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    Colonic polyps in Nigerians, a change in trends: A retrospective single‑center clinicopathological study
    (Wolters Kluwer - Medknow, 2022) Adegoke, O. O.; Ajani, M. A.; Nwanji, I. D.
    Background: Adenomatous polyps in the colon are recognized precursors of colorectal carcinoma; however, the low incidence of these polyps in sub Saharan Africans has led many to believe that the pathway of colorectal cancer may differ in this region. The objective of this study was aimed to determine the change in trends of colonic polyps in Nigeria. Methods: This was a 10 year retrospective review of all colonic polyp specimens received at the Department of Pathology in our hospital utilizing the histopathology request cards and hematoxylin and eosin stained slides. The data were analyzed using the IBM SPSS Statistics (version 23; IBM Corporation, Armonk, New York, USA). Results: A total of 131 cases were reviewed. The age of patients ranged from 5 to 86 years with a mean age of 55 years. The male to female ratio was 1.6:1. The mean age was 59.4 years. Of the 131 cases reviewed, 62 patients had adenomatous polyps, 49 had inflammatory polyps while 20 others included juvenile polyps, hyperplastic polyps, and hamartomatous polyps. Conclusion: Adenomatous polyps are increasingly being seen among Africans in the sub Sahara region and perhaps they are not as rare as it was once thought provided the facilities for the diagnosis are available. They may yet play a more important role than has been ascribed to them in the pathogenesis of colorectal carcinomas in Africans.
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    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.
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    Histopathology turnaround time of surgical biopsies in a Nigerian tertiary health-care facility
    (Wolters Kluwer - Medknow, 2021) Ajani, M. A.; Adegoke, O. O.; Nwanji, I. D.; Nwadiokwu, J. I.
    Background: Turnaround time (TAT) analysis is finding increasing relevance in clinical laboratories due to its relevance in the quality of care of patients. TAT involves all the various processes that occur within the laboratory. Aims: The aim of this study was to analyze the histopathology TAT of surgical biopsies at the Department of Pathology, University College Hospital (UCH), Ibadan. Materials and Methods: This was a retrospective analysis of 1085 samples received at the Department of Pathology, UCH, Ibadan, from January to April 2020. Samples were categorized into small, intermediate, and large sizes. Average duration spent in the grossing room, processing, reporting, and result verification was calculated, and the total TAT was determined from the summation of the duration of these processes. Results: The mean TAT for all samples was 22 days(±10 days). Reception grossing, histological processing, reporting, and transcription accounted for an average of 1.5 (7%), 5.9 (27%), 9.1 (41%), and 5.6 (25%) days and percentage of TAT, respectively. There was no significant difference in the mean TATs for small , intermediate-, and large-sized samples. Conclusion: We identified reporting time as the largest contributor to TAT. Other areas of delay were noted at tissue processing and result verification. Adoption of new technology and staff orientation may help to reduce the observed TAT.
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    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.
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    Premalignant and malignant lesions of the esophagus: a single institutional experience
    (Medical and Dental Consultants Association of Nigeria, University of Abuja Teaching Hospital, 2020) Ajani, M. A.; Adegoke, O. O.; Nwanji, I. D.; Omenai, S. A.; Akande, K. O.
    Background: Esophageal malignancy is a highly aggressive tumor with a poor prognosis. A number of lesions occurring in the esophagus are associated with a high risk of malignant transformation. While the patterns of esophageal cancers have been documented in a number of African countries, there is a limited data on the Nigerian situation. This study was aimed at reviewing the histological patterns of premalignant and malignant lesions of the esophagus. Methods: This was a 10 year retrospective study of histologically confirmed premalignant and malignant lesions of the esophagus seen at the University College Hospital, Ibadan, between January 2009 and December 2018. Data retrieved from the departmental records were analyzed using the SPSS computer software version 20.0. Results: There were 45 cases diagnosed with premalignant lesions and 32 cases diagnosed with malignant lesions out of the 363 biopsies during the study period. The most common premalignant lesion was Barret’s esophagus (68.9%). Premalignant lesions were more common in males (64.4%). The mean age for patients with a diagnosis of premalignant lesions was 55 years. The mean age at the diagnosis for esophageal cancer was 61.5 years. Squamous cell carcinoma was the predominant histological subtype seen (65.6%) with adenocarcinomas accounting for the remainder of cases (35.4%). Conclusion: Squamous cell carcinoma is the most common malignancy of the esophagus in our study. Adenocarcinomas of the esophagus were not as rare as documented in previous African studies. This finding may imply a changing pattern in esophageal malignancies in tandem with the pattern in Western countries.