Scholarly works in Pathology (Basic Med Sci)
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Item Histopathological analysis of male breast cancer in Southwestern Nigeria: A single-center retrospective study(Wolters Kluwer - Medknow, 2021) Ajani, M. A.; Odetola, S. S.; Awosusi, B. L.; Fatunla, E. O.; Salami, A. A.Background: Breast cancer in men is still an uncommon and largely understudied disease. It accounts for 1% of all breast cancers. The aim of this study was to review all the male breast cancer cases diagnosed at the tertiary medical institution in South West Nigeria over a 10‑year period and to compare the findings with other similar studies done in Nigeria and globally. Methods: We retrospectively reviewed all histologically diagnosed cases of male breast cancers in the Department of Pathology, Tertiary Medical Institution in South West Nigeria over a 10‑year period from January 1, 2009, to December 31, 2018. Clinicopathological parameters including patients’ age, laterality, and specific histological sub‑types were extracted from surgical day book and Cancer Registry of the Department. The data were analyzed using the IBM SPSS Statistics (version 22; IBM Corporation, Armonk, New York, USA). The results were subsequently presented in tables, relative frequencies, group percentages, and photomicrographs. Results: Forty‑two cases of male breast cancer were seen, accounting for 1.7% of all breast cancer cases. The age range was between 22 and 91 years with a mean age of 60.3 years, and a peak occurrence was in the 8th decade. The right breast was more affected than the left, accounting for 52% of the total number of cases seen. The most common histological sub‑type found was invasive ductal carcinoma, accounting for 88% of all the cases. Conclusion: Male breast cancer is relatively uncommon compared to female breast cancer. It is more common in the older age group, and invasive ductal carcinoma is still the most common histological subtype.Item A Histomorphological Pattern of Gallbladder Lesions in a Tertiary Hospital in Southwestern Nigeria: A Retrospective Descriptive Study(Rwanda Medical Association, 2021) Ajani, M. A.; Onakpoma, F. A.; Fatunla, E. O.; Adegoke, O. O.; Salami, A. A.BACKGROUND: The gallbladder is one of the most common specimens encountered in the surgical pathology laboratory, and gallstone related diseases are among the most common medical problems requiring surgical intervention. This study's objective was to determine the histomorphological patterns and frequency of gall bladder lesions from cholecystectomy specimens received in our institution for over twenty years. METHODS: We carried out a retrospective review of all cholecystectomy specimens received at the pathology department for 20 years from January 1999 to December 2018. The specimens were obtained from within and outside the hospital facility. The demographic data, clinical details, and histological diagnosis were retrieved from the departmental records and were analyzed with SPSS version 23. RESULTS: A total of 211 cholecystectomy specimens were received during the study period. Patients’ age ranged from 14 to 84 years, with a mean age of 47.6 ± 0.899 years. There was a female preponderance with male to female ratio of 43:168 (1:3.9). Surgery for gallbladder disease was most commonly performed in the age range of 41-50 years. Out of the 211 specimens, 153 (72.5%) had calculi and 58 (27.5%) were acalculous. Chronic calculous cholecystitis was the most common histopathological diagnosis (65.4%). Others were chronic acalculous cholecystitis (18.0%), acute on chronic acalculous cholecystitis (2.4%), adenocarcinoma (3.3%), metastatic adenocarcinoma (0.1%), adenocarcinoma with chronic calculous cholecystitis (0.5%), klatskin tumour (0.5%), and normal gallbladders (1.9%). CONCLUSION: This study revealed that the commonest indication for cholecystectomy in our hospital was gall stone disease. Malignancy of the gallbladder is uncommonItem 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.Item Histopathological Profile of Childhood Thyroid Carcinoma in Ibadan, Southwestern Nigeria(University of Malawi, College of Medicine, in collaboration with the Medical Association of Malawi., 2020) Ajani, M. A.; Omenai, S. A.; Nwadiokwu, J. I.; Salami, A. A.Background Thyroid carcinoma is a common endocrine malignancy. It is, however, rare in childhood