presented with chronic diarrhoea to surgical team initially, who incidentally found to have a minimally enhancing irregular hypodense lesion at medial segment right lower lobe based on CT thorax finding. This patient later was diagnosed to have malignant lung carcinoid tumour based on histopathological examination with liver and bone metastasis. This case highlights the rare presentation of carcinoid tumour. A thorough history, supplemented by imaging and bronchoscopic examinations may lead to the diagnosis.International Journal of Human and Health Sciences Vol. 05 No. 01 January’21 Page: 108-111
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