Browsing by Author "Okolo, C. A."

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An assessment of ovarian cancer histologic types across the African Diaspora
(2021) George, S. H. L.; Omotoso, A.; Pinto, A.; Mustapha, A.; Sanchez-Covarrubias, A. P.; Umar, U. A.; Umar, A. B.; Oluwasola, T. A. O.; Okolo, C. A.; Anthony, U. U.; Ukekw, F. I.; Bakari, M. A.; Dahiru, A. M. C.; Abdullahi, H. I.; Abimiku, B. A.; Abdurrahman, A.; Usman, A.; Ahmed, S. A.; Usman, H. A.; Kabir, A.; Eleje, G. U.; Chiemeka, M. E.; Nzeribe, E.; Nweke, I.; Kadas, S. A.; Suleiman, D. E.; Ekanem, E.; Uche, U. M.; Paul, J.; Agwu, U. M.; Edegbe, F. O.; Anorlu, R. I.; Banjo, A.; Ajenifuja, K. O.; Fawole, A. A.; Kazeem, I. O. O.; Magaji, F.; Silas, O.; Athanasius, B. P.; Tamunomie, N. K.; Abudu, E. B. K.; Ango, I. G.; Abdullahi K.; Lawal, I.; Kabir, S. A.; Ekanem, V.; Ezeanochie, M.; Yahaya, U. R.; Castillo, M. N.; Bahall, V.; Chatrani, V.; Brambury, I.; Bowe, S.; Halliday, D.; Bruney, G.; Butler, R.; Ragin, C.; Odedina, F.; Chamala, S.; Schlumbrecht, M.; Audu, B.
Objective: Ovarian cancer in Black women is common in many West African countries but is relatively rare in North America. Black women have worse survival outcomes when compared to White women. Ovarian cancer histotype, diagnosis, and age at presentation are known prognostic factors for outcome. We sought to conduct a preliminary comparative assessment of these factors across the African diaspora. Methods: Patients diagnosed with ovarian cancer (all histologies) between June 2016- December 2019 in Departments of Pathology at 25 participating sites in Nigeria were identified. Comparative population-based data, inclusive of Caribbean-born Blacks (CBB) and US-born Blacks (USB), were additionally captured from the International Agency for Research on Cancer and Florida Cancer Data Systems. Histology, country of birth, and age at diagnosis data were collected and evaluated across the three subgroups: USB, CBB and Nigerians. Statistical analyses were done using chi-square and student’s t-test with significance set at p<0.05. Results: Nigerians had the highest proportion of germ cell tumor (GCT, 11.5%) and sexcord stromal (SCST, 16.2%) ovarian cancers relative to CBB and USB (p=0.001). CBB (79.4%) and USB (77.3%) women were diagnosed with a larger proportion of serous ovarian cancer than Nigerians (60.4%) (p<0.0001). Nigerians were diagnosed with epithelial ovarian cancers at the youngest age (51.7± 12.8 years) relative to USB (58.9 ± 15.0) and CBB (59.0± 13.0,p<0.001). Black women [CBB (25.2 ± 15.0), Nigerians (29.5 ± 15.1), and USB (33.9 ± 17.9)] were diagnosed with GCT younger than White women (35.4 ± 20.5, p=0.011). Black women [Nigerians (47.5 ± 15.9), USB (50.9 ± 18.3) and CBB (50.9 ± 18.3)] were also diagnosed with SCST younger than White women (55.6 ± 16.5, p<0.01). Conclusion: There is significant variation in age of diagnosis and distribution of ovarian cancer histotype/diagnosis across the African diaspora. The etiology of these findings requires further investigation.
An overview of the genetics of cervical cancer.
(2018) Gbadegesin, M. A.; Soremekun, O.; Oluwasola, T. A. O.; Okolo, C. A.; Oluwasola, A. O.
Cervical cancer is the fourth most common cancer in women, and the seventh of all human cancers. It is the most rampant cancer of the female genital tract in the developing world and manifests in two common histological subtypes: squamous cell carcinoma which is derived from squamous cells of the cervix and cervical adenocarcinoma which arose from the glandular cells. Most cases of deaths from cervical cancer occur in the less developed countries of the world where there are ineffective screening systems. Factors that increase the risk for developing cervical cancer include infection by Human Papilloma Virus (HPV) as the main direct factor and other indirect factors such as smoking, dietary habits, age, race, socioeconomic status, sexual history, use of oral contraceptives, high parity and the human immunodeficiency virus infection. Identifying the genetic alterations that predispose to or associate with cervical cancer will help in the screening of patients at risk of the cancer thereby allowing early diagnosis and prompt management with better outcomes. In this review we describe the role of HPV DNA integration into the host cellular genome, the effects of viral E6 and E7 proteins, and the loss of heterozygosity as genetic factors in cervical cancer.
