Scholarly works in Pathology (Vet Medicine)
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Item Recent advance in the pathology of pitutiary adenomas(Elsevier BV, 2015) Ayodeji, S.; Effiong, A.; Adefolarin, M.Introduction: Pituitary adenomas are the third most common intracranial tumours. The 2004 WHO classification of pituitary adenomas has recommended the use of immunohistochemistry, electron microscopy and molecular techniques along with clinical and morphological evaluation in making a diagnosis. This review examines the subtypes of pituitary adenomas seen using the different diagnostic techniques. Materials and Methods: A comprehensive search of literature as well as an online search of databases was made. Results: The classification and molecular properties of the different subclasses are highlighted in this review. Pituitary adenomas are among the most frequent intracranial tumours and can present with over-expression of the hormones normally produced by the pituitary gland or pressure symptoms from the tumour. Pituitary adenomas are clonal tumours and often show over-expression of tumour suppressor genes which can sometimes be familial. Molecular studies have shown expression of common genes that can be employed to group pituitary adenomas based on their histogenetic origin. These genetic properties can be helpful in delineating those tumours which do not show clear cut lineage. This is particularly useful in the assessment of silent and plurihormonal adenomas. Several subclasses exist and the presentation may be different depending on the particular hormone produced. The prolactinomas are the commonest type followed by the silent adenomas with Gonadotroph and TSH producing adenomas constituting the rare types. Conclusion. Pituitary carcinomas are rare tumours diagnosed only in the presence of metastatic deposits in other tissues.Item Radiation nephritis: anti-inflammatory effect of dexamethasone in adult wistar rats (rattus norvegicus)(Sociedad Chilena de Anatomía, Temuco, Chile, 2008) Owoeye, O.; Malomo, A. O.; Elumelu, T. N.; Salami, A. A.; Osuagwu, F. C.; Akinlolu, A. A.; Adenipekun, A.; Shokunbi, M. T."The anti-inflammatory effect of dexamethasone on the irradiated kidneys of adult Wistar rats (Rattus norvegicus) was studied. Eighteen adult Wistar rats were, after acclimatization, randomly divided into 3 groups of 6 animals per group. The control group had normal saline, receiving neither drugs nor radiation. The second group received normal saline and radiation. The third group received pretreatment with dexamethasone at 1mg/kg body weight/day for 2 days followed by radiation. Radiation was delivered to the animals as a single fraction of 2.5 Gy of gamma rays from Cobalt-60 source, using an AECL Theatron 780-C Teletherapy machine. After exposure to the different interventions, the animals were sacrificed on the 14th post-irradiation day and the kidneys dissected out from each animal. The renal tissues were subjected to histological processing, and then studied using an eyepiece objective ruler calibrated with a 2mm stage micrometer for histomorphometric studies. The result of the study showed that all irradiated animals suffered weight loss by the 14th day post-irradiation (p<0.05) irrespective of the additional treatment with dexamethasone and this was statistically significant. Histomorphometry showed that the maximum width of the glomerular capsule was significantly greater in the radiation groups than in the control at p<0.05. The maximal glomerular diameter was significantly greater in irradiated animals compared with the control animals at p<0.05. The outcome of this study showed that the intraperitoneal administration of dexamethasone at 1mg/kg body weight/day for 2 days prior to treatment with irradiation did not prevent weight loss nor ameliorate the swelling of the nephrons resulting from the effect of radiation injury to the Wistar rat."Item A comparison of the effect of chlorhexidine,tap water and normal saline on healing wounds(Sociedad Chilena de Anatomía, Temuco, Chile, 2006) Salami, A. A.; Imosemi, I. O.; Owoeye, O. O.Many researchers have advocated in recent times that antiseptic use in healing wounds should be discouraged. Antiseptics have been found to retard healing of wounds. Innocuous solutions like normal saline and tap water are being considered as better alternatives to antiseptics. Chlorhexidine, a commonly used antiseptic, is known to be less toxic on granulation cells. We decided to compare the effect of chlorhexidine, normal saline and tap water on healing wounds. Three groups of wistar rats had 2 by 2cm full thickness wounds made on their right dorsolateral flanks. The wounds were dressed with either chlorhexidine, normal saline or tap water. Wounds were examined at three-day intervals and measurements of area covered were taken on the first day of study and the ninth day. Wound contraction on the ninth day and number of days for healing to take place in the different groups was taken and statistical analysis using student t-test