Pathology
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Item Diagnostic Utility of EMA, Vimentin and CD117 Immunohistochemical Markers in Subtyping Renal Cell Carcinoma in a Nigerian Tertiary Hospital: A 10-year Retrospective Study.(West African College of Physicians and the West African College of Surgeons, 2023) Nwadiokwu, O. O; Adegoke, M. A.; Ajani, C. A.; Okolo, B. L.; Awosusi, V. C.; Okebalama J. I.; Adegoke, O. O.; Ajani, M. A.; Okolo, C. A.; Awosusi, B. L.; Okebalama, V. C.BACKGROUND: Renal cell carcinoma is the most lethal urological cancer and contributes significantly to morbidity and mortality due to cancers of the urogenital tract. In routine diagnostic surgical pathology practice of renal tumours, immunohistochemistry is a helpful ancillary technique after routine H & E. The role of renal immunohistochemistry is explored in this study. MATERIALS AND METHODS: The paraffin-embedded tissue blocks of all the confirmed cases of renal cell carcinoma seen at the University College Hospital (UCH), Ibadan, during the 10-year study period of 2007 to 2016 were retrieved, sectioned and immunohistochemistry done using monoclonal antibodies for EMA, Vimentin and CD117 following standard protocols. Frequency statistics and chi-square were applied to data to determine proportions and associations using the Statistical Package for the Social Sciences (SPSS) version 23. RESULTS: A total of 48 cases of renal cell carcinoma were seen within the study period that met the inclusion criteria for the study. The age range of the patients was between 3 to 76 years with an average age of 44.17 years. The male-to-female ratio was 1:1.3. Fuhrman Grade 2 nuclei were predominant (43.75%) while Fuhrman Grade 4 nuclei had the lowest frequency (6.25%). EMAstaining patterns for the different histological patterns of RCC showed no statistically significant difference while Vimentin and CD117 staining patterns showed a statistically significant difference. There was no statistically significant difference observed between the staining patterns of all three markers and the nuclear grades of the cases of RCC. CONCLUSION: This study demonstrated the usefulness of Vimentin and CD117 in differentiating chromophobe variant of renal cell carcinoma from other subtypes while EMA showed variable expression across the various subtypes. WAJM 2023; 40(10); 1035 -1040.Item Prevalence and review of pathological anatomy of gestational choriocarcinoma in Ibadan(Journal Gurus, 2022) Awosusi, B. L.; Ajani, M. A.; Adegoke, O. O.; Salami, A. A.; Okolo, C. A.Objectives: Gestational choriocarcinoma (GCC) is a highly malignant epithelial tumor arising from the trophoblast of any type of gestational event, most often a complete hydatidiform mole. Choriocarcinoma is the most aggressive form of gestational trophoblastic neoplasia owing to their rapid growth and metastatic potential. This study reviewed all cases of GCC seen at the University College Hospital Ibadan. Methods: This was a 20 year retrospective hospital-based study designed to review all histologically diagnosed cases of choriocarcinoma registered at the Department of Pathology, University College Hospital (UCH), Ibadan, Nigeria, from 1st January, 1997 to 31st December, 2016. Clinicopathological data was extracted from the departmental surgical day book, Ward register, Department of Medical Records and Cancer Registry. The data was analyzed using the Statistical Package for Social Sciences, version 22. The results were presented in tables, relative frequencies and group percentages. Results: One hundred and eighty three cases of gestational trophoblastic disease were histologically diagnosed within the study period out of which 36 cases were GCC accounting for 19.7%. 55.6% of all the cases were received as endometrial biopsies, 33.3% as hysterectomy specimens, 8.3% as cervical biopsies and 2.8 as an anterior vaginal wall mass. Choriocarcinoma occurred in the age range 20 to 50 years with majority of cases occurring in the third decade of life. Conclusion: Gestational choriocarcinoma is still the most common gestational trophoblastic neoplasia seen in our environment. Awareness of this tumour with a high index of suspicion is needed for an accurate diagnosis and patient management.Item Overexpression of human epidermal growth factor receptor 2 protein in urothelial carcinoma of the urinary bladder in Ibadan: a single-institutional experience(Faculty of pathology, national postgraduate medical college of nigeria, 2020) Fatunla, E. O.; Ajani, M. A.; Onakpoma, F. A.; Takure, A. O.; Okolo, C. A.Background: Overexpression of human epidermal growth factor receptor 2 (HER 2) protein has been shown to have both prognostic and therapeutic values in several malignancies including urothelial carcinoma of urinary bladder (UCB). Aims: This study aimed to determine HER 2 protein overexpression and evaluate its correlation with clinico pathological parameters in UCB. Materials and Methods: This was a descriptive-analytical study involving the immunohistochemical review of all histologically diagnosed urinary bladder malignancy in the Department of