Pathology

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IMMUNOPATHOLOGY OF AMOEBIASIS IN IBADAN
(1971) ABIOYE, A. A.
Amoebiasis exemplifies a disease of protean manifestations which presents many perplexing problems. In this thesis an attempt is made to define a number of the wide variations which have been observed in the pathological manifestations of the disease. The work consists of both retrospective and prospective Studies. The retrospective study involved a review of the 7922 protocols of the autopsies at the University College Hospital, Ibadan, during the ten year period 1958 to 1967. 135 cases in which lesions of amoebiasis were described, were selected for special study using 276 cases of other diarrhoeal diseases as controls. The results of this review defined the pathology and complications of amoebiasis seen at the UCH, during the period covered by this study. A prospective study which included field surveys. laboratory studies on patients and controls; and in-vitro studies of the parasite was also carried out. Parasitological, biochemical and immunological techniques were applied in the prospective study of 1291 subjects in a field survey. In addition some 200 hospital materials were included in the prospective study. The results obtained provided the basis for the suggestions made concerning the different methods that can be applied to the future study of the prevalence of amoebiasis in any given population exposed to the risk of infection by Entamoeba histolytica. Local (Ibadan) strains of Entamoeba histolytica have been successfully cultured and the in-vitro characteristics studied. From the materials provi.ded by the in-vitro cultures of the organism, investigations have been made on E. histolytica antigens and the corresponding antibodies produced in man. The results of these investigations have been utilized in immunological studies, designed to define the mechanism of production of some of the problems posed by amoebic infections. The severity and high fatality of the disease in pregnancy and puerperium, was studied in detail. The observation that amoebiasis tends to be more severe and to have a higher mortality in pregnant and puerperal women was made only recently. At the time the present studies were planned, the association of pregnancy with severe amoebiasis had not been well established, and the mechanism for this association was unknown. It was, however, wall known that pregnant women were more liable to severe for-ms of certain other infectious diseases and it was considered possible that a similar mechanism might be operating in the case of amoebiasis. The present work confirms these clinical observations. Thus from the statistical analyses of the results of both the autopsy and prevalence studies, it became evident that the high fatality of amoebiasis during pregnancy and the early puerperium was not fortuitous but real. A fulminating type of lesion affecting the whole length of the large bowel is commoner in pregnant women and in those in the early puerperium dying of amoebiasis, than in any other cases of amoebiasis seen at autopsy. Furthermore, the biochemical and immunological studies help to throw some light on the mechanism of the selectivity of Infection by E. histolytical. These same results, also provide some explanation for the severity of amoebiasis during pregnancy and the allied states. The conclusions, support the hypothesis of lowered resistance to infectious diseases during pregnancy. Speculative submissions are, therefore, made on the defective immune mechanism occurring during pregnancy and the early puerperium. Thus, the inability of pregnant women to produce 'sufficient antibodies' to amoebic infections, demonstrated by the reactivity of the immunoglobulins in amoebiasis, confirms the suspicion of the existence of a derangement of host-defence mechanisms during pregnancy. This raises the hope and encourages future search for the specific serum agents) which may account for the deranged immune mechanism. On similar basis, the characterization of amoebic antigens together with that of the corresponding antibodies, offers a new field in the study of the immunopathology of amoebiasis. In conclusion, from the combined autopsy, prevalence, in-vitro experimental, biochemical, and immunological studies, it is submitted: 1. That the association of pregnancy with the severe form of amoebiasis at least, in this part of the world, is one of the perplexing problems posed by the disease. 2. That chronic amoebic infection is associated with the development of growth-inhibiting factors in the serum, for example, in patients with amoebic liver abscess. 3. That, on the contrary, growth promoting factors were demonstrated in the sera of pregnant/puerperal women with or without acute amoebic dysentery. 4. It is suggested that the severity of the disease in pregnant/puerperal women is a reflection of the derangement of immune response during pregnancy, with particular reference to the production of serum immunoglobulins.
