Pathology
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Item A surveillance of estrogen receptor (er), progesterone receptor (pr) and human epidermal growth factor receptor-2 (her-2) status in malignant female breast lesions in Bayelsa state, Nigeria.(IJSER Publishing, 2019) Oduma-Sandy, C. I.; Achukwu, P. U.; Ajani, M. A.A three (3) year retrospective study of Estrogen Receptor (ER), Progesterone receptor (PR) and Human Epidermal growth factor receptor-2 (HER2) status of previously diagnosed female breast cancers was done using immunohistochemistochemistry. Formalin fixed paraffin embedded (FFPE) tissue blocks of breast cancer cases from 2009-2011 were retrieved from the tissue block archives of the two major tertiary health institutions in the state; Federal Medical Centre, Yenagoa and Niger Delta University Teaching Hospital, Okolobiri. The result of this research work revealed the incidences of the receptor status as it occurred among 36 malignant female breast lesions in Bayelsa State as follows; ER+ve=13.8%, ER-ve=86.2%, PR+ve=19.4%, PR-ve=80.6%, HER2+ve=33.3% HER2-ve=66.7%, TR+=13.3% while TR-=55.7%. The statistical analysis of the result revealed that no significant relationship exists between the various age groups and the respective incidences of the receptor status. In the same vein, no significant relationship exists between the respective histopathologic diagnosis of the samples used and the incidences of the respective receptor status except for ER+ve and ER-ve whose incidences were found to have a significant relationship with the histopathologic diagnosis. This by implication means that the incidences of ER+ve and ER-ve respectively maybe dependent on the histopathologic diagnosis at P < 0.05. In conclusion, it is worthy of note here that while researches are on to tackle cancers and breast cancer in particular, there is need for even distribution of IHC facility or other molecular studies in the nation because of its role in breast cancer prevention strategies and patient management.Item 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.Item 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.Item 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.Item 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.Item 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.Item 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.Item 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.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.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.Item 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.