and often occurs as a result of radiation exposure or inherited genetic mutations. Most childhood thyroid carcinomas are well differentiated. There are very few epidemiological studies of this disease in Nigeria, and our study aimed to determine the frequency in a subset of our population. The study aimed to determine the prevalence and histopathological characteristics of childhood thyroid carcinoma in our environment. Methods This was a retrospective review of histopathologically diagnosed thyroid carcinoma in children less than 18 years of age in the Department of Pathology, University College Hospital, Ibadan, over a 40-year period. Histopathological diagnosis, age, sex, and other relevant clinical information were extracted from the hospital records and surgical pathology records of the department. All cases of patients under 18 years old had their slides re-examined and reclassified by two pathologists according to the World Health Organization histopathological classification of thyroid tumours. Results There were 25 cases of thyroid carcinomas seen in children within the study period. Papillary thyroid carcinoma was the most common, accounting for 80% of the cases. Follicular carcinoma accounted for 12%, and medullary and anaplastic carcinoma accounted for 4% each. The mean age at presentation was 13 years. There was a female preponderance, with females accounting for 60% of cases. Tumours with distant metastasis made up 20% of the cases. Conclusion Childhood thyroid carcinomas are rare in our environment, with a minority of cases presenting with metastases.Item P57kip2 Immunohistochemical Marker as a Diagnostic tool for Cases of Hydatidiform Moles in a Tertiary Health Facility in Southwestern Nigeria(Wolters Kluwer - Medknow, 2020) Awosusi, B. L.; Ajani, M. A.; Adegoke, O. O.; Salami, A. A.; Okolo, C. A.Background: Hydatidiform mole (HM) is the most common gestational trophoblastic disease. P57kip2 has been reported to be helpful in differentiating between partial and complete HMs. Objectives: The study aims to evaluate the P57kip2 immunohistochemical (IHC) marker as a useful ancillary investigation to differentiate complete hydatidiform mole (CHM) from partial hydatidiform mole (PHM). Materials and Methods: A retrospective study of all histologically diagnosed HM cases over a 20 year period was undertaken. Clinicopathological parameters were extracted from the surgical day book and medical record archives. Archival haematoxylin‑.and eosin‑stained slides and formalin‑fixed paraffin‑embedded tissue blocks of all cases of HM diagnosed within the study period were retrieved and reviewed. Cases of HM were reclassified using the P57kip2 IHC marker. The data obtained were analysed using the SPSS version 23. Results: One hundred cases of HMs were studied. CHM accounted for 68%, while PHM accounted for the remaining 32%. The incidence of HM was 2.98 cases per 1000 deliveries. The ratio of CHM to PHM was found to be 2.1:1. Seventy‑two per cent of the cases were diagnosed in the first trimester, while the remaining 28% were diagnosed in the second trimester of pregnancy. Based on the P57kip2 IHC staining pattern, HM cases were finally reclassified into 68 cases of CHM and 32 cases of PHM. The age range for all the HM cases was 18–50 years with the majority of the cases seen in the third and fourth decades of life. Conclusion: P57kip2 could be useful as an ancillary investigation in confirming the diagnosis of CHM and differentiating it from PHM, particularly in difficult and challenging cases.Item Inflammatory pseudotumor: a 20‑year single institutional experience(Wolters Kluwer - Medknow, 2020) Ajani, M. A.; Fatunla, E. O.; Onakpoma, F. A.; Salami, A. A."Background: Inflammatory pseudotumor (IPT) is a relatively rare benign disease. The aim of the study was to demonstrate the demographic distribution, clinical presentation, and histomorphological characteristics of IPT while highlighting its associated diagnostic challenges. Materials and Methods: A retrospective cross‑sectional review of all the IPT diagnosed in our institution between January 1999 and December 2018 was conducted. The samples were received from within and outside the hospital facility. The demographic data, clinical history, and histologic reports were reviewed. Results: A total of 25 cases of histologically confirmed IPT were seen. Patients’ age ranges