Enhanced wound contraction in fresh wounds dressed with honey in wistar rats (rattus novergicus)
(West African College of Physicians and the West African College of Surgeons, 2004) Osuagwu, F. C.; Oladejo, O. W.; Imosemi, I. O.; Aiku, A.; Ekpo, O. E.; Salami, A. A.; Oyedele, O. O; Akang E. U.
Background: Due to reports that honey accelerates wound healing, an investigation on its role in wound con- traction in fresh wounds inflicted on wistar rats was car- ried out. Method: Twenty adult male wistar rats had 2cm by 2cm square wound inflicted on their right dorsolateral trunk. They were divided into two groups. The experimental group had their wounds dressed with honey while the control group had normal saline dressing. Wound dress- ing was done every five days and measurements taken at each dressing. Wound morphology was also assessed. Results: Dressing with honey significantly enhanced percentage wound contraction on day 10 with value of 79.20±2.94 compared to control value of 53.50 ±4.32. p=0.0. The mean wound measurement on day 10 reduced significantly in honey group, 1.15±0.18 compared to con- trol group 2.38±0.28. p=0.002. However, there was no significant difference in fibroblast count per high power field in honey group 68.0 ±2.59 compared to control 90.2 17.40, p=0.242. Honey dressing increased mean blood vessel count per high power field, 18.8±3.77 albeit non significantly when compared to control value of 13.4±2.44, p=0.264. Also honey dressing caused increased granulation tissue for- mation in wounds dressed with honey compared to con- trol group. Conclusion: Our study suggests that honey dressing enhances wound contraction in fresh wounds which is one of the key features of wound healing.
Sexual risk nehaviour of street Youth in South West Nigeria
(East African Public Health Association, 2009) Owoaje, E.T.; Uchendu, O. C.
Objectives Previous studies have mainly focused on sexual behaviour of in-school Nigerian youths with little attention to those on the street. This survey was conducted to determine the sexual risk behaviours of young people on the streets of Ibadan, Nigeria. Methodology A cross sectional survey was conducted among youths aged 15-24 years in the major markets, motor parks and commercial areas in two local government areas in Ibadan. Participants in the study areas were identified in groups based on their occupational activity and all consenting young people were interviewed. A semi-structured questionnaire was used to obtain information on sexual behaviours, condom use and history of sexually transmitted infections. Data was managed using SPSS version 11. Results Most (68.8%) were males, 79.0%, were sexually experienced, the median age at sexual debut for males was 15 years and 16 years for females. More females (53.9%) compared to (34.5%) males reported that their first partners were five or more years older, p<0.01. Condom use during the first sexual intercourse was reported by only 32.2%. Sex with a commercial sex worker or exchange of sex for money was reported by 18.2% (20.6% of males versus 12.2% of females, p=0.01). Factors significantly associated with history of transactional sex were; male gender; older age (20-24 years); being out of school and regular alcohol use. Multiple sexual partnering was reported by 58.2%, the significant predictors were male gender; early age at sexual debut; regular alcohol use and history of transactional sex. Inconsistent condom use was reported by 44.8%, the predictors were female gender; regular alcohol use and history of transactional sex in the previous year. Conclusion Majority of these young people on the streets are sexually active and many engage in high risk sexual behaviours. Development of appropriate sexual and reproductive health interventions is recommended.
Correlation of intraoperative cytological and final histological diagnoses
(Wiley, 2014) Salami, A.; Adeleye, A.; Ogun, G.; Adeoye, A.; Adeolu, A.; Okolo, C.; Eze, U.; Abdullahi, Y.; Lawan, A.; Ogunbiyi, J.; Akang, E.; Shokunbi, M.; Azeez, A.; Malomo, A.