Bilateral Ganglionic Haemorrhagic Stroke Complicating Suspected Meningococcaemia: A Case Report
(Association of Resident Doctors, University College Hospital, Ibadan, Nigeria, 2020) Omenai, S. A.; Okonkwo, O. O.; Salami, A. A.; Labaeka, A. A.; Okolo, C. A.
Haemorrhagic stroke in pyogenic meningitis is a rare complication, accounting for about 2% of all complications. It often results from disseminated intravascular coagulation, a complication of bacterial meningitis, and portends a poor prognosis. A superimposed intracranial haemorrhage, although extremely rare, is associated with a high mortality rate. We report a child who had haemorrhagic stroke during the acute phase of bacterial meningitis. The diagnosis was made during post-mortem examination. It was discovered that she had suffered haemorrhagic necrosis of both basal ganglion nuclei. Early imaging is advised in meningitis patients presenting with altered levels of consciousness to detect cerebrovascular complications. Introduction Meningitis is a severe infection of the leptomeninges caused by viruses, bacteria, parasites, or fungi. Mortality rates are as low as 2% in infants and children and as high as 20–30% in neonates and adults. Cerebral vasculopathy is a complication of bacterial meningitis, with ischaemic stroke being much more common than haemorrhagic stroke, usually occurring during the acute phase of meningitis. Bacterial meningitis remains a leading cause of mortality from infectious disease globally, and the neurologic complications associated with this disease are a major contributor to mortality. In the paediatric age group, meningitis usually develops after encapsulated bacteria colonising the nasopharynx are disseminated into the blood and breach the blood–brain barrier, colonising the leptomeninges where they rapidly multiply. The body’s immune system mounts a response against the microbes. Studies in rabbits with C3 deficiency have demonstrated the importance of the complement system in meningitis. Genetic deficiencies in early response cytokines such as TNF-α, IL-1β, and IL-6 predispose individuals to central nervous system infections that may run a fulminant course. Cerebral vasculopathy in bacterial meningitis can occur from infection by organisms such as Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae, and Staphylococcus aureus. Haemorrhagic stroke from bacterial meningitis is rare. Various pathophysiological mechanisms have been proposed, including focal hyperperfusion from loss of cerebral autoregulation, disseminated intravascular coagulation (DIC), localized vasculitis, and microaneurysm formation. This complication confers a worse prognosis on meningitis, with higher morbidity and mortality. Early diagnosis of cerebrovascular events complicating meningitis allows for prompt surgical intervention to improve prognosis. We report the case of a nine-year-old female child who presented and died within 24 hours of presentation from bilateral basal ganglia haemorrhages due to acute bacterial meningitis. Case Report A nine-year-old female was seen in the paediatric clinic with a history of fever, sore throat, non-productive cough, vomiting, and generalized body weakness. She was a known asthmatic. She was nebulized and placed on antibiotics and antimalarials. Her condition deteriorated later in the night. She was brought into the children’s emergency unit with a six-hour history of fever and lack of response to calls for two hours. She was admitted into the intensive care unit and managed as a case of meningitis. On presentation, she was acutely ill, anicteric, and not cyanosed. There was tachycardia, with a blood pressure of 90/60 mmHg. She was tachypnoeic and dyspnoeic, with crepitations in the lower lung zones. The Glasgow Coma Score (GCS) was 13, the neck was supple, and Kernig’s and Brudzinski’s signs were negative. Pupils were 3 mm bilaterally and reacted briskly to light. Muscle tone and reflexes were normal, with no facioparesis. Laboratory tests revealed thrombocytopenia (platelet count 85,000/mm³), elevated INR (3.5), and deranged prothrombin time (41 seconds). Blood culture did not yield growth. Her GCS dropped to 6 within two hours of admission; she had two episodes of tonic convulsions and went into refractory shock despite intravenous boluses and adequate inotropic support. Nasogastric aspirate was bloody, and blood stains were seen in her perineum. She desaturated with SpO₂ of 65% while on 100% oxygen. Her GCS further dropped to 3 within fourteen hours of admission. She was managed with intravenous antibiotics, fluids, steroids, and antimalarials. Cranial imaging was not performed prior to death. She spent a total of seventeen hours on admission before demise. Although there was no growth on blood culture and a lumbar puncture was deferred, she was managed as a possible case of meningococcaemia. At autopsy, there was linear ecchymosis on the arm and ecchymosis on the right ventricular wall. Mesenteric and splenic haematoma with haemorrhagic gastropathy were noted. The lungs were markedly congested, showing features of diffuse alveolar damage with microthrombi. Histology of the kidneys showed extensive tubular necrosis, and both adrenal glands showed haemorrhagic infarctions. The brain was heavy, weighing 1600 g (normal 1150–1250 g), with greyish-white exudates over the convexities of the parietal lobes and superior cerebellar hemispheres; there was no frank pus. Coronal sections of the cerebral hemispheres showed bilateral basal ganglia haemorrhages affecting both lenticular nuclei and sparing the caudate. Histology revealed haemorrhagic infarction of the basal ganglia with associated microthrombi. The patient had no features of hypertension, and the vessels showed only mild fatty streaks of the abdominal aorta.
