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   2016| December  | Volume 7 | Issue 2  
    Online since December 19, 2017

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Cytopathology practice in Lagos, Nigeria: our experience
Francis Adedayo Faduyile, Sunday Sokunle Soyemi, Olugbenga Olayide Oyewole
December 2016, 7(2):117-122
Background: Fine Needle Aspiration (FNAC) is a simple cost effective and rapid diagnostic technique. It is used in addition with exfoliative/fluid cytology to help clinicians in the management of patients who present with abnormal masses in the body. This study is to present our experience of FNAC and non gynaecological cytology (NGC) in diagnostic cytopathology and highlight the varieties of samples for cytopathology analysis. Materials and Methods: This is a six year retrospective study of all FNAC and NGC specimen seen in Lagos State University Teaching Hospital, Ikeja and Lag Path Consulting laboratory, Ikeja, Lagos State between January 2008 and December 2013. All cytopathology reports and records were retrieved and analyzed using the Statistical Package for the Social Sciences version 20.Test for statistical significance was set at p<0.05. Results: A total of 1855 patients were seen during this period with a male female ratio of 1:3 and a mean age of 40.61±17.49 years. Breast FNAC was the most common request seen (37.4%) which was followed by fluid cytology (28%) and then thyroid (12.7%), soft tissues (10.2%) and lymph nodes (9.2%). FNAC breast, lymph node and soft tissues showed 29.5%, 22.2% and 8.9% malignancy rate respectively. Fluid cytology requests were seen more in extreme of ages. Conclusion: FNAC of breast lumps, fluid/exfoliative cytology and thyroid enlargement are the most common specimens seen. Breast lump aspirates showed the highest malignant diagnosis. With continued use of this investigation, training and retraining of pathologists and clinicians in cytopathology is advocated for better result.
[ABSTRACT]   Full text not available  [PDF]
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Primary mature cystic teratoma of the lung: A case report
U Mohammed, K Abdullahi, U Abubakar, AF Abubakar, UA Aminu
December 2016, 7(2):123-126
Background: Primary teratomas of the lung are extremely rare neoplasms. They are thought to originate from derivatives of the third pharyngeal pouch. They generally present with non-specific symptoms including chest pain, cough, hemoptysis, bronchiectasis and pneumonia. Case Report: A 38 year old farmer who presented with a week's history of cough and haemoptysis. He had no other significant clinical and social history. On examination: findings were essentially within normal limits except for a slightly dull percussion note on the left upper zone with decreased air entry. Chest X-ray showed a honey comb appearance on the left upper lobe of the lung. Chest CT scan (mediastinal window) showed multiple mediastinal lymphadenopathy; lung window showed a mass destroying the left upper and middle (lingular) lobe. A working diagnosis of destroyed left upper lung lobe secondary to? pulmonary tuberculosis to rule out bronchogenic carcinoma was made. He was prepared for and had left posterior lateral thoracotomy with left upper lobectomy. The resected lung tissue was sent to the Histopathology laboratory, which revealed mature cystic teratoma following microscopic examination of hematoxylin and eosin stained sections of formalin fixed paraffin embedded tissue blocks. Conclusion: Extra-gonadal germ cell tumors should be a differential diagnosis of lesions of the mediastinum, to aid timely diagnosis and management.
[ABSTRACT]   Full text not available  [PDF]
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Hepatocellular carcinoma in Zaria: An analysis of the morphology and associated risk factors
Usman Bello, Samaila Modupeola Omotara, Iliyasu Yawale
December 2016, 7(2):96-101
Background: There is substantial global variation in the prevalence of hepatocellular carcinoma (HCC). This variation depends on the prevailing aetiology and/or risk factors present in any particular locale, thus the need to document our experience with HCC in Zaria. Materials and Methods: This is a 15years morphological assessment of all diagnosed cases of HCC. Microscopic features detailing different pathologies were analysed and graded using the Edmond Steiner grading system.1 Risks factors documented in accompanying case files were collated, the HBV and HCV statuses were determined by serological assays during patients' initial work up while alcoholism was determined based on quantity consumed per day over specified period. Results: Overall, sixty two cases were studied comprising 39 males and 23 females with a M: F ratio of 1.7:1. The ages ranged from 15 to 74years and a peak in the 5th decade of life with 21cases. The hepatotropic viruses were the commonest risk factors; HBV-35.5%, HCV- 9.7% and HBV/HCV co infection- 12.5%. Overall, chronic hepatitis accounted for 58% of cases. Other risk factors included alcohol consumption and morbid obesity which accounted for 6.5% and 3.2% cases respectively while cirrhosis and steatohepatitis accounted for 46.8% and 25.8% respectively. 66.1% cases were Edmond Steiner grades I and II diseases. Only 2 cases of clear cell HCC and solitary cases of sarcomatoid and sclerosing HCC variants were recorded. Conclusion: The common risk factors for HCC were the hepatotropic viruses.
