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Item Diagnostic accuracy of tru-cut biopsy of breast lumps at University College Hospital, Ibadan(College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria, 2015) Oluwasola, A. G.; Adeoye, A. O.; Afolabi, A. O.; Adeniji-Sofoluwe, A. T. S.; Salami, A.; Ajani, M. A.; Ogundiran, T. O.; Obajimi, M. O.Background: Tru-cut needle biopsies form an integral part of Triple assessment of breast cancer and include clinical assessment, mammography and core needle biopsy. No study has been done to evaluate the validity of the procedure in our environment. This study was done to evaluate the validity of core needle biopsies in our centre. Method: A retrospective study of patients with tru-cut needle biopsies of breast lumps and follow-up excisional biopsy or mastectomy done in the Department of Surgery, University College Hospital, Ibadan over a ten year period was done. Fifty one patients who fulfilled the inclusion criteria had their records obtained from the Department of Pathology. The diagnosis was classified into benign and malignant with the excisional biopsy or mastectomy diagnosis used as the gold standard. The sensitivity, specificity and accuracy were calculated and kappa was also done to evaluate the degree of agreement. Results: A total of 51 cases were included in this study. The average age of the patients was 47 ± 13 years with a range from 19 to 81 years. Thirty of the biopsies (59%) had a definitive diagnosis of malignancy while twenty one (41%) were benign. The overall sensitivity, specificity and accuracy were 86%, 71% and 80.4% respectively. The specificity of malignant biopsies was 68% while benign was 35%. The level of agreement for malignant biopsies was higher than benign biopsies with a kappa of 0.39 for malignant diagnosis as against 0.29 for benign. Conclusion: Tru-cut needle biopsies have a comparable sensitivity and specificity to excisional biopsies. Diagnostic accuracy can be further enhanced with the adoption of image guided biopsies.Item Diagnostic accuracy of tru-cut biopsy of breast lumps at University College Hospital, Ibadan(College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria, 2015) Oluwasola, A. G.; Adeoye, A. O.; Afolabi, A. O.; Adeniji-Sofoluwe, A. T. S.; Salami, A.; Ajani, M. A.; Ogundiran, T. O.; Obajimi, M. O.Background: Tru-cut needle biopsies form an integral part of Triple assessment of breast cancer and include clinical assessment, mammography and core needle biopsy. No study has been done to evaluate the validity of the procedure in our environment. This study was done to evaluate the validity of core needle biopsies in our centre. Method: A retrospective study of patients with tru-cut needle biopsies of breast lumps and follow-up excisional biopsy or mastectomy done in the Department of Surgery, University College Hospital, Ibadan over a ten year period was done. Fifty one patients who fulfilled the inclusion criteria had their records obtained from the Department of Pathology. The diagnosis was classified into benign and malignant with the excisional biopsy or mastectomy diagnosis used as the gold standard. The sensitivity, specificity and accuracy were calculated and kappa was also done to evaluate the degree of agreement. Results: A total of 51 cases were included in this study. The average age of the patients was 47 ± 13 years with a range from 19 to 81 years. Thirty of the biopsies (59%) had a definitive diagnosis of malignancy while twenty one (41%) were benign. The overall sensitivity, specificity and accuracy were 86%, 71% and 80.4% respectively. The specificity of malignant biopsies was 68% while benign was 35%. The level of agreement for malignant biopsies was higher than benign biopsies with a kappa of 0.39 for malignant diagnosis as against 0.29 for benign. Conclusion: Tru-cut needle biopsies have a comparable sensitivity and specificity to excisional biopsies. Diagnostic accuracy can be further enhanced with the adoption of image guided biopsies.Item Diagnostic accuracy of tru-cut biopsy of breast lumps at University College Hospital, Ibadan(College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria, 2015) Oluwasola, A. G.; Adeoye, A. O.; Afolabi, A. O.; Adeniji-Sofoluwe, A. T. S.; Salami, A.; Ajani, M. A.; Ogundiran, T. O.; Obajimi, M. O.Background: Tru-cut needle biopsies form an integral part of Triple assessment of breast cancer and include clinical assessment, mammography and core needle biopsy. No study has been done to evaluate the validity of the procedure in our environment. This study was done to evaluate the validity of core needle biopsies in our centre. Method: A retrospective study of patients with tru-cut needle biopsies of breast lumps and follow-up excisional biopsy or mastectomy done in the Department of Surgery, University College Hospital, Ibadan over a ten year period was done. Fifty one patients who fulfilled the inclusion criteria had their records obtained from the Department of Pathology. The diagnosis was classified into benign and malignant with the excisional biopsy or mastectomy diagnosis used as the gold standard. The sensitivity, specificity and accuracy were calculated and kappa was also done to evaluate the degree of agreement. Results: A total of 51 cases were included in this study. The average age of the patients was 47 ± 13 years with a range from 19 to 81 years. Thirty of the biopsies (59%) had a definitive diagnosis of malignancy while twenty one (41%) were benign. The overall sensitivity, specificity and accuracy were 86%, 71% and 80.4% respectively. The specificity of malignant biopsies was 68% while benign was 35%. The level of agreement for malignant biopsies was higher than benign biopsies with a kappa of 0.39 for malignant diagnosis as against 0.29 for benign. Conclusion: Tru-cut needle biopsies have a comparable sensitivity and specificity to excisional biopsies. Diagnostic accuracy can be further enhanced with the adoption of image guided biopsies.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 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 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.Item Metastatic prostate cancer presenting as a rapidly increasing gluteal muscle mass at an intramuscular injection site(Remedy Publications LLC., 2022-02) Olapade-Olaopa, O. E.; Adebayo, A. S.; Osobu, E.; Ajani, M.; Ogunlayi, S.; Magbagbeola, O. A.; Farinre, O. M.; Ogunbiyi, O. J.; Ogunlade, S. O.Prostate cancer is the second commonest male cancer globally. However, diagnosis may be delayed or missed due to atypical presentations such as metastases to unusual sites. The axial skeleton, lymph nodes, and viscera are the common sites for prostate cancer metastasis with skeletal muscles being uncommonly affected, and until now there has been no report of metastasis to the gluteal muscles from the disease. We present the case of a 78-year-old man with no lower urinary tract symptoms who presented with a 2-year history of a right supra-gluteal mass at the site of an intramuscular injection hematoma/abscess that rapidly increased in size 5 months prior to presentation and an abnormal gait. CT and MRI scans were suggestive of a malignant mass (possibly a rhabdomyosarcoma) and enlarged multinodular prostate with bilateral lymphadenopathy. A biopsy of the gluteal mass confirmed metastatic adenocarcinoma with the colon or the prostate being possible primaries. His serum PSA was markedly elevated (3441 ng/ml) but his other tumor markers were normal. Prostate biopsies confirmed a Gleason 4+3=7 prostate cancer and ADT was commenced. He responded well and remains in good health 15 months into his treatment with a marked reduction in the size of his gluteal mass and a restoration of a normal gait. His serum PSA and Testosterone are presently 2.4 ng/ml and 0.3 mmol/L respectively.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.