Bilateral ovarian serous cystadenocarcinoma in a teenager: a case report.
(2017) Oluwasola, T. A. O.; Abdusalam, R. A.; Okolo, C. A.; Odukogbe, A. A.
Background: Genital Chlamydial trachomatis infection, though often asymptomatic, is an established indirect causative agent of female infertility via its activities on the tubal physiology. Many risk factors are postulated for its acquisition and the main thrust of this study was to establish the organisms’ correlates among infertile women attending gynaecologic clinic in Ibadan. Methods: A systematic sampling technique was used on each selected day to recruit women who met the inclusion criteria into the study using a sampling frame of 2. Interviewer-administered questionnaires were used to obtain attributes considered as risk factors for acquiring genital Chlamydia trachomatis infection from 150 consenting infertile women between January and November 2015. These attributes included sexual history, social status, alcohol intake and past history of sexually transmitted infections (STIs). Blood samples and endocervical swabs were subsequently taken for detection of C. trachomatis infection using polymerase chain reaction (PCR). Data analysis was done using SPSS version 20.0. Results: The mean age of the respondents was 34.1±5.6 years and 7.30% were positive for C. trachomatis. Chlamydia trachomatis infection was significantly associated with past history of gonorrhoea, history of multiple sexual partners, husband that has other sexual partners and lifetime sexual partners greater than one. Conclusions: The prevalence of asymptomatic C. trachomatis among infertile women indicated the pathogen as a potential aetiologic agent of female infertility and supported the asymptomatic nature of the infection. The risk factors found to be associated with the organisms’ infection lend out further support to the sexual transmissibility of C. trachomatis.
Cervical Lymphadenopathy in Ibadan, Nigeria.
(Association of Resident Doctors, University College Hospital, Ibadan, Nigeria, 2017) Aramide, K. O.; Ajani, M. A.; Okolo, C. A.
Aim: To determine the pattern and causes of lymph node enlargement of cervical region in Ibadan, Nigeria. Materials and Methods: A 10-year (2003-2012) retrospective study was conducted on all head and neck lymph node biopsies received at the Department of Pathology, University College Hospital, Ibadan, Nigeria. Results: A total of 101 lymph node biopsies of cervical region were received within this period of study. 59.4% cases were seen in Males. Second decade of life has the highest number of cases (22.8%) followed by 3rd decade (17.8%). The common cause of cervical lymphadenopathy include non - specific hyperplasia, tumour metastasis and Non Hodgkin’s lymphoma seen in 27 (26.7%), 22 (21.8%) and 20 (19.8%) respectively. Granulomatous and Hodgkin’s Lymphoma constitute 17 (16.8%) and 11 (10.9%) respectively. The granulomatous causes were all due to tuberculosis. A single case of Rosai-Dorfman disease was seen in a male in the 3rd decade of life. Conclusion: This study shows that metastatic tumours, Hodgkins lymphoma and Non Hodgkins lymphoma constituting 52.4% of all cases of cervical lymphadenopathy are common in this environment therefore highlighting the need for early and proper evaluation of patients.
Childhood ovarian neoplasms in Ibadan, South‑western Nigeria.
(Wolters Kluwer - Medknow, 2016) Ajani, M. A.; Aramide, K. O.; Ajani, T. A.; Salami, A. A.; Okolo, C. A.
