Pathology
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Item Pediatric meningiomas in Southwestern Nigeria: A single-institutional experience(Elsevier Inc., 2019) Salami, A. A.; Okunlola, A. I.; Ajani, M. A.; Adekanmbi, A. A.; Balogun, J. A.BACKGROUND: Meningiomas are the second commonest intracranial tumors in many places worldwide. They are rare in the pediatric age group, however, and most studies have been able to document only a few patients. Meningiomas in pediatric patients have also been shown to behave differently from those in the adult population. This study was done to examine histologic types of meningiomas seen in pediatric patients from a predominantly African population using the 2016 World Health Organization (WHO) grading system for intracranial tumors. METHODS: Data from the operating logs of patients and histology reports of the samples sent to the pathology department during the study period were extracted. The data obtained were the age, sex, location of the intracranial tumor, histologic diagnosis, WHO grade, and tumor recurrence. RESULTS: Nine pediatric age patients were found among the 166 surgically excised meningiomas received at the pathology department in our institution over a 19-year period. The age range was from 8 months to 17 years. There was a male-to-female ratio of 1:2 with a female predominance. Six tumors were basally located. All tumors were WHO grade I, with transitional meningiomas being the commonest, followed by meningothelial. There was no history of recurrence in any of the tumors after complete surgical excisions. CONCLUSIONS: Our study showed the rarity of meningiomas in the study population, and there was a predominance of basally located tumors.Item Paediatric bilateral thalamic glioma: Case report and literature review(Elsevier B.V., 2019) Badejo, O. A.; Osobu, B. E.; Salami, A. A.; Adeyinka, A. O.; Shokunbi, M. T.1. Introduction Primary thalamic tumours are rare [1]. They account for 1–1.5% of all brain tumours and approximately a quarter of them occur in children younger than 15 years [2,3]. Bilateral thalamic gliomas (BTGs) are extremely rare sub-types of thalamic tumours, which are known to have a poor outcome regardless of the treatment modality [4]. About 70 cases have been reported so far in the literature [5]. We present the outcome of treatment of BTG in a three-year-old Nigerian child and a brief review of the literature on these uncommon types of central nervous system tumours. 2. Case Presentation A three-year-old right-handed boy presented with headache, abnormal gait, and inability to sit unsupported of one week duration. There was an associated history of drowsiness, excessive sleeping, and multiple episodes of projectile vomiting. Examination revealed a young boy who was fully conscious but drowsy. His pupils were of normal size but reacted sluggishly to light. He had bilateral abducens nerve palsies, bilateral papilloedema, global hypertonia/hyperreflexia, and bilateral extensor plantar responses. He also had truncal ataxia and dysmetria but no sensorimotor deficit. Examination of other systems revealed normal findings. A clinical diagnosis of acute onset raised intracranial pressure from an infratentorial space-occupying lesion was made. Cranial computed tomography scan showed bilateral symmetrical enlarged thalamic nuclei which were hypodense to isodense and non-contrast enhancing (Fig. 1a and b). There was associated obstructive hydrocephalus. Brain magnetic resonance imaging showed bilateral symmetrical non-enhancing masses involving both thalami (with estimated volumes of 40.17 cm³ on the right and 44.84 cm³ on the left). These were hypointense on T1-weighted images and hyperintense on T2-weighted and FLAIR images. There was associated dilatation of the lateral ventricles and effacement of the quadrigeminal/ambient cisterns bilaterally (Fig. 2a–d). A radiological diagnosis of a bilateral thalamic tumour was made. The patient's management was multidisciplinary, involving the neurological surgery, radiology, pathology, paediatric oncology, and radiation oncology teams. A biopsy specimen obtained via an endoscopic transventricular route showed features of a WHO grade II diffuse astrocytoma (Fig. 3a–c). He subsequently received sixteen courses of Vincristine/Carboplatin chemotherapy, which was later changed to Etoposide/Cisplatin on account of clinico-radiological evidence of tumour progression. He had cerebrospinal fluid diversion (via a ventriculoperitoneal shunt) five months after the initial procedure due to worsening hydrocephalus (Fig. 4a–c). The second-line chemotherapeutic agents were discontinued after the third cycle on request by the patient's mother because of their side effects (bone marrow suppression, widespread dermatitis, recurrent chest infection). Radiotherapy was considered unsafe in this patient given his age and the potential for radiation-induced neurocognitive decline (on the advice of the radiation oncology team). Repeat neuroimaging at six months following the initial surgery showed further tumour progression with involvement of the caudate nuclei and brainstem, and extension into the lateral ventricles (Fig. 5a–c). Attempts at switching his chemotherapeutic agents were futile due to non-availability of the drugs. At nine months post tumour biopsy, he had recurrent headache and vomiting, expressive aphasia, worsening gait imbalance, ataxia, paraparesis, bilateral ptosis, upgaze paresis, and choreoform movements. He subsequently defaulted follow-up.Item Protein Quality, Haematological and Histopathological Studies of Rats Fed with Maize-based Complementary Diet Enriched with Fermented and Germinated Moringa Oleifera Seed Flour(Juniper Publishers, 2018) Adeoti, O. A.; Osundahunsi, O. F.; Salami, A. A.This study is about the production of Maize-based complementary diet enriched with fermented and germinated moringa oleifera seed holds great promise in alleviating malnutrition so prominent among Nigerian children less than five years. However, there is scanty scientific information on its protein quality and safety which is necessary prelude to trials on human subjects. This study hence reports a controlled feeding trial involving 30 weanling wister rats housed in individual standard metabolic cages under room temperature condition. Following a subsequent daily feeding of the rats for 28 days, the protein quality of the diet with the haematological and histological studies was conducted. Results showed that the diets had a statistically significant effect on the growth rate on the test rats when compared with the control. The protein quality evaluation of the diets showed that the protein efficiency ratio ranged from 2.10 to 2.38 while the biological value ranged from 62.01 to 89.01 %. The true protein digestibility and protein rating were 55.79 to 79.25 % and 35.42 to 48.61 respectively. The relative weight of organs of the rats fed with the complementary diets showed that the weights of the kidney and liver ranged from 0.57 to 0.76g and 2.87 to 3.60g respectively. The growth performance of the rats fed with the formulated complementary diets showed that the formulated diets contributed to the growth status of the animals indicating that protein quality of the diets could support the growth and development of the infants. The haematological indices showed that the packed cell volume of the sample ranged from 36.67 to 40.67% and the red blood cell counts was 5.00 to 5.93 (×106 mm3). The white blood cell counts ranged from 3.47 to 3.98 (×103mm3) while the mean corpuscular haemoglobin and mean corspucularhaemoglobin concentration ranged from 10.04 to 11.71Pg and 33.10 to 33.45% respectively. Moreover, rat’s biopsy (histopathology) revealed no necrosis in the observed livers of the rats fed with the diets. Evidently, ogi-fermented moringa oleiefera seed complementary diet has no established detrimental effect and may therefore be safe for humansItem 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, EIntroduction: 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 servicesItem 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.Item 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.Item 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.Item 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.Item 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.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.