from 7 to 74 years with a mean age of 38.96 years and standard deviation ± 17.94 years. There was a bimodal peak occurrence in the third and fifth decades. Most of the patients were adults (23, 92%), whereas only 2 (8%) were children. There was a female preponderance with a male‑to‑female ratio of 1:2.6. The head and neck had the highest number of cases (44%), followed by the gastrointestinal tract (GIT) (40%). Eight (73%) of head and neck cases occurred in the orbit. The presenting complaints depended on the site of the lesion with pain and swelling being the commonest symptoms irrespective of the site of the lesions. Two cases of bilateral IPT were observed. Immunohistochemistry was used in a certain condition of diagnostic dilemma. Conclusion: This study showed a female preponderance of IPT with the head and neck and GIT being the most common location. It is important to rule out other differentials in the diagnosis of IPT."Item Histopathological characteristics of gynaecomastia in Southwestern Nigeria: A review from a tertiary hospital(Wolters Kluwer - Medknow, 2020) Ajani, M. A.; Salami, A. A.; Awosusi, B. L.; Omenai, S. A.; Iyapo, O.; Odetola, S. S.Background: Gynaecomastia is a benign proliferation of the glandular tissue of the male breast. It is thought to be present in at least a third of men in the course of their lifetime. This study aims to review the histomorphological characteristics of gynaecomastia seen at the department of Pathology, University College Hospital (UCH), Ibadan, over 10 years period. Methods: A hospital-based retrospective study was undertaken to review the histopathology reports of all gynaecomastia cases diagnosed at the Department of Pathology, UCH Ibadan, over a 10‑year period from 01 January, 2009 to 31 December, 2018. Patient’s biodata, histological diagnosis and clinical details were extracted from the surgical day books and laboratory request forms. The data were analysed for the frequency distribution using the SPSS software version 22. Results: Gynaecomastia accounts for 2.5% of all breast biopsies received within the study period and accounted for 68.1% of all benign breast lesions seen in males. The left breast was the most affected with 48.8% of the cases, whereas 17.2% of the cases were bilateral. The age range of patients with gynaecomastia seen in this study is between 12 and 80 years with a mean age of 43.36 years. The most common histopathological subtype seen in this study is the florid type gynaecomastia. Conclusion: Gynaecomastia is the most common diagnosis from male breast biopsies. The left breast is the most commonly affected breast. The florid type gynaecomastia is the main histopathological variant seen in this study.Item Histopathological characteristics of gynaecomastia in Southwestern Nigeria: A review from a tertiary hospital(Wolters Kluwer - Medknow, 2020) Ajani, M. A.; Salami, A. A.; Awosusi, B. L.; Omenai, S. A.; Iyapo, O.; Odetola, S. S.Background: Gynaecomastia is a benign proliferation of the glandular tissue of the male breast. It is thought to be present in at least a third of men in the course of their lifetime. This study aims to review the histomorphological characteristics of gynaecomastia seen at the department of Pathology, University College Hospital (UCH), Ibadan, over 10 years period. Methods: A hospital-based retrospective study was undertaken to review the histopathology reports of all gynaecomastia cases diagnosed at the Department of Pathology, UCH Ibadan, over a 10‑year period from 01 January, 2009 to 31 December, 2018. Patient’s biodata, histological diagnosis and clinical details were extracted from the surgical day books and laboratory request forms. The data were analysed for the frequency distribution using the SPSS software version 22. Results: Gynaecomastia accounts for 2.5% of all breast biopsies received within the study period and accounted for 68.1% of all benign breast lesions seen in males. The left breast was the most affected with 48.8% of the cases, whereas 17.2% of the cases were bilateral. The age range of patients with gynaecomastia seen in this study is between 12 and 80 years with a mean age of 43.36 years. The most common histopathological subtype seen in this study is the florid type gynaecomastia. Conclusion: Gynaecomastia is the most common diagnosis from male breast biopsies. The left breast is the most commonly