Childhood ovarian neoplasms are very rare. Little information is available on the relative pattern and frequency of these tumors in Nigerian children. Earlier study done in Ibadan involved ovarian neoplasms in children and adolescents. The aim of this study is to review cases of ovarian neoplasms in childrenMaterials and Methods: This was a retrospective study. Twenty four cases of childhood ovarian neoplasms were seen in patientsResults: Childhood ovarian neoplasms accounted for 2.8% of all cases of ovarian tumors seen in this period. Fourteen (58.3%) cases of childhood ovarian neoplasms were benign, and 10 (41.7%) were malignant. Mature cystic teratoma occurring in 13 (54.2%) was the most common childhood ovarian neoplasm and was most prevalent between 10 and 14 years of age. Burkitt lymphoma was the most common 4 (40%) malignant childhood ovarian tumor and prevalent between 5 and 14 years of age. Conclusion: Mature cystic teratoma remains the single most common childhood ovarian neoplasms, and Burkitt’s lymphoma is the most malignant childhood ovarian tumor in Ibadan, South western Nigeria.
Childhood ovarian neoplasms in Ibadan,South‑western Nigeria
(Wolters Kluwer – Medknow, 2016) Ajani, M. A.; Aramide, K. O.; Ajani, T. A.; Salami, A. A.; Okolo, C. A.
Background: Childhood ovarian neoplasms are very rare. Little information is available on the relative pattern and frequency of these tumors in Nigerian children. Earlier study done in Ibadan involved ovarian neoplasms in children and adolescents. The aim of this study is to review cases of ovarian neoplasms in children <15 years over a 22½ year period. Materials and Methods: This was a retrospective study. Twenty‑four cases of childhood ovarian neoplasms were seen in patients <15 years of age. These cases were classified using the current World Health Organization histological classification of ovarian tumors. Results: Childhood ovarian neoplasms accounted for 2.8% of all cases of ovarian tumors seen in this period. Fourteen (58.3%) cases of childhood ovarian neoplasms were benign, and 10 (41.7%) were malignant. Mature cystic teratoma occurring in 13 (54.2%) was the most common childhood ovarian neoplasm and was most prevalent between 10 and 14 years of age. Burkitt lymphoma was the most common 4 (40%) malignant childhood ovarian tumor and prevalent between 5 and 14 years of age. Conclusion: Mature cystic teratoma remains the single most common childhood ovarian neoplasm, and Burkitt’s lymphoma is the most malignant childhood ovarian tumor in Ibadan, South‑western Nigeria.
Comparative study of methods of diagnosis of Helicobacter pylori infection in Ibadan
(Society for Gastroenterology and Hepatology in Nigeria, 2011) Oluwasola, A. O.; Okolo, C. A.; Otegbayo, J. A.; Adeniyi, B.; Kehinde, A. O.; Akere, A.; Ola, S. O.; Lawal, T. O.; Idowu, P. A.; Odaibo, G.; Lawan, A. I.
Correlation of cervical cytology and visual inspection with acetic HIV-positive women
(Informa Healthcare USA, Inc, 2008) Akinwuntan, A. I.; Adesina, O. A.; Okolo, C. A.; Oluwasola, O. A.; Oludokun, A.,; Ifemeje, A. A.; Adewole, I. F.
The prevalence of squamous intraepithelial lesion is higher among human immunodeficiency virus (HIV)-positive women. These lesions when they occur in these patients are also more difficult to treat. A total of 205 consenting HIV-seropositive women were recruited. A cervical cytology (Pap smear) was taken, followed by visual inspection with freshly prepared 5% acetic acid and cervical biopsy taken from the squamocolumnar junction as the reference for diagnosis to avoid verification bias. The sensitivity of VIA was 76.0% (95% CI 52.0-91.0); specificity 83.0% (95% CI 77.0-88.0); positive predictive value 34.0% (95% CI 21.0-49.0). The sensitivity of cervical cytology (Pap smear) was 57.0% (95% CI 34.0-77.0), specificity of 95.0% (95% CI 90.0-97.0), and positive predictive value of 55.0% (95% CI 33.0-75.0). In HIV-seropositive women, the sensitivity of VIA is 76.0%, making it a useful screening test for preinvasive lesion of the cervix in low resource settings.
Diagnostic Utility of EMA, Vimentin and CD117 Immunohistochemical Markers in Subtyping Renal Cell Carcinoma in a Nigerian Tertiary Hospital: A 10-year Retrospective Study.
(West African College of Physicians and the West African College of Surgeons, 2023) Nwadiokwu, O. O; Adegoke, M. A.; Ajani, C. A.; Okolo, B. L.; Awosusi, V. C.; Okebalama J. I.; Adegoke, O. O.; Ajani, M. A.; Okolo, C. A.; Awosusi, B. L.; Okebalama, V. C.