Objective: Intraoperative cytology is a cost-effective, rapid, and easy technique, and studies have shown good correlation between intraoperative cytology and histology. We undertook this study to compare the intraoperative cytology diagnoses of brain lesions made in our unit over a 10-year period with the definitive histological diagnoses. The aim was to determine the degree of accuracy of this procedure. Study design: This is a retrospective study of intraoperative neuropathology consultation cytology smears or imprints and histology of 69 cases obtained over a 10-year period. Cytology smears were stained using both Papanicolaou and Giemsa. Histology sections were prepared from routine formalin-fixed paraffin- embedded tissue and stained using H and E method. Each of the smears and histology samples were assessed by at least two pathologists. Cytological diagnosis was correlated with final histological diagnosis. The sensitivity and specificity of cytological diagnosis was evaluated using final histological diagnosis as gold standard. Results: Correlation was strongest with inflammatory lesions followed by low-grade neoplasms. High-grade neoplasms also showed good concordance, but the degree of correlation was lower than in the other categories. Misdiagnosis was commonest with benign tumors. Conclusion: Intraoperative cytology is a relatively simple, reliable, and accurate diagnostic technique and should be more commonly used, particularly in low-resource settings. Diagn. Cytopathol.
Features and outcome of surgical management of spinal tumors in a cohort of nigerian patients
(Elsevier Inc, 2014) Adeolu, A. A.; Oyemolade, T. A.; Salami, A. A.; Adigun, T. A.; Malomo, A. O.; Akang, E. A.; Shokunbi, M. T.
OBJECTIVE: There is a dearth of information on operated cases of spinal tumors in patients in sub-Saharan Africa. The objective of this study was to evaluate the histologic pattern, anatomic distribution, and extent and outcome of surgery of Nigerian patients with spinal tumors. METHODS: This retrospective study comprised a cohort of Nigerians who underwent surgery for spinal tumors. Data obtained included patient demographics, duration of symptoms, anatomic location, imaging findings, Frankel grading before and after surgery, and type and outcome of surgery. Univariate analysis was performed, and results were compared with results from other parts of the world. RESULTS: There were 59 patients (male-to-female ratio 1:1.1) with a bimodal age distribution. The highest (20.34%) incidence was seen in the 20e29 age group. More than half (58.06%) of the patients presented with a duration of symptoms of at least 6 months (duration of symptoms was >12 months in 35.48%). Motor deficit was present in 97.73% of patients at presentation. Functional grading was Frankel A in 38.10% of patients, Frankel C in 26.19%, Frankel B in 16.67%, Frankel D in 16.67%, and Frankel E in 2.38%. The tumors were mostly in the thoracic region (65.45%), and 58% were extradural in location. Gross total tumor excision was performed in 50.88% of the cases, and subtotal resection was performed in 24.56%. Spinal stabilization was performed in 17.86% with spinous process wiring and vertical strut being the most common method of stabilization (80%) among this group. Metastasis was the most common histologic tumor type (23.21%). Meningioma accounted for 12.50% of tumors, and ependymoma, astrocytoma, and hemangioma each accounted for 7.14%. The most common source of metastasis was the prostate (38.46%). Postoperatively, 45% of patients improved neurologically, 52.5% remained the same, and 2.5% deteriorated. There was no perioperative mortality. CONCLUSIONS: Metastasis was the most common histologic type of spinal tumor in this study, and the most common location was extradural. The outcome was satisfactory in most cases with neurologic function remaining the same or improving after surgery in most patients.
Extensive Right Pleural and Chest Wall Malignant Fibrous Histiocytoma at an Unusual Age: Computed Tomography Features
(BMJ Group, 2015) Adekanmi, A. J.; Ajani, M. A.