was done to compare the values. Gross morphology of the wounds was also observed. The result showed an inhibitory effect of chlorhexidine on healing wounds. The wound contraction in the antiseptic group was less than the tap water and saline group on day nine. The average number of days for wound healing to be completed in the antiseptic group was more than the other two. These results were statistically significant when compared with the other two groups. There was no statistical difference in the wound contraction values and rate of healing of the saline and tap water dressed wounds. Grossly, all the wounds dressed with antiseptic also had greenish exudates on their surface by day nine with pale looking granulation tissue, and there was greater mortality in this group.Item Fracture of the humeral bone as the first clinical presentation of metastatic papillary thyroid carcinoma in Ibadan(Sciencedomain international, 2019) Ajani, M. A.; Awosusi, B. L.; Fatunla, E. O.; Adegoke, O. O.; Salami, A. A.Papillary thyroid carcinoma is the commonest type of thyroid cancer representing 75 to 85 per cent of all thyroid cancer cases. It is often well-differentiated, slow-growing, and localized, although it can metastasize. This is a case of a 49-year-old male who presented with a pathological fracture of the left humerus. A bone biopsy was done at the surgery which had a histological diagnosis of metastatic thyroid carcinoma. A total thyroidectomy was subsequently done and was histologically reported as a follicular variant of papillary thyroid carcinoma. The patient was clinically stable post thyroidectomy and was discharged home on the 10th postoperative day and he is currently being followed-up in the surgical outpatient clinic. Pathological fracture as the initial clinical presentation is an unusual manifestation of metastatic thyroid carcinoma; therefore a high index of suspicion is needed to make this diagnosis. In any patient presenting with a pathologic fracture, the possibility of metastatic carcinoma from the thyroid gland should always be considered.Item Germline variants and somatic mutation signatures of breast cancer across populations of African and European ancestry in the US and Nigeria(John Wiley & Sons Ltd, 2019) Wang, S. F.; Pitt, J. J.; Zheng, Y.; Yoshimatsu, T. F.; Gao, G.; Sanni, A.; Oluwasola, O.; Ajani, M.; Fitzgerald, D.; Odetunde, A.; Khramtsova, G.; Hurley, I.; Popoola, A.; Falusi, A.; Ogundiran, T.; Obafunwa, J.; Ojengbede, O.; Ibrahim, N.; Barretina, J.; White, K. P.; Huo, D.; Olopade, O. I.Somatic mutation signatures may represent footprints of genetic and environmental exposures that cause different cancer. Few studies have comprehensively examined their association with germline variants, and none in an indigenous African population. SomaticSignatures was employed to extract mutation signatures based on whole-genome or whole-exome sequencing data from female patients with breast cancer (TCGA, training set, n = 1,011; Nigerian samples, validation set, n = 170), and to estimate contributions of signatures in each sample. Association between somatic signatures and common single nucleotide polymorphisms (SNPs) or rare deleterious variants were examined using linear regression. Nine stable signatures were inferred, and four signatures (APOBEC C>T, APOBEC C>G, aging and homologous recombination deficiency) were highly similar to known COSMIC signatures and explained the majority (60–85%) of signature contributions. There were significant heritable components associated with APOBEC C>T signature (h2 = 0.575, p = 0.010) and the combined APOBEC signatures (h2 = 0.432, p = 0.042). In TCGA dataset, seven common SNPs within or near GNB5 were significantly associated with an increased proportion (beta = 0.33, 95% CI = 0.21–0.45) of APOBEC signature contribution at genome-wide significance, while rare germline mutations in MTCL1 was also significantly associated with a higher contribution of this signature (p = 6.1 × 10−6 ). This is the first study to identify associations between germline variants and mutational patterns in breast cancer across diverse populations and geography. The findings provide evidence to substantiate causal links between germline genetic risk variants and carcinogenesis.Item Endometriosis misdiagnosed as a metastatic ovarian tumour(Scientific Research Publishing, 2019) Imaralu, J. O.; Ajani, M. A.; Adesina, M. A.; Ojo, N. K.Endometriosis is a debilitating problem with pain in the short term and high risk of infertility later. It is an oestrogen-dependent condition found in about 10% of women of reproductive age, about 1/3 of infertile women and as high as 80% of women with chronic pelvic pain. The condition is not well understood and thus associated with misdiagnosis and delayed diagnosis. Higher rates of misdiagnosis occur in blacks and this is especially for pelvic tumors-fibroids and ovarian tumors. We present here the case of a 30-year-old nullipara, who had an umbilical nodule (Sister Mary Joseph’s) and was found on imaging to have a pelvic tumor