BACKGROUND: Renal cell carcinoma is the most lethal urological cancer and contributes significantly to morbidity and mortality due to cancers of the urogenital tract. In routine diagnostic surgical pathology practice of renal tumours, immunohistochemistry is a helpful ancillary technique after routine H & E. The role of renal immunohistochemistry is explored in this study. MATERIALS AND METHODS: The paraffin-embedded tissue blocks of all the confirmed cases of renal cell carcinoma seen at the University College Hospital (UCH), Ibadan, during the 10-year study period of 2007 to 2016 were retrieved, sectioned and immunohistochemistry done using monoclonal antibodies for EMA, Vimentin and CD117 following standard protocols. Frequency statistics and chi-square were applied to data to determine proportions and associations using the Statistical Package for the Social Sciences (SPSS) version 23. RESULTS: A total of 48 cases of renal cell carcinoma were seen within the study period that met the inclusion criteria for the study. The age range of the patients was between 3 to 76 years with an average age of 44.17 years. The male-to-female ratio was 1:1.3. Fuhrman Grade 2 nuclei were predominant (43.75%) while Fuhrman Grade 4 nuclei had the lowest frequency (6.25%). EMAstaining patterns for the different histological patterns of RCC showed no statistically significant difference while Vimentin and CD117 staining patterns showed a statistically significant difference. There was no statistically significant difference observed between the staining patterns of all three markers and the nuclear grades of the cases of RCC. CONCLUSION: This study demonstrated the usefulness of Vimentin and CD117 in differentiating chromophobe variant of renal cell carcinoma from other subtypes while EMA showed variable expression across the various subtypes. WAJM 2023; 40(10); 1035 -1040.
Histopathological characteristics of carcinoma of the uterine cervix in a tertiary hospital in southern Nigeria
(Wolters Kluwer - Medknow, 2020) Omenai, S. A.; Ajani, M. A.; Okolo, C. A.
Carcinoma of the uterine cervix is the fourth‑most common cancer among women worldwide, and the leading cause of cancer‑related death for women in developing countries. Objective: Cervical carcinoma is a major cause of mortality in a developing nation such as Nigeria. This study provides an update on the prevalence of pathological variants of cervical carcinomas seen at the University College Hospital, Ibadan, Southwestern Nigeria. Materials and Methods: This is a retrospective study involving the review of all the histologically diagnosed cervical carcinoma in the Department of Pathology, University College Hospital, Ibadan between January 2012 and December 2016. The histologically diagnosed cancers and the relevant clinical and histopathological information relating to these tumors were extracted from the records of the department. All cases were treated as anonymous with strict confidentiality. The cases were classified using the World Health Organization histological classification of tumors of the cervix (2014). The obtained data were analyzed using the Statistical Package for the Social Sciences version 23. Results: A total of 294 cases were included in this study. The peak age of diagnosis was in the 6th decade. Two hundred and fifty‑two cases (86.0%) were squamous cell carcinoma, 18 cases (6.1%) were adenocarcinomas, 16 cases (5.5%) were adenosquamous carcinomas, and 6 cases (2.2%) were adenoid cystic carcinomas, and one representing 0.3% was a neuroendocrine carcinoma. The most common histological grade was moderately differentiated (Grade 2). The large cell nonkeratinizing squamous cell carcinoma was the most common histological variant. Conclusion: A majority of cervical carcinomas are squamous cell carcinomas and are majorly the large cell nonkeratinizing variant.
Histopathological pattern of primary ovarian neoplasms in South Western Nigeria.
(Association of Resident Doctors of Jos University Teaching HospitalAssociation of Resident Doctors of Jos University Teaching Hospital, 2016) Ajani, M. A.; Aramide, K. O.; Salami, A.; Okolo, C. A.
Background: Ovarian tumours are common form s o f neoplasms in women. This study aims to determine the histopathological pattern o f primary ovarian neoplasms in South-western Nigeria. Method: A retrospective study was undertaken to review the histopathology reports o f all primary ovarian neoplasm specimens submitted to the Department o f Pathology, University College Hospital, Ibadan from January 1991 to June 2013. Patients'biodata were extractedfrom the requestforms and surgical day books. Results: There were 821 cases o f primary ovarian neoplasms. 359 (43.7%) cases were surface epithelial neoplasms which were found in patients with age range 10-89 years. Three hundred and thirteen (38%) cases o f germ cell tumour were found in patients with age range 0-70 years. One hundred andforty-six (17.8%) cases ofsex cord stromal tumour werefound in patients with age range 0-99 years. Mature Cystic Teratoma was the most common (54.7%) among benign ovarian neoplasms with 20-29 years being the age range with highest tumours while serous cystadenocarcinoma was the most common (33.2%) primary malignant ovarian neoplasms with 50-59years being the age range with highest tumours. Conclusion: Surface epithelial tumours were the most common ovarian neoplasmfollowed by germ cell tumours. This pattern is observed in most parts of Nigeria, some African and Asian countries, and in the Western world.