affected breast. The florid type gynaecomastia is the main histopathological variant seen in this study.Item Secondary ovarian neoplasms in a tertiary hospital in southwestern Nigeria(Association of Resident Doctors, University College Hospital, Ibadan, Nigeria, 2019) Ajani, M. A.; Iyapo, O.; Salami, A.; Okolo, C. A.Background: The ovary is a common site of involvement for metastases constituting 5-30% of all malignant ovarian neoplasms. Over half of these tumours are bilateral. The commonest sources are stomach, large bowel, appendix, breast, uterus (corpus and cervix) and lung. Aim: The aim of this study was to determine the histopathological pattern of metastases to the ovary at the University College Hospital, Ibadan, Southwestern Nigeria. Material and Methods: This was a retrospective study. All histologically confirmed cases of metastases to the ovary from the records and files of the Department of Pathology, University College Hospital (UCH), Ibadan between January 1991 and June 2013 were used for the study. These were cases diagnosed following total abdominal hysterectomy, total abdominal hystero-salpingooophorectomy, bilateral salpingo-oophorectomy, omentectomy, and multiple peritoneal biopsies and post-mortems at the University College Hospital between January 1991 and June 2013. Cases with inadequate clinical data and whose blocks and or slides could not be retrieved were excluded from the study. The data obtained were analysed using the Statistical Package for Social Sciences version 20 Results: There were 46 cases of metastases to the ovary constituting 5.3% of total ovarian neoplasms. Thirty (63.9%) cases were metastatic carcinomas with the affected patients’ age range of 20-79 years, and peak incidence within the age group of 30-39 years. Nineteen out of 30 cases of metastatic carcinomas were from adenocarcinoma of colon, 6 cases were from the gastric carcinoma while the remaining five cases were from the squamous cell carcinoma of the uterine cervix. Fifteen (31.9%) cases of Burkitt Lymphoma were found with patients with age range of 0-39 years, and the peak age of occurrence at the 2nd decade. The only case of metastatic Malignant Mixed Mullerian Tumour and metastatic Leiomyosarcoma were found in the 3rd and 4th decades of life respectively Conclusion: This study has shown that metastases to the ovary occur in younger age groups in our environment. Therefore this study emphasizes that in young females with ovarian masses, the likelihood of metastatic tumours should not be discarded because, correct and precise diagnosis of secondary ovarian malignancy is critical as it has significant implication on the patients’ choice of management and prognosisItem Distribution and characteristics of endometriotic lesions in South- Western Nigeria: A single institutional experience(Zambia Medical Association, 2019) Ajani, M. A.; Salami, A.; Nwanji, I. D.; Olusanya, A. A.; Fatunla, O. E.Background: Endometriosis poses a significant burden mainly to women of child bearing age. Historically, endometriosis was thought to be of low prevalence among African women. However, recent studies have documented an increased prevalence than previously thought. This study aimed to determine the distribution and characteristics of endometriotic lesions among Nigerian women . Methods: A retrospective study of all histologically diagnosed cases of endometriosis from the records of the Department of Pathology, University College Hospital, Ibadan from 1st January, 1997 to 31st October, 2018.The age of the women, location and distribution of the lesions were analysed. Results: A total of 85 cases of endometriosis were diagnosed histologically in the period under review. The mean age was 35 years with an age range of 18 to 52 years. The most commonly affected age groups were those between 30-39 years (47.1%) and 20-29 years (30.6%). The most commonly affected site was the ovary (58.8%) followed by the umbilicus (11.9%) and fallopian tubes (9.4%). Fourteen patients (28%) had bilateral ovarian involvement. Left sided ovarian lesions predominated (61.1% versus 38.9%). Eighteen (21.2%) patients had lesions at more than one site frequently involving both ovaries. Conclusion: Endometriosis affected mainly women of childbearing age with particular predilection for the ovaries. Endometriosis affecting the umbilicus is not uncommon among Nigerian women.