Pathology, University College Hospital, Ibadan, between January 2002 and December 2016. Urinary bladder malignancies whose tissue blocks could not be found and/or demographic data were not available were excluded. Immunohistochemistry analysis was done using rabbit anti HER 2 antibody (Biocare) and American Society of Clinical Oncology/College of American Pathologists guidelines established for breast cancer were used for HER 2 status scoring. The statistical analysis was carried out usingthe Statistical Package for the Social Sciences, version 22 (SPSS Inc, Chicago, Illinois, USA). Results: HER 2 overexpression was found in four (6.3%) cases. All the HER 2 positive cases were males. One (2.9%) of the 35 high grade UCB showed positive HER 2 overexpression, whereas three (10.7%) of the 28 low grade tumor were positive for HER 2 protein overexpression.There was no statistically significant association between HER 2 protein overexpression and histological grades of UCB and muscle invasion by the tumor. Conclusion: Our study demonstrated the low percentage of HER 2 overexpression in UCB with no significant association with tumor grades and muscle invasion. Larger samples involving multiple centers can provide more robust information and further evaluate HER 2 overexpression in urothelial carcinoma in our environment.Item P57kip2 immunohistochemical marker as a diagnostic tool for cases of hydatidiform moles in a tertiary health facility in southwestern Nigeria(National Postgraduate Medical Journal, 2020) Awosusi, B. L.; Ajani, M. A.; Adegoke, O. O.; Salami, A. A.; Okolo, C. A.Background: Hydatidiform mole (HM) is the most common gestational trophoblastic disease. P57kip2 has been reported to be helpful in differentiating between partial and complete HMs. Objectives: The study aims to evaluate the P57kip2 immunohistochemical (IHC) marker as a useful ancillary investigation to differentiate complete hydatidiform mole (CHM) from partial hydatidiform mole (PHM). Materials andMethods: Aretrospective study of all histologically diagnosed HM cases over a 20 year period was undertaken. Clinicopathological parameters were extracted from the surgical day book and medical record archives. Archival haematoxylin- and eosin-stained slides and formalin fixed paraffin embedded tissue blocks of all cases of HM diagnosed within the study period were retrieved and reviewed. Cases of HM were reclassified using the P57kip2 IHC marker. The data obtained were analysed using the SPSS version 23. Results: One hundred cases of HMs were studied. CHM accounted for 68%, while PHM accounted for the remaining 32%. The incidence of HM was 2.98 cases per 1000 deliveries. The ratio of CHM to PHM was found to be 2.1:1. Seventy two per cent of the cases were diagnosed in the first trimester, while the remaining 28% were diagnosed in the second trimester of pregnancy. Based on the P57kip2 IHC staining pattern, HM cases were finally reclassified into 68 cases of CHM and 32 cases of PHM. The age range for all the HM cases was 18–50 years with the majority of the cases seen in the third and fourth decades of life. Conclusion: P57kip2 could be useful as an ancillary investigation in confirming the diagnosis of CHM and differentiating it from PHM, particularly in difficult and challenging cases.Item Hormonal receptor expression in endometrial carcinoma: a retrospective immunohistochemical study in a Nigerian tertiary hospital(Medknow, 2022) Odetola, S. S.; Ajani, M. A.; Iyapo, O.; Salami, A. A.; Okolo, C. A.Background: Endometrial carcinoma is the commonest genital tract malignancy in most developed nations, but it lags behind cervical carcinoma and ovarian cancers in most developing nations including Nigeria. Estrogen has been described as a promoter of endometrial carcinogenesis. Objectives: The aim of this study was to demonstrate the frequency of estrogen receptor (ER) and progesterone receptor (PR) expressions of endometrial carcinoma and to correlate it with tumour grade. Materials and Methods: Cases of endometrial carcinoma diagnosed in the Department of Pathology over a 10-year period were reviewed retrospectively. The paraffin-embedded blocks were retrieved, and immunohistochemistry for ER and PR was performed on them. Haematoxylin and eosin (H&E) slides were reviewed, and tumours were graded by three independent pathologists. Data were analysed using SPSS version 22. The level of significance was set at P ≤ 0.05. Results: There were 44 cases of endometrial carcinoma. ER and PR were positive in 29.5% and 18.2% of endometrial carcinoma, respectively. There was no significant association between ER (P = 0.361) and PR (P = 0.204) expressions and histological grade of the tumour. The most common histological grade was grade 3 with 70% of cases (36 cases), whereas 13 cases (26%) were grade 2 and only 2 cases (4%) were grade 1. Conclusion: The positive expressions of ER and PR in endometrial carcinoma suggest that steroid receptor studies may be of potential benefit in the management of some patients with endometrial carcinoma. Future studies employing larger sample size are therefore recommended.