Histopathological pattern of primary ovarian neoplasms in south‑western Nigeria
(Association of Resident Doctors of Jos University, 2016) Ajani, M. A.; Aramide, K. O.; Salami, A. A.; Okolo, C. A.
Background: Ovarian tumours are common forms of neoplasms in women. This study aims to determine the histopathological pattern of primary ovarian neoplasms in south-western Nigeria. Method: A retrospective study was undertaken to review the histopathology reports of all primary ovarian neoplasm specimens submitted to the Department of Pathology, University College Hospital, Ibadan from January 1991 to June 2013. Patients’ biodata were extracted from request forms and surgical day books. Results: There were 821 cases of primary ovarian neoplasms. Surface epithelial neoplasms accounted for 359 (43.7%) of cases and were found in patients aged 10–89 years. Germ cell tumours numbered 313 (38.0%) in patients aged 0–70 years, while sex cord stromal tumours numbered 146 (17.8%) in patients aged 0–99 years. Among benign ovarian neoplasms, Mature Cystic Teratoma was the most common (54.7%) with the 20–29 year age range having the highest frequency. Among primary malignant ovarian neoplasms, serous cystadenocarcinoma was the most common (33.2%) and most frequent in the 50–59 year age group. Conclusion: Surface epithelial tumours were the most common ovarian neoplasms followed by germ cell tumours. This histopathological pattern is observed in most parts of Nigeria, some African and Asian countries, and in the Western world.
Histopathology of head and neck lymphomas in Ibadan
(Medknow, 2020) Ajani, M. A.; Nwanji, I. D.; Olaniran, F. O.; Ogun, G. O.; Okolo, C. A.; Akinmoladun, V. I.
Background: Lymphomas are a heterogeneous group of tumors of lymphoid tissue in which there is a malignant proliferation of cells of the lymphatic system. They are the most frequent nonepithelial malignancy in the head and neck region. Objectives: The aim of this study was to evaluate the histological pattern of the disease in the head and neck region and trends in presentation seen in our center Materials and Methods: This was a retrospective study of cases of head and neck lymphoma (HNL) seen in the Pathology Department of the University College Hospital Ibadan, Nigeria over a period of 37 years (1981–2017). Information extracted from the records included the sociodemographics of the patients, tumor location, and histological type among others. Data were analyzed and results were presented as frequencies and percentages. Results: There were a total of 373 cases of histologically and/or cytologically diagnosed HNL seen during the study period (an average of 10 cases per year). The mean age of patients was 33.5±21.9 years with male:female ratio of 1.6:1. Most HNL were non-Hodgkin’s lymphomas (NHL), accounting for 91% of cases. Nodal disease was seen in 39% of cases. The bone (prominently, the jaws) predominated (25%) in extranodal lesions. Burkitt’s lymphoma was the most common specific subtype of NHL, occurring in 25.5% of cases. Conclusion: There has been an apparent upward trend in the prevalence of HNL over the past four decades, although other parameters such as age and sex predilection appear unaffected. Factors responsible for this trend need to be interrogated and ascertained.
Hormonal receptor expression in endometrial carcinoma: a retrospective immunohistochemical study in a Nigerian tertiary hospital
(Medknow, 2022) Odetola, S. S.; Ajani, M. A.; Iyapo, O.; Salami, A. A.; Okolo, C. A.
Background: Endometrial carcinoma is the commonest genital tract malignancy in most developed nations, but it lags behind cervical carcinoma and ovarian cancers in most developing nations including Nigeria. Estrogen has been described as a promoter of endometrial carcinogenesis. Objectives: The aim of this study was to demonstrate the frequency of estrogen receptor (ER) and progesterone receptor (PR) expressions of endometrial carcinoma and to correlate it with tumour grade. Materials and Methods: Cases of endometrial carcinoma diagnosed in the Department of Pathology over a 10-year period were reviewed retrospectively. The paraffin-embedded blocks were retrieved, and immunohistochemistry for ER and PR was performed on them. Haematoxylin and eosin (H&E) slides were reviewed, and tumours were graded by three independent pathologists. Data were analysed using SPSS version 22. The level of significance was set at P ≤ 0.05. Results: There were 44 cases of endometrial carcinoma. ER and PR were positive in 29.5% and 18.2% of endometrial carcinoma, respectively. There was no significant association between ER (P = 0.361) and PR (P = 0.204) expressions and histological grade of the tumour. The most common histological grade was grade 3 with 70% of cases (36 cases), whereas 13 cases (26%) were grade 2 and only 2 cases (4%) were grade 1. Conclusion: The positive expressions of ER and PR in endometrial carcinoma suggest that steroid receptor studies may be of potential benefit in the management of some patients with endometrial carcinoma. Future studies employing larger sample size are therefore recommended.
