Pathology

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    Secondary ovarian neoplasms in a tertiary hospital in South-Western Nigeria
    (Association of Resident Doctors, University College Hospital, Ibadan, Nigeria, 2019) Ajani, M. A.; Iyapo, O.; Salami, A.; Okolo, C. A.
    Background: The ovary is a common site of involvement for metastases constituting 5-30% of all malignant ovarian neoplasms. Over half of these tumours are bilateral. The commonest sources are stomach, large bowel, appendix, breast, uterus (corpus and cervix) and lung. Aim: The aim of this study was to determine the histopathological pattern of metastases to the ovary at the University College Hospital, Ibadan, South western Nigeria. Material and Methods: This was a retrospective study. All histologically confirmed cases of metastases to the ovary from the records and files of the Department of Pathology, University College Hospital (UCH), Ibadan between January 1991 and June 2013 were used for the study. These were cases diagnosed following total abdominal hysterectomy, total abdominal hystero-salpingo oophorectomy, bilateral salpingo-oophorectomy, omentectomy, and multiple peritoneal biopsies and post-mortems at the University College Hospital between January 1991 and June 2013. Cases with inadequate clinical data and whose blocks and or slides could not be retrieved were excluded from the study. The data obtained were analysed using the Statistical Package for Social Sciences version 20 Results: There were 46 cases of metastases to the ovary constituting 5.3% of total ovarian neoplasms. Thirty (63.9%) cases were metastatic carcinomas with the affected patients’ age range of 20-79 years, and peak incidence within the age group of 30-39 years. Nineteen out of 30 cases of metastatic carcinomas were from adenocarcinoma of colon, 6 cases were from the gastric carcinoma while the remaining five cases were from the squamous cell carcinoma of the uterine cervix. Fifteen (31.9%) cases of Burkitt Lymphoma were found with patients with age range of 0-39 years, and the peak age of occurrence at the 2nd decade. The only case of metastatic Malignant Mixed Mullerian Tumour and metastatic Leiomyosarcoma were found in the 3rd and 4th decades of life respectively Conclusion: This study has shown that metastases to the ovary occur in younger age groups in our environment. Therefore this study emphasizes that in young females with ovarian masses, the likelihood of metastatic tumours should not be discarded because, correct and precise diagnosis of secondary ovarian malignancy is critical as it has significant implication on the patients’ choice of management and prognosis.
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    Distribution and characteristics of endometriotic lesions in South- Western Nigeria: A single institutional experience
    (African Journals OnLine, 2019) Ajani, M. A.; Salami, A.; Nwanji, I. D.; Olusanya, A. A.; Fatunla, O. E.
    Background: Endometriosis poses a significant burden mainly to women of child bearing age. Historically, endometriosis was thought to be of low prevalence among African women. However, recent studies have documented an increased prevalence than previously thought. This study aimed to determine the distribution and characteristics of endometriotic lesions among Nigerian women. Methods: A retrospective study of all histologically diagnosed cases of endometriosis from the records of the Department of Pathology, University College Hospital, Ibadan from 1st January, 1997 to 31st October, 2018.The age of the women, location and distribution of the lesions were analysed. Results: A total of 85 cases of endometriosis were diagnosed histologically in the period under review. The mean age was 35 years with an age range of 18 to 52 years. The most commonly affected age groups were those between 30-39 years (47.1%) and 20-29 years (30.6%). The most commonly affected site was the ovary (58.8%) followed by the umbilicus (11.9%) and fallopian tubes (9.4%). Fourteen patients (28%) had bilateral ovarian involvement. Left sided ovarian lesions predominated (61.1% versus 38.9%). Eighteen (21.2%) patients had lesions at more than one site frequently involving both ovaries. Conclusion: Endometriosis affected mainly women of childbearing age with particular predilection for the ovaries. Endometriosis affecting the umbilicus is not uncommon among Nigerian women.
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    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.
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    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.
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    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.