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Item Programme death ligand 1 expressions as a surrogate for determining immunotherapy in cervical carcinoma patients(Public Library of Science (PLOS), 2022) Omenai, S. A.; Ajani, M. A.; Okolo, C. A.Background The programme death ligand1 and its receptor (PD-1/PD-L1) interaction is a target for block age by immunotherapy that uses the body’s own immune system. Some studies show that PD-L1 expressing tumours are also more aggressive with poor prognosis. This study evalu ated the immunohistochemical expression of PD-L1 in uterine cervical carcinomas. Women with cervical cancer would benefit from its use as a marker in therapy and prognosis. Methods Hospital-based cross-sectional retrospective study was conducted. The study materials included 183 archived formalin fixed and paraffin embedded (FFPE) tissue blocks with histo logical diagnosis of cervical carcinoma diagnosed in our facility within a five-year period (January 2012 and December 2016) that met the study criteria. Data were extracted from records in the Department and immunohistochemistry was done using polyclonal antibodies to PD-L1 (GTX104763, Genetex). Obtained data were analysed using SPSS version 23. P < 0.05 was considered significant. Results A hundred and eighty-three cases of cervical cancer were studied. PD-L1 was positive in 57.4% of all cases. The diffuse pattern of staining was the major pattern accounting for 88.5% of positive cases. Poorly differentiated cervical carcinomas are less likely to express PD-L1. Within the histologic types, the squamous cell carcinomas expressed PD-L1 in 58.7%, and 50% of adenocarcinomas were positive. PD-L1 was not expressed in all cases of adenoid cystic carcinomas and basaloid squamous cell carcinomas. Conclusion A significant population of cervical carcinoma expresses PD-L1 by immunohistochemistry. PD L1 prevalence is lower amongst the poorly differentiated cancers compared to other grades.Item 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.Item 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.Item 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.Item 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.Item Morphological Pattern of Endometrial Biopsies In South Western Nigeria.(Association of Resident Doctors, University College Hospital, 2016) Abdullahi, Y. M.; Ajani, M. A.; Iyapo, O.; Aramide, K. O.; Okolo, C. A.; Akang, E. E.Background: Endometrium remains the most sensitive indicator of ovarian function and endometrial biopsy is one of the diagnostic procedures in endometrial pathology. The current study was carried out to examine the morphological pattern of endometrial biopsies in Ibadan, South-western Nigeria and compare the results with similar studies. Method: A retrospective study was undertaken to review all cases of endometrial biopsies received in the Department of Pathology, University College Hospital, Ibadan between January 1999 and December 2008. The patients’ data were retrieved from the surgical pathology daybooks and Histology Request forms. The neoplastic lesions were classified according to 2003 World Health Organization classification for endometrial neoplasms. Results: A total of 2,444 cases of endometrial biopsies were received during the 10-year study period. The functional endometrial changes were the most common histopathological diagnostic category, accounting for 53.8% (1035) of cases. Other pathological diagnoses included endometritis (7.8%), simple endometrial hyperplasia (5.8%), partial hydatidiform mole (2.3%), complete hydatidiform mole (2.1%) and malignant neoplastic lesions (3.9%). Infertility was the most common (57%) indication for endometrial biopsies followed by uterine bleeding (33%) while the least common clinical indication were the menstrual disorders (10%). Conclusion: The functional endometrial changes account for the highest morphological patterns while malignant lesions account for the least pattern of the endometrial biopsies evaluated for etiological basis of infertility, uterine bleeding and menstrual disorders in Ibadan. Infertility was the commonest indication for endometrial biopsies while the least common clinical indication was menstrual disorders.