Hormonal Receptor Expression in Endometrial Carcinoma: A Retrospective Immunohistochemical Study in a Nigerian Tertiary Hospital
(Wolters Kluwer - Medknow, 2022) Odetola, S. S.; Ajani, M. A.; Iyapo, O.; Salami, A. A.; Okolo, C. A.
Background Endometrial carcinoma is the commonest genital tract malignancy in most developed nations, but it lags behind cervical carcinoma and ovarian cancers in most developing nations, including Nigeria. Estrogen has been described as a promoter of endometrial carcinogenesis. Objectives The aim of this study was to demonstrate the frequency of estrogen receptor (ER) and progesterone receptor (PR) expressions in endometrial carcinoma and to correlate them with tumour grade. Materials and Methods Cases of endometrial carcinoma diagnosed in the Department of Pathology over a 10-year period were reviewed retrospectively. The paraffin-embedded blocks were retrieved, and immunohistochemistry for ER and PR was performed on them. Haematoxylin and eosin (H&E) slides were reviewed, and tumours were graded by three independent pathologists. Data were analysed using SPSS version 22. The level of significance was set at P ≤ 0.05. Results There were 44 cases of endometrial carcinoma. ER and PR were positive in 29.5% and 18.2% of cases, respectively. There was no significant association between ER (P = 0.361) and PR (P = 0.204) expressions and histological grade of the tumour. The most common histological grade was grade 3, with 70% of cases (36 cases), whereas 13 cases (26%) were grade 2 and only 2 cases (4%) were grade 1. Conclusion The positive expressions of ER and PR in endometrial carcinoma suggest that steroid receptor studies may be of potential benefit in the management of some patients with endometrial carcinoma. Future studies employing larger sample sizes are therefore recommended.
Human epidermal growth factor receptor 2 overexpression in endometrial carcinomas at a tertiary center in sub-Saharan Africa
(Faculty of pathology, national postgraduate medical college of Nigeria, 2022) Odetola, S. S.; Ajani, M. A.; Nwanji, I. D.; Salami, A. A.; Okolo, C. A.
Background: Endometrial cancer is the third most common gynecological malignancy, following cervical and ovarian malignancies. Prognosis among the women of African origin is, however, worse as they tend to have high grade tumors and late presentation. Close to 50% of high grade endometrial cancers show human epidermal growth factor receptor 2 (HER2) overexpression and may thus benefit from targeted treatment. Aims: This study aimed to determine the overexpression status of HER2 protein among the cases of endometrial carcinoma. Materials and Methods: All cases of histologically diagnosed endometrial carcinoma from January 2007 to December 2016 were retrieved from the files and records of department of pathology in our hospital. Cases were classified and graded according to the World Health Organization (2014 version) classification of endometrial carcinoma followed by immunohistochemical staining for HER2 overexpression. Results: There were a total of 51 cases of endometrial carcinoma that met the inclusion criteria during the study. The mean age of patients was 63 years. As a group, nonendometrioid carcinomas predominated (55%). The majority (70%) of cases showed high grade histological morphology. Positive Her2/Neu expression was seen in 11 cases (22%) of endometrial carcinoma. There was no statistically significant association between hormone expression status and age, histological variant, or grade. Conclusion: Endometrial carcinomas among Nigerian women are predominantly nonendometroid and high grade. HER2 overexpression was seen in a fifth of cases. Future studies should explore the response of targeted therapy among Nigerian patients showing HER2 overexpression.
Intussusception and Volvulus secondary to jejunal Adenocarcinoma in an adult Nigerian male; a case report
(Wolters Kluwer - Medknow, 2010) Okolo, C. A.; Afolabi, A. O.; Sababi, S. M.
A 31 year-old Nigerian man with jejuno-jejunal intussusception with the lead point being an adenocarcinoma complicated by small intestinal volvulus is presented. The subtle clinical features of an underlying small bowel malignancy were masked by the overwhelming clinical and radiological features of intussusception. This rare case is reported to remind clinicians to have an increased index of suspicion of malignancy in patients who present with the usual features of chronic anemia, weight loss and loss of appetite with an intra-abdominal mass. The presentation of acute intestinal obstruction, with mesenteric vein thrombosis probably due to intussusception or volvulus should not however lower the suspicion. Histological evaluation of surgical biopsies is of immense importance.