Aims: To describe a rare case of malignant fibrous histiocytoma at an unusual age of sixteen (16) years. Also to sensitize the medical community to the need for thorough evaluation of an opaque hemithorax and to describe the imaging features of this rare neoplastic disease. Presentation of Case: This was a 16 year old girl who presented with progressive swelling and recurrent right chest pain of 10 months duration and difficult breathing of 6 weeks duration. There was associated weight loss, dry cough and low grade intermittent fever. She had solitary cervical lymphadenopathy, grade II finger clubbing and low hematocrit. Discussion: Malignant fibrous histiocytomas (MFHs) are tumors of adulthood with a mean age of 59 years. It has predilection for the extremities, the abdominal cavity and the retroperitoneum. Primary pleural occurrence is relatively rare. This is a rare case of an extensive malignant fibrous histiocytoma of the right pleura with chest wall involvement presenting at an unusual young age of 16 years, at variance with the ages documented in the literatures. Imaging findings of the histologically proven tumor were also described on high resolution chest Computed Tomography. Conclusion: Malignant fibrous histiocytomas may occur much earlier than the age documented in most literatures. This case showed that not all cases of extensive opaque hemithorax are due to massive pleural effusion and further and better diagnostic imaging will be necessary for prompt and proper management.
Diagnostic accuracy of tru-cut biopsy of breast lumps at University College Hospital, Ibadan.
(College of Medicine, University of Ibadan, 2015) Oluwasola, A. O.; Adeoye, A. O.; Afolabi, A. O.; Adeniji-Sofoluwe, A. T.; Salami, A.; Ajani M. A.; Ogundiran, T. O.; Obajimi M. O.
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 o f 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 m astectomy 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 o f the patients was 47±13years 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. C onclusion: T ru-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.
Childhood ovarian neoplasms in Ibadan, South‑western Nigeria.
(Wolters Kluwer - Medknow, 2016) Ajani, M. A.; Aramide, K. O.; Ajani, T. A.; Salami, A. A.; Okolo, C. A.
Childhood ovarian neoplasms are very rare. Little information is available on the relative pattern and frequency of these tumors in Nigerian children. Earlier study done in Ibadan involved ovarian neoplasms in children and adolescents. The aim of this study is to review cases of ovarian neoplasms in childrenMaterials and Methods: This was a retrospective study. Twenty four cases of childhood ovarian neoplasms were seen in patientsResults: Childhood ovarian neoplasms accounted for 2.8% of all cases of ovarian tumors seen in this period. Fourteen (58.3%) cases of childhood ovarian neoplasms were benign, and 10 (41.7%) were malignant. Mature cystic teratoma occurring in 13 (54.2%) was the most common childhood ovarian neoplasm and was most prevalent between 10 and 14 years of age. Burkitt lymphoma was the most common 4 (40%) malignant childhood ovarian tumor and prevalent between 5 and 14 years of age. Conclusion: Mature cystic teratoma remains the single most common childhood ovarian neoplasms, and Burkitt’s lymphoma is the most malignant childhood ovarian tumor in Ibadan, South western Nigeria.
Histopathological pattern of primary ovarian neoplasms in South Western Nigeria.
(Association of Resident Doctors of Jos University Teaching HospitalAssociation of Resident Doctors of Jos University Teaching Hospital, 2016) Ajani, M. A.; Aramide, K. O.; Salami, A.; Okolo, C. A.
Background: Ovarian tumours are common form s o f neoplasms in women. This study aims to determine the histopathological pattern o f primary ovarian neoplasms in South-western Nigeria. Method: A retrospective study was undertaken to review the histopathology reports o f all primary ovarian neoplasm specimens submitted to the Department o f Pathology, University College Hospital, Ibadan from January 1991 to June 2013. Patients'biodata were extractedfrom the requestforms and surgical day books. Results: There were 821 cases o f primary ovarian neoplasms. 359 (43.7%) cases were surface epithelial neoplasms which were found in patients with age range 10-89 years. Three hundred and thirteen (38%) cases o f germ cell tumour were found in patients with age range 0-70 years. One hundred andforty-six (17.8%) cases ofsex cord stromal tumour werefound in patients with age range 0-99 years. Mature Cystic Teratoma was the most common (54.7%) among benign ovarian neoplasms with 20-29 years being the age range with highest tumours while serous cystadenocarcinoma was the most common (33.2%) primary malignant ovarian neoplasms with 50-59years being the age range with highest tumours. Conclusion: Surface epithelial tumours were the most common ovarian neoplasmfollowed by germ cell tumours. This pattern is observed in most parts of Nigeria, some African and Asian countries, and in the Western world.