[ABSTRACT]   Full text not available  [PDF]
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Fungal osteomyelitis with avascular necrosis of femoral head in a known sickle cell anaemia patient
MOA Samaila, AA Babadoko, MI Maitama, LZ Yau, K Adoke, A Adebayo
December 2016, 7(2):127-129
Fungal infection at the same site of an avascular necrosis (AVN) in sickle cell anaemia (SCA) is a rarity even though the incidence of deep fungal infection in recent time has been steadily increasing in immune-compromised, chronically ill and debilitated persons. The prevalence of AVN in SCA is approximately 10% while the burden of sickle cell disease in sub-Saharan Africa is highest globally. We present a 17year old SCA female with an AVN of right femur head and a concurrent African histoplasmosis.
[ABSTRACT]   Full text not available  [PDF]
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Pathological and radiological correlation of diseases in contemporary medical practice
Abdulmumini Hassan Rafindadi
December 2016, 7(2):73-83
In modern times clinical care of patients relies heavily on the specialties of radiology and pathology for diagnosis. The two specialties have always existed independently in medical institutions, with some level of cooperation when there is the need to correlate the findings in specific patients; in recent times, particularly in breast cancer screening and diagnosis, bone pathology and image-guided biopsy. Pathology and radiology have had different historical and developmental experiences, but both have seen an explosion of knowledge, and technological, and scientific developments in recent times. Rudolf Virchow (1821-1902) is considered as the father of modern pathology, while Wilhelm Conrad Rontgen is the discoverer of electromagnetic radiation the basis of X-ray. The field of histopathology has made tremendous progress, particularly in the area of immunohistochemistry and the application of molecular techniques, which are useful in the diagnosis and follow up of cancer patients. These form an important basis of personalised medicine. Modern radiology relies on mammography, ultrasound, computerised tomography, magnetic resonance imaging, positron emission tomography, nuclear medicine and interventional radiology. Pathology and radiology form the core of cancer diagnosis in clinical practice. Specific areas of cooperation between the two fields include fine needle aspiration cytology, breast cancer control programme, sentinel lymph node localization, cases of adenocarcinoma of the lung with specific signatures, and interstitial lung disease. Finally, standardization of reports will ensure use of controlled terminology and reporting structures. There is need to commence radiologic pathologic correlation courses for residents in the country as is practiced in the North America in order to partly meet this challenge.
[ABSTRACT]   Full text not available  [PDF]
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Salivary gland neoplasms in Zaria, Nigeria: A 20-year retrospective analysis
K Abdullahi, M. O. A. Samaila, MS Shehu, Y Iliyasu
December 2016, 7(2):84-90
Background: Salivary gland neoplasms are rare and can pose complex diagnostic questions and management challenges to the Histopathologist and Surgeon respectively. Materials and Methods: The study was carried out in the Pathology Department of the Ahmadu Bello University Teaching Hospital (ABUTH) Zaria, Nigeria. Universal sampling was employed, in which from the departmental records(Reception Registers, Bench Books, Request forms, etc), all cases registered as salivary gland tumors over the period: 1st January, 1989 to 31st December 2008 (20 years) were consecutively selected specifically with respect to patients' age, sex, and site of biopsy. The corresponding Hematoxylin and Eosin (H & E) stained slides were retrieved from the departmental archives and reviewed using diagnostic criteria laid down by WHO Classification of Tumors of the Head and Neck. Data obtained was entered into and analyzed using the Statistical Package for the Social Sciences (SPSS, 20) and presented using frequencies and percentages. Results: Salivary gland neoplasms constituted 2.1% of all neoplastic lesions seen in the study period. The male-to-female ratio was equal. Peak age range was 31-40 years. Malignant tumours accounted for 50.7% (n = 131) and benign tumours 49.2% (n = 127). Pleomorphic adenoma had the highest frequency of 43.4% and adenoid cystic carcinoma was the second commonest (25.9%). Conclusion: Salivary gland neoplasms are rare with males being more likely to have malignant salivary gland tumors as compared to females.
