Maharat Nakhon Ratchasima Hospital Journal

Atypical presentation of CLL/SLL as pancreatic mass: case report

2025-10-03T10:01:42+07:00

Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is a mature B-cell neoplasm and the most prevalent leukemia in adults in Western countries, though it is less common in Asian populations and more frequently observed in males. Case Presentation: A 54-year-old female with no underlying disease, who presented with left lower quadrant pain and dysuria. Discussion: A 54-year-old female with no underlying disease presented with left lower quadrant pain and dysuria. Initial evaluation with non-contrast MDCT revealed a 0.4 cm ureterovesical junction stone without associated hydroureter or hydronephrosis, as well as an incidental 2.6 x 3.8 x 5.1 cm isodense soft tissue mass in the gastrohepatic region abutting the pancreatic tail. Subsequent contrast-enhanced MDCT identified a well-defined, enhancing lesion measuring 2.4 x 3.7 cm attached to the antero-superior aspect of the pancreatic body, raising suspicion for an exophytic pancreatic tumor. The patient underwent laparoscopic spleen-preserving distal pancreatectomy. Results: Histopathological analysis of the resected specimen revealed chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) involving an adjacent lymph node. Conclusions: This case underscores the importance of investigating incidental findings on imaging. Although the mass initially mimicked a pancreatic tumor, a multidisciplinary approach and surgical intervention led to a definitive diagnosis of CLL/SLL. Clinicians should be aware of extranodal presentations of lymphoma that can mimic primary organ tumors.

Maharat Nakhon Ratchasima Hospital Journal Vol. 42 No. 2 (July–December 2025) ISSN: 3088-1900 (Online)

2025-12-22T11:47:40+07:00

In-hospital Mortality of Fragility Hip Fracture in Oldest-old patient

2025-08-26T21:29:16+07:00

With an aging population, hip fractures in the elderly have become a growing concern. Oldest-old patients aged 80 years and above are particularly vulnerable to complications and in-hospital mortality. The objective of this study was to ascertain the prevalence of in-hospital mortality and pinpoint associated risk factors among Oldest-old patients presenting with hip fractures. Methods: This retrospective cohort study analyzed data from a hip fracture database at Maharat Nakhon Ratchasima Hospital from January 2020 to December 2021. Patients aged 80 years and above were included. Statistical analysis was performed to compare characteristics between patients who died and survived during hospitalization. Results: A total of 435 patients aged 80 years and above were included. The in-hospital mortality rate was 5.52%. Renal dysfunction was significantly associated with increased mortality. Deceased patients had significantly lower estimated glomerular filtration rates (GFR) compared to survivors (P = 0.021). Moreover, 25% of deceased patients had stage 4 or higher chronic kidney disease (CKD), significantly higher than 8.27% in survivors (P = 0.01). Postoperative pneumonia was another significant complication observed in the deceased group. Conclusion: Elderly hip fracture patients aged 80 years and above are at high risk of in-hospital mortality. Renal dysfunction (stage 4 or higher chronic kidney disease) and postoperative pneumonia were identified as significant risk factors. Proactive assessment and management of these risk factors may help reduce mortality in this vulnerable population.

Forensic Science in the Asia-Pacific: Artificial Intelligence trends and clinical applications

2025-10-01T13:28:29+07:00

The Asian Forensic Sciences Network (AFSN) and the Asia Pacific Medico-Legal Agencies (APMLA) Annual Meeting 2025 took place in the Republic of Korea (September 15–19, 2025), celebrating the 70th anniversary of Korea’s National Forensic Service (NFS). This report summarizes the key scientific and technological trends presented, alongside a personal reflection on the hospital's research contribution. Materials and Methods: This special article reviewed and analyzed data from a total of 332 technical abstracts (160 oral and 172 e-poster presentations) delivered across various Working Groups.
A quantitative assessment of the application of Artificial Intelligence (AI), Machine Learning (ML), and Deep Learning (DL) technologies was performed. Results: A total of 39 presentations were identified as related to AI/ML/DL, predominantly focusing on Digital Forensics and Forensic Medicine. The author's research, “Using Machine Learning Models to Identify Key Clinical Clues in Forensic Detection of Nasal Bone Fractures” (FMWG-PP-15), was the sole abstract from the Ministry of Public Health (MOPH) and the only e-poster applying ML to clinical forensic diagnosis. The Random Forest model achieved high predictive ability (AUC 0.95) by identifying nasal ridge crepitation/stepping as the key clinical predictor. Conclusion: A prevailing trend in the Asia-Pacific region is the significant transition toward AI-driven forensics, presenting a crucial opportunity to incorporate machine learning technologies into hospital-based clinical forensic diagnostics. This integration aims to improve the accuracy and standardization of injury assessments and advance the development of forensic sciences.