Ten-year review of peripheral lymphadenopathy in tertiary hospital in South Western Nigeria
(African Field Epidemiology Network, 2016) Aramide, K.; Ajani, M. A.; Oluwasola, O.
Peripheral lymphadenopathy is a common clinical presentation in Nigeria, and there have been many studies published on it from different parts of the country. This study is to provide an update on the clinicopathological pattern of lymphadenopathy in Ibadan. Methods: Lymph node biopsies received at the Department of Pathology, University College Hospital, Ibadan, Nigeria from January st 2003 to December 31st 2012 were reviewed. Special stains and immunohistochemistry were also applied. Results: 429 cases,251 females and 178 in males were studied. Modal age group was in the sixth decade. The mean age of females (41.4 years) was significantly greater than that of males (34.5 years), p=0.000. Commonest sites were axillary (31.5%) and neck groups (24%), with axillary nodes more often involved in females and neck group of nodes more often involved in males. Metastatic cancer and reactive hyperplasia were the commonest diseases. Males more frequently had non-specific hyperplasia (34.3%) and non-Hodgkin lymphoma (23.6%), while females more often had metastasis (45.4%) and non specific hyperplasia (19.1%). Patients with metastatic cancer had the highest mean age of 46.5 years, followed by those with malignant lymphomas and reactive hyperplasia. Conclusion: Primary and metastatic malignancies are common causes of lymphadenopathy in this environment. The use of selective immunohistochemical antibody panels is advocated for proper diagnosis of malignant lesions of the lymph node.
Central nervous system tumours in children in Ibadan, Nigeria: a histopathologic study
(Pan African Medical Journal and African Field Epidemiology Network, 2016) Ogun, G. O.; Adeleye, A. O.; Babatunde, T. O.; Ogun, O. A.; Salami, A. A.; Brown, B. J.; Akang, E
Introduction: Contrary to some earlier teachings that central nervous system (CNS) tumours are uncommon in black children, these neoplasms are the fourth most common paediatric tumours in Ibadan. Our centre is the major referral centre for CNS tumours in Nigeria. The last major study of paediatric CNS neoplasms from Ibadan was in 1985. An update of the data on paediatric CNS neoplasms at our centre is presented. Methods: A retrospective review of all histologically diagnosed CNS tumours in children (0-14 years) from January 2001 to December 2010 from the database of the Department of Pathology, University College Hospital, Ibadan, Nigeria was done. The cases were classified using the 2007 WHO Classification of Tumours of the Central Nervous System and were also based on their supratentorial and infratentorial locations. Results: Seventy-seven tumours, 44 in males, were included in the study. Astrocytic tumour comprised 20 cases, embryonal tumours 15, ependymal tumours 15, germ cell tumours 6, sellar tumours (all craniopharyngiomas) 9 and other histological types- 12 cases. Thirty-seven were WHO Grade 1, eleven Grade 2, ten Grade 3 and nineteen Grade 4 neoplasms. Thirty-six cases were supratentorial and thirty-eight were infratentorial in location. The most common tumours in this series were pilocytic astrocytomas, medulloblastomas, craniopharyngiomas and ependymomas in that order. Conclusion: Childhood CNS tumours are being increasingly diagnosed in our centre. This is largely explained by the recent expansion of the available neurosurgical services
Childhood ovarian neoplasms in Ibadan,South‑western Nigeria
(Wolters Kluwer – Medknow, 2016) Ajani, M. A.; Aramide, K. O.; Ajani, T. A.; Salami, A. A.; Okolo, C. A.