[ABSTRACT]   Full text not available  [PDF]
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Histopathological pattern of intracranial neoplasms in a neurosurgical centre in Nigeria
SM Sahabi, CA Okolo, EE Akang
December 2016, 7(2):102-111
Background: The pattern of intracranial neoplasms in Nigeria has evolved over the years, with the introduction of additional neurological facilities in each of the major geopolitical regions of the country. This study represents the most current and largest study from Ibadan, Nigeria, covering a 17-year period. Materials and Method: This was a 17-year histopathological review of all intracranial biopsies seen at the Department of Pathology, University College Hospital Ibadan. Results: Intracranial neoplasms accounted for 1.6% of 82,379 surgical biopsies seen and 0.8% of the 9,463 autopsies performed during the study period. There was a gradual increase over the years from 26 cases in 1991 to 49 cases in 2007. The male to female ratio was 1.3:1. Neuroepithelial neoplasms accounted for 32.8%, meningeal neoplasms 28.6%, and sellar region neoplasms for 21.8% of cases. 91.3% were primary, while 8.7% were metastatic neoplasms. 21.6% of all intracranial neoplasms were infratentorial, while 78.4% were supratentorial. The cerebral convexity, sellar region and posterior cranial fossa were the most common locations of intracranial neoplasms. Astrocytic neoplasms were the most frequent neuroepithelial neoplasms, with pilocytic astrocytomas accounting for 38.6% of the neuroepithelial neoplasms. Transitional meningiomas accounted for 44.6% of the meningeal neoplasms. Pituitary adenoma and craniopharyngioma comprised 14% and 7.9% of all intracranial neoplasms respectively. Metastatic neoplasms included rhabdomyosarcoma (16.1%), Burkitt's lymphoma (9.7%), soft tissue sarcoma (6.5%), malignant melanoma (6.5%), thyroid carcinoma (6.5%) and choriocarcinoma (6.5%). Conclusion: The pattern of intracranial neoplasms displayed in this study reveals several interesting observations, which include similarities with previous published studies in West Africa and other parts of the world.
[ABSTRACT]   Full text not available  [PDF]
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Lower serum level of adiponectin is associated with increased insulin resistance in Nigerian women with gestational diabetes mellitus
Abdullahi Mohammed, Ibrahim Sambo Aliyu, Mohammed Manu
December 2016, 7(2):91-95
Background: The exact mechanism implicated in the pathophysiology of the insulin resistance causing gestational diabetes mellitus (GDM) is still not completely understood. Adiponectin is an adipocytokine that is proposed to be a potential mediator of the insulin resistance, but its role is not clear; Findings from studies done across different ethnic groups yielded conflicting results. The aim of the study is to determine the association between serum level of adiponectin and insulin resistance in Nigerian women with GDM. Materials and Method: 100 pregnant women with GDM and another 100 healthy pregnant controls were enrolled in the study. Participating subjects were evaluated between 24-28 weeks gestation. Serum fasting insulin and adiponectin were measured. Insulin resistance index was calculated as homeostatic model assessment for insulin resistance (HOMA-IR). Results: Pregnant women with GDM were more insulin resistant than the controls (3.14 ± 0.19 vs. 2.89 ± 0.20, p < 0.05). Decreased maternal serum adiponectin level was associated with higher insulin resistance in pregnant women with GDM (r = -0.58, p < 0.05). This association remained significant even after adjustment for age and body mass index. Conclusion: We conclude that among the pregnant Nigerian women with GDM in this study, decreased maternal serum adiponectin level is associated with higher insulin resistance.