which was suspected to be an ovarian cancer. Diagnostic laparoscopy during the menstrual phase however revealed endometriosis in early stage. Misdiagnosis of endometriosis has potential to distort the course of the disease and endanger fertility prospects; early laparoscopic evaluation of patients with unclear pelvic pathologies would help to prevent this occurrence.Item Calcified bilateral ovarian fibroma in a 15 year old female: case report and literature review(Sciencedomain International, 2019) Adesina, A. M.; Imaralu, J. O.; Yusuf, A. O.; Ajani, M. A.Aim: To highlight the potential for misdiagnosis of ovarian fibromas and need for careful evaluation especially when fertility altering decisions need to be taken in the young adolescent. Presentation of Case: The authors here review literature and present the case of a 15 year old pre menarchal patient with bilateral, solid hard ovarian tumors with marked ascites, who had bilateral salpingo-oophorectomy, in whom the tumors turned out to be bilateral calcific ovarian fibromas. Discussion: Ovarian neoplasia are often misdiagnosed because of their non-specific symptoms and similarities to other pathologies on radiological imaging. The management of adolescents with ovarian tumors poses peculiar challenges as there is need for a balance between the risk of malignancy and the need to preserve fertility. About 1/3 of pelvic masses in pre-pubertal girls are malignant. This fact in addition to the non-specific features of malignancy in this patient such as weight loss, ascites, necessitated further evaluation which included laparotomy. Conclusion: Ovarian fibromas occur in adolescents and can pose a diagnostic dilemma; a high index of suspicion is required to plan fertility-sparing and cancer-limiting management.Item "Characterization of Nigerian breast cancer reveals prevalent homologous recombination deficiency and aggressive molecular features"(Nature Research, 2018) Pitt, J. J.; Riester, M.; Zheng, Y.; Yoshimatsu, T. F.; Sanni, A.; Oluwasola, O.; Veloso, A.; Labrot, E.; Wang, S.; Odetunde, A.; Ademola, A.; Okedere, B.; Mahan, S.; Leary, R.; Macomber, M.; Ajani, M.; Johnson, R. S.; Fitzgerald, D.; Grundstad, A. J.; Tuteja, J. H.; Khramtsova, G.; Zhang, J.; Sveen, E.; Hwang, B.; Clayton, W.; Nkwodimmah, C.; Famooto, B.; Obasi, E.; Aderoju, V.; Oludara, M.; Omodele, F.; Akinyele, O.; Adeoye, A.||; Ogundiran, T.; Babalola, C.; MacIsaac, K.; Popoola, A.; Morrissey, M. P.; Chen, L. S.; Wang, J.; Olopade, C. O.; Falusi, A. G.; Winckler, W.; Haase, K.; Van Loo, P.; Obafunwa, J.; Papoutsakis, D.; Ojengbede, O.; Weber, B.; Ibrahim, N.; White, K. P.; Huo, D.; Olopade, O. I.; Barretina, JRacial/ethnic disparities in breast cancer mortality continue to widen but genomic studies rarely interrogate breast cancer in diverse populations. Through genome, exome, and RNA sequencing, we examined the molecular features of breast cancers using 194 patients from Nigeria and 1037 patients from The Cancer Genome Atlas (TCGA). Relative to Black and White cohorts in TCGA, Nigerian HR + /HER2 − tumors are characterized by increased homologous recombination deficiency signature, pervasive TP53 mutations, and greater structural variation—indicating aggressive biology. GATA3 mutations are also more frequent in Nigerians regardless of subtype. Higher proportions of APOBEC-mediated substitutions strongly associate with PIK3CA and CDH1 mutations, which are underrepresented in Nigerians and Blacks. PLK2, KDM6A, and B2M are also identified as previously unreported significantly mutated genes in breast cancer. This dataset provides novel insights into potential molecular mechanisms underlying outcome disparities and lay a foundation for deployment of precision therapeutics in underserved populations.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 Can Vascularity Determine Degenerative Behavior of Uterine Fibroids? Huge Parasitic Uterine Fibroid Mass Mimicking an Ovarian Tumor(Annex Publishers, 2017) Imaralu, J.O.; Mustapha, A.; Yusuf, A.; Aramide, K.Uterine fibroids have been misdiagnosed for a range of conditions from ovarian to colonic or even retroperitoneal tumors. Apart from the effects of a known and diagnosed fibroid, misdiagnosed fibroids have their own implications for the patient which may include iatrogenic impaired reproductive capability and quality of life. An understanding of fibroid degenerations, especially atypical variants produced by associations between fibroid tumors and bowel or mesentery may help overcome this diagnostic dilemma and aid optimal care. Case Report: The authors report the case of a 30 year old nullipara, who had a huge cystic abdominal tumor with rich vascularity from a broad mesentery, causing complex degenerations and consequently an unusual anatomy. This fibroid tumor was misdiagnosed clinically and at radio-diagnosis for an ovarian malignancy, because of the nature of degenerations that had taken place. Conclusion: An understanding of such atypical degenerations may help to overcome diagnostic dilemma and aid optimal care.