Background: Childhood ovarian neoplasms are very rare. Little information is available on the relative pattern and frequency of these tumors in Nigerian children. Earlier study done in Ibadan involved ovarian neoplasms in children and adolescents. The aim of this study is to review cases of ovarian neoplasms in children <15 years over a 22½ year period. Materials and Methods: This was a retrospective study. Twenty‑four cases of childhood ovarian neoplasms were seen in patients <15 years of age. These cases were classified using the current World Health Organization histological classification of ovarian tumors. Results: Childhood ovarian neoplasms accounted for 2.8% of all cases of ovarian tumors seen in this period. Fourteen (58.3%) cases of childhood ovarian neoplasms were benign, and 10 (41.7%) were malignant. Mature cystic teratoma occurring in 13 (54.2%) was the most common childhood ovarian neoplasm and was most prevalent between 10 and 14 years of age. Burkitt lymphoma was the most common 4 (40%) malignant childhood ovarian tumor and prevalent between 5 and 14 years of age. Conclusion: Mature cystic teratoma remains the single most common childhood ovarian neoplasm, and Burkitt’s lymphoma is the most malignant childhood ovarian tumor in Ibadan, South‑western Nigeria.
Proliferaton index in pituitary adenomas from a black African population
(Elsevier B.V., 2016) Salami, A.; Ajani, M.; Adeolu, A.; Ogun, O.; Adeleye, A.; Ogun, O.; Okolo, C.; Malomo, A.; Akang, E.
Background: The WHO has recognized a variant of pituitary adenomas with potential aggressive behavior which have been termed atypical pituitary adenomas. This group of tumours are recognized by their mitotic rate of more than >3%, p53 expression and invasion of surrounding structures. There has however been no study of the occurrence of these tumours in a black African population. This study is a preliminary attempt to examine this group of tumours in blacks. Methods: This study retrospectively reviewed fifty-seven histologically diagnosed and immunohistochemically characterized pituitary adenomas received in our department over a twenty-one year period. Specimens were stained with ki67, a nuclear marker of cell proliferation which has been identified as the single best predictor of atypical pituitary adenoma. Results: Twelve of the tumours showed atypical features with eight (67%) of these tumours being prolactinomas. Two of the tumours were gonadotrophs and two were null cell adenomas. There was no correlation with age or gender. Two of the tumours required neurosurgical re-exploration with one of these showing a higher mitotic index in the second biopsy. Conclusion: The study suggests similarity in the rate of occurrence of pituitary adenomas with atypical features in a black African population with what is seen in Caucasians. Prolactinomas constitute a significant percentage of the tumours with this feature
Pattern of triple negative epithelial ovarian cancer in indigenous African women [version 1; referees: 2 approved
(F1000 Research Ltd, 2016) Ajani, M. A.; Salami, A. A.; Awolude, O. A.; Oluwasola, A. O.
Background: Triple negative epithelial ovarian cancer (TNEOC) refers to ovarian carcinomas that do not express estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-type 2 (HER-2/neu). The aim of this study is to determine the pattern of triple negative epithelial ovarian cancer in indigenous African women. Methods: We performed a retrospective review of ER, PR, and HER-2/neu expression in 90 Nigerian patients with histologically diagnosed epithelial ovarian cancer. Lack of expression of ER, PR, and HER-2/neu antigens was used to determine carcinomas that are among the TNEOC. We also compared the clinicopathological parameters (age, International Federation of Gynaecology and Obstetrics (FIGO) stage, grade, and histological subtype) in patients with TNEOC and non-TNEOC. Results: Thirty-eight (42.2%) of the 90 tumours diagnosed as EOC were negative for ER, PR, and HER-2/neu expression. There was no significant association between TNEOC with other parameters such as age, FIGO stage, and histological grade. Sixteen (66.7%) of the 24 mucinous carcinomas were triple negative, while only 21 (33.3%) of the 63 serous carcinomas were triple negative, and one (50%) of the two endometrioid carcinomas was triple negative. There was a significant association between triple-negative tumours and histological subtypes of EOC (p = 0.034). Conclusions: A subtype of epithelial ovarian cancer that is negative for ER, PR, and HER-2/neu has been discovered in indigenous African women. TNEOC expression is high and is comparable to the triple negative breast cancer subtype seen in people of African ancestry. Future study of TNEOC in a large sample size should be considered.