[ABSTRACT]   Full text not available  [PDF]
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Parapharyngeal cavernous lymphangioma - A case report
U Mohammed, KR Iseh, SM Sahabi, N Aliyu, K Abdullahi
December 2016, 7(2):130-134
Lymphatic malformations of the head and neck, also known as lymphangiomas or cystic hygromas, are a diverse group of lesion. They represent benign hamartomatous tumours of lymphatic vessels with a marked predilection for the head, neck and oral cavity. Cavernous or microcystic lymphangioma, however, is composed of small lymphatic spaces and poses a therapeutic dilemma by its propensity to cause airway and feeding difficulties and by its tendency to recur despite extensive surgery. Case report: We present JB a 6 year old pupil who presented to clinic with 4 years history of recurrent sore throat. There was no dryness of the tongue, peri-areolar swelling, epistaxis nor snoring. On examination there was fullness in the right lateral wall of the oropharynx pushing towards the midline, with soft palatal bulging at the same site displacing the uvula to the left. The overlying mucosa appeared normal with no hyperemia or exudate. Other investigations were within normal limits. Intraoperatively there was a huge firm parapharyngeal mass (mainly muscular) involving the right side of the soft palate, as well as the superior, middle and part of the inferior constrictor muscle. Assessment of a parapharyngeal tumour was made with differentials of (soft palatal tumour or tonsillar tumour). The excised tissue was submitted for histology. Histological diagnosis of cavernous lymphangioma was made. Conclusion: Lymphangioma of the parapharyngeal space is a rare entity. It is difficult to diagnose purely on clinical examination, needing extra attention as it is deeply located in the neck spaces which contain neurovascular structure. Preoperative imaging plays a crucial role in identification of the lesion because it can help avoid complications during surgical exploration.
[ABSTRACT]   Full text not available  [PDF]
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Immunohistochemical analysis of human papilloma virus on cervical biopsy in patients attending Aminu Kano Teaching Hospital, Kano
GY Riruwai, GI Eze, AB Umar, AZ Mohammed
December 2016, 7(2):112-116
Background: Epidemiological study has shown that human papilloma virus infections play a major role in cervical pre-invasive and invasive lesions. Aim: Application of immunological methods can detect Human Papilloma Virus genetic material in almost 100% of the premalignant and malignant tissues of the uterine cervix. Materials and Methods: One hundred and twenty five blocks previously prepared cervical biopsy block from January, 2015 to December, 2015 were retrieved and re-evaluated to confirm the nature of specimen microscopically. Clinical data such as the age, sex and routine diagnosis were extracted from the record in the Histopathology Department of Aminu Kano Teaching Hospital Kano. Result: Statistically one hundred and twenty five blocks were identified and used for the study. Out of which, 32(25.6%) were age group 20-30 years, 32(25.6%) were 31-40 years, 29(23.2%) were 41-50 years and 32(25.6%) were 50 years and above. Relationship of age and different stages of dysplastic lesions shows women of 20-30 years have 2(6.3%) of inflammation, 1(3.1%) CIN1, 4(12.5%) CIN2, 0(0%) CIN3 and 25(78.1%) are cancer. Thirty one to fourty years were 0 (0%) inflammations, 5(15.6%) CIN1, 1(3.1%) CIN2, 3(9.4%) CIN3, 25(78.1%) were cancers. Fourty one to fifty years has 0 (0%) inflammations, 5(15.6%) CIN1, 1(3.1%) CIN1, 3(9.4%) CIN3, 23(71.9%) are cancers. Fifty one years and above were found to have no inflammation, CIN1, CIN2, and CIN3 while 32(100%) were cancers. This indicate that (p<0.01.) using Anova Statistical package. Conclusion: Immunological staining using P16 can be used to differentiate High Risk Human Papilloma Virus from Low Risk Human Papilloma Virus in cervical lesions. P16 antibody is found to be useful as a dysplasia associated antigen in differentiating High Risk Human Papilloma Virus from Low Risk Human Papilloma Virus.
[ABSTRACT]   Full text not available  [PDF]
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Appropriate name for the anatomic pathology department in Nigerian Health Institutions
Innocent Emmanuel, Chidi Okorie Onwuka, Yakubu Daniel
December 2016, 7(2):135-137
Full text not available  [PDF]
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