Kidney disease in hepatitis B surface antigen-positive children: experience from a centre in south-west Nigeria and a review of the Nigerian literature
(Taylor and Francis, 2017) Asinobi, A. O.; Ademola, A. D.; Okolo, C. A.; Adepoju, A. A.; Samuel, S. M.; Hoy, W. E.
Background: Kidney disease is an important extra-hepatic manifestation of hepatitis B virus (HBV) infection. However, there is paucity of recent literature on kidney disease in children and adolescents with HBV infection from several parts of sub-Saharan Africa including Nigeria. Objective: To review the pattern of kidney disease in hepatitis B surface antigen (HBsAg)-positive children and adolescents seen at a tertiary hospital in south-west Nigeria. Methods: A retrospective study was undertaken of HBsAg-seropositive children with kidney disease managed at University College Hospital, Ibadan, from January 2004 to December 2015. Patients were identified from the paediatric nephrology unit admissions and the renal histology registers. Results: 24 children and adolescents were studied, 17 of whom were male (70.8%), and the median age was 10.0 years (range 3–15). Ten (41.7%) had nephrotic syndrome, five (20.8%) had non-nephrotic glomerulonephritis, five (20.8%) were in end-stage renal disease (ESRD), including a patient with posterior urethral valves, and four had acute kidney injury secondary to acute tubular necrosis. Renal histology was available for 10 patients: nine had nephrotic syndrome associated with minimal change disease in six, focal segmental glomerulosclerosis in two and one had membanoproliferative glomerulonephritis. The patient with non-nephrotic glomerulonephritis had diffuse global sclerosis. Conclusion: The pattern of kidney disease in HBV-positive children demonstrated a predominance of nephrotic syndrome, followed by non-nephrotic glomerulonephritis, ESRD and acute kidney injury. Better diagnostic facilities and treatment are required. Prevention of HBV infection by universal childhood immunisation is the ultimate goal.
Knowledge dissemination and evaluation in a cervical cancer screening implementation program in Nigeria
(Elsevier Inc., 2007) Miller, D.; Okolo, C. A.; Mirabal, Y.; Guillaud, M.; Arulogun, O. S.; Oladepo, O.; Crain, B.; Follen, M.; Adewole, I. F.
Objectives: Our goals were to train health professionals in Nigeria using the text, "Planning and Implementing Cervical Cancer Prevention and Control Programs: A Manual for Managers", and then evaluate the knowledge dissemination process using a pre- and post-test assessment. The manual was developed by the ACCP, WHO, TARC, PATT-T,Engender Health, TI-TPTEGO, and PAT-TO with funding from the Gates Foundation. It is an inclusive guide to implementation and maintenance of screen-and-treat cervical cancer prevention clinics and is ideally suited for programs operating in the developing world. Methods. Training took place at a conference in Ibadan, Nigeria. Participants included teams of physicians, nurses, bioengineers, data managers, and administrators who met in joint and parallel sessions to "train the trainers". This meeting was designed to provide both training and equipment to personnel to be involved in the implementation of a cervical cancer control initiative in Nigeria. A 36 item pre-test was administered prior to a group study sessions. A slide presentation summarized salient points before the post-test was given. The results were entered into an MS Excel spreadsheet for descriptive statistics about (I) the participants, (2) the test, (3) an examination of profession, years of work experience, years of education, and gender as predictors of two outcomes (low pre-test score and large difference between pre- and post-tests) and (4) overall performance on the exam. Results. There were 70 participants and trainers, of which 53 took the exam. Most of the examinees were physicians. Some participants did not fill out the post-test, leaving their tests inevaluable. A closer look at the test revealed eight questions that were confusing and nine that were too easy. All participant subgroups performed better on the post-test than the pre-test; the improvements were statistically significant. While profession impacted the results, profession was not statistically significant. Years of work experience, years of education, and gender did not affect test results. Conclusions. While the study suffers from a small sample size, a few ambiguous questions, and the need for pilot testing the instrument prior to the meeting, the report evaluates the manual very favorably. The authors showed a significant gain in knowledge. The manual gives "the big picture" and does so with clarity. The text and supplementary material outline the work that needs to proceed in an organized program, and the material was easily understandable in Nigeria. Future evaluations could benefit from more participants and varied learning structures.