Histopathological pattern of primary ovarian neoplasms in south‑western Nigeria
(Association of Resident Doctors of Jos University, 2016) Ajani, M. A.; Aramide, K. O.; Salami, A. A.; Okolo, C. A.
Background: Ovarian tumours are common forms of neoplasms in women. This study aims to determine the histopathological pattern of primary ovarian neoplasms in south-western Nigeria. Method: A retrospective study was undertaken to review the histopathology reports of all primary ovarian neoplasm specimens submitted to the Department of Pathology, University College Hospital, Ibadan from January 1991 to June 2013. Patients’ biodata were extracted from request forms and surgical day books. Results: There were 821 cases of primary ovarian neoplasms. Surface epithelial neoplasms accounted for 359 (43.7%) of cases and were found in patients aged 10–89 years. Germ cell tumours numbered 313 (38.0%) in patients aged 0–70 years, while sex cord stromal tumours numbered 146 (17.8%) in patients aged 0–99 years. Among benign ovarian neoplasms, Mature Cystic Teratoma was the most common (54.7%) with the 20–29 year age range having the highest frequency. Among primary malignant ovarian neoplasms, serous cystadenocarcinoma was the most common (33.2%) and most frequent in the 50–59 year age group. Conclusion: Surface epithelial tumours were the most common ovarian neoplasms followed by germ cell tumours. This histopathological pattern is observed in most parts of Nigeria, some African and Asian countries, and in the Western world.
Awareness and perception of risk for cervical cancer among women in Ogbomoso, Nigeria
(Society of Gynaecology and Obstetrics of Nigeria (SOGON), 2017) Abiodun, A.B.; Oluwasola, T.A.O.; Durodola, A.O.; Ajani, M.A.; Abiodun, A.D.; Adeomi, A.A.
Background: Cervical cancer, though preventable, remains the leading cause of cancer death among women in developing countries after breast. Lack of awareness and access to preventive methods remains a key factor contributing to high levels of cervical cancer in these populations. Objectives: The study aimed to assess the level of awareness of, and perception of risk for, cervical cancer among women attending Bowen University Teaching Hospital (BUTH) general outpatient clinic. Methodology: This was a cross-sectional study conducted at the BUTH, Ogbomoso. Data were obtained from 318 consenting women using systematic random sampling method. An interviewer-administered questionnaire was used to gather information about their sociodemographic characteristics, marital and reproductive history, and awareness and perception of risk for cervical cancer. Data were analyzed using Statistical Package for the Social Sciences version 23.0. The level of statistical significance was set at P < 0.05. Results: Awareness for cervical cancer and its screening tests were 22.6% and 17.9%, respectively, with major sources of information being from health talks and hospital staffs. About 5.7% believed that they may be at risk whereas only 1.6% had ever 2 = 10.46,2 = 20.05, P = 0.005) and early coitarche (been screened. Perception of risk is significantly associated with age ( P = 0.015). Overall, respondents’ attitude was positive to cervical cancer screening. Conclusion: The level of awareness of cervical cancer and screening was low among the respondents. Increased media campaign about its risks and preventive measures is urgently needed.
Hormone–receptor expression status of epithelial ovarian cancer in Ibadan, South-Western Nigeria
(African Field Epidemiology Network, 2017) Ajani, M. A.; Salami, A.; Awolude, O. A.; Oluwasola, A. O.
Epidemiological evidence strongly suggests that steroid hormones are implicated in the pathogenesis of ovarian cancer. Estrogen receptor (ER) and Progesterone receptor (PR) are prognostic indicators for a number of epithelial tumors and may play the same role in ovarian cancers. This study aims to evaluate the expression of ER and PR in epithelial ovarian cancer (EOC) in an African population and compare it with other prognostic factors such as age, International Federation of Gynaecology and Obstetrics (FIGO) stage, grade and histological subtype. Methods: Ninety cases of histologically confirmed EOC were reviewed. Immunohistochemistry was used to assess their ER and PR expression status and was then compared with other demographic variables using statistical methods, with level of significance set at p < 0.05. Results: 30.2% and 8.3% of serous and mucinous carcinomas respectively were ER positive while 41.2% and 22.5% of both tumour types were PR positive. One of the two endometrioid carcinomas showed PR expression but neither were positive for ER. The only case of Brenner tumour in the series was ER positive but negative for PR. There was a significant association between ER and the histological subtypes (p = 0.042) while no significant association was found between PR expression and histological subtypes (p = 0.650). No significant association was found between hormone receptor status, age and stage of the EOC. Conclusion: The study showed a lower ER expression in serous carcinoma compared to large cohorts from developed countries. Future translational studies could be used to determine response of EOC to endocrine therapy.
Sudden death in giant pituitary adenomas: two case reports with literature review
(Wolters Kluwer - Medknow, 2017) Salami, A.; Babatunde, T.; Ogun, O.; Lawan, A.; Abubakar‑Akanbi, S.; Nweke, M.
Pituitary macroadenomas are rare tumors constituting <1% of intracranial tumors. The giant macroadenomas are even rarer and have the potential to cause fatality due mostly to mass effects within the intracranial space. Most cases are nonfunctional and are either null cell adenomas or gonadotroph adenomas in which symptoms may have been ignored by the patient. Sudden deaths from intracranial tumors are uncommon and pituitary adenomas are very rarely associated with unexpected deaths. Here, we present two cases of giant pituitary adenomas both of which were undiagnosed before demise of the patient. The autopsy report showed no other findings except the sellar tumor. Immunohistochemistry of both tumors showed null cell adenoma
Brain weights in adult africans
(The Brazilian Society of Anatomy (SBA), 2017) Salami, A.; Ajani, M.; Orhorho, I.; Ogun, G.; Adeoye, A.; Okolo, C.; Oluwasola, A.; Ogunbiyi, J.
Introduction: The average brain weight of adult humans, using Caucasian figures, is said to be between 1300g to 1400g. Few studies have however been done to make actual evaluations of brain weights in adult Africans. This study seeks to examine the weight of brains from people of African descent with respect to variations in sex and age in decades using autopsy specimens. Materials and Methods: Analysis of the weight of brains removed from both male and female adult patients during fresh autopsy of their bodies in our center over a ten year period was done. The study criteria required non-involvement of the central nervous system in the cause of death. The brains were grouped based on age in decades and further grouped into early, middle and late age groups. Descriptive statistical analysis was done using SPSS 20 statistics software. Results: A total of one hundred and sixteen brains were included in the study and the mean brain weight was 1280g with a range between 1015g to 1590g. There was no statistically significant difference in the mean brain weight of the different age groups. The average male brain was heavier than those of females and the difference was statistically significant. Conclusion: The brain weight of adult Africans in our study is similar to that seen in Caucasians. There is no statistically significant difference in the brain weight of adults from early adulthood to the elderly adults. Male adults have statistically heavier brains than the females
Solitary colonic neurofibroma in an African child
(SpringerOpen, 2018) Ogundoyin, O. O.; Ajani, M. A.
Neurofibromas are a group of heterogeneous neurocutaneous disorders. They are benign neoplasms consisting of neural and connective tissue components affecting any organ system. Gastrointestinal involvement in neurofibromatosis type 1 (NF1) are rare and are late manifestations of the disease, but in exceptional cases they can be the initial sign of neurofibromatosis in patients who have no external stigmata that arouse suspicion. Neurofibromatosis of the colon as a part of the NF1 is rare. Isolated colonic neurofibromatosis without other features suggestive of NF1 is rarely encountered in clinical practice. We report the case of a 12-year-old boy with an isolated colonic neurofibromatosis presenting with a right hypochondrial mass with no external features of NF1. We report this case as its presentation in children may give a diagnostic dilemma and the probability of malignant digestive disease associated with NF1 should be kept in mind, regardless of the age of the patient.