Az Mohammed

A histopathologic study of salivary gland tumors in Kano, northern Nigeria.

Significant differences in the global distribution of salivary gland tumors have been reported, but no formal study has been carried out here in Kano, the largest city in northern Nigeria. We therefore undertook this eight-year retrospective study of all histologically diagnosed salivary neoplasms at the histopathology laboratory of our referral teaching hospital in Kano. Seventy-eight salivary gland tumors were diagnosed during the eight-year study period accounting for 0.4% of all neoplasms. Benign tumors were more prevalent, comprising 56.4%, while malignancies were 43.6%. Pleomorphic adenoma and mucoepidermoid carcinoma were the commonest histological types constituting 48.7% and 23.1% respectively, while the most frequent sites were parotid, submandibular and minor salivary glands accounting for 49%, 26% and 24% respectively. As in most studies of black populations there were no adenolymphomas. Age distribution was bimodal with a benign peak in the third decade and a malignant peak in the sixth. Our findings were broadly similar to most other African reports but somewhat at variance with Western literature. Improved hospital attendance with more comprehensive reporting would yield more representative data.

Pathology of peripheral lymph node biopsies in Kano, Northern Nigeria

BACKGROUND Lymphadenopathy is a common clinical problem here in Kano, Northern Nigeria but there has been no formal study. We therefore undertook this review to evaluate the pattern in our locality. METHOD This is a seven-year (1998-2004) retrospective review of all histologically diagnosed lymph node biopsies received at Aminu Kano Teaching Hospital, Kano. RESULTS Cervical, axillary and inguinal nodes were the most frequently biopsied accounting for 46%, 23% and 13%, while tuberculosis, lymphomas and metastases were the most commonly diagnosed lesions comprising 30%, 24% and 19% respectively. In general, benign lesions were more common constituting 57% of nodal biopsies. Lymphadenopathy was observed to be most prevalent in the first three decades. CONCLUSION Our findings were broadly similar to most other Nigerian studies and slightly at variance with other African countries but significantly different from the Western World. The limitations of lymph node histopathology in the absence of modern molecular diagnostic techniques are highlighted.

Xanthoma disseminatum in a black African woman

Purpose  To report a partial steroid response of xanthoma disseminatum in a black African woman. Design  Case report and literature review. Methods  Histopathologic study of cutaneous tumour and clinical follow-up. Results  A 32-year-old black African woman with mucocutaneous xanthomatosis and dysphonia, which partially responded to treatment with steroids. Conclusions  Xanthoma dissseminatum is a rare condition for which there is no medical treatment. We reported the condition in a black African woman whose skin and CNS symptoms regressed remarkably within 22 weeks of steroid therapy.Purpose  To report a partial steroid response of xanthoma disseminatum in a black African woman.

Dyschromatosis universalis hereditaria in a young Nigerian female

Dyschromatosis universalis hereditaria (DUH) is a clinically heterogeneous disorder that shows generalized mottled pigmentation. It occurs most commonly in Japanese persons, with sporadic reports from South Africa, India, and Iraq. Histopathology reveals a variable degree of pigmentary incontinence. Although the precise etiology of this disorder is not yet known, the clinicopathological findings implicate an inherent abnormality of melanosomes or melanin processing. We describe a case in a young Nigerian girl.

Intraoperative colonic lavage in emergency surgical treatment of left-sided large bowel lesions.

There has been a trend towards resection and primary anastomosis after on-table lavage in patients with left sided colonic emergencies. This study will analyse the outcome in our centre. Thirty-two patients underwent the operation for various lesions of the left colon and the rectum between December 1998 and December 2002. The mean age of the patients was 37.7 ± 11.1 years. Mean extra time for the procedure was 37.4 ± 5.2 min. The mean hospital stay was 11.2 ± 2.9 days. Postoperative complications included four cases (12.5%) of wound infection, and one (3.1%) right sub-phrenic abscess. No clinical anastomotic leakage or mortality was recorded. This study shows that primary anastomosis with on-table colonic lavage can be a safe procedure in selected, low risk patients.

Ichthyosis hystrix Curth-Macklin type in an African girl.

Ichthyosis hystrix Curth–Macklin type is a rare autosomal dominant skin disorder characterized by extensive hyperkeratosis and palmo‐plantar keratoderma. It results from heterozygous frameshift mutation in keratin 1 gene (KRT1). Histological features, showing perinuclear vacuolization and binucleated cells, are similar to those of epidermolytic hyperkeratosis except for the absence of epidermolysis. The present report describes the condition in a 16‐year‐old African girl where available treatment was disappointing.

Immunohistochemical study of epithelial-myofibroblast interaction in Barrett metaplasia

CONTEXT Sub-epithelial myofibroblasts are known to influence the biology (proliferation, differentiation and apoptosis) of overlying epithelia. In the intestine, myofibroblasts have been demonstrated to be essential for epithelial differentiation. It is therefore hypothesized that myofibroblasts may also be involved in intestinal metaplasia that is characteristic of Barrett esophagus. OBJECTIVE This study endeavors to immunohistologically evaluate epithelial-myofibroblast interaction in Barretts metaplasia. MATERIALS AND METHODS Nineteen archival esophageal endoscopic biopsies of Barretts metaplasia were immune-phenotyped for the following epithelial and myofibroblast antigens - cytokeratins (CK) 8, 13, 18, CDX2 (Caudal type homeobox 2), a-smooth muscle actin (SMA). RESULTS alpha-SMA immunostaining revealed close association between myofibroblasts and metaplastic Barretts epithelium but not with normal esophageal squamous epithelium. Myofibroblasts were more prominent in dysplastic than in non-dysplastic Barrett metaplasia. CDX2 and CK 8/18, indicators of intestinal differentiation were expressed in Barrett metaplasia but not normal esophageal squamous epithelium, while the reverse was the case for CK 13, which only stained normal esophageal squamous epithelium. CONCLUSION Although their precise role is yet to be clearly defined, sub-epithelial myofibroblasts are very likely involved in the pathogenesis of Barretts metaplasia.

Histopathological study of soft tissue sarcomas seen in a teaching hospital in Kano, Nigeria

Background and Objective: Malignant soft tissue tumours account for less than 1% of overall human burden of malignant tumours. Increasing incidences of these tumours have been noted worldwide. This study aims to determine the pattern of soft tissue sarcomas seen in a teaching hospital. Materials and Methods: The study comprised of all cases of soft tissue sarcoma diagnosed over a 10-year review from 1 January 1999-31 December 2008. Results: A total of 264 cases of soft tissue sarcomas were reviewed; 162 males and 102 females with a male to female ratio of 1.6:1. The age range was between 3 months and 89 years with a mean age of 39.0 years. Kaposi sarcoma was the predominant histological type with 56 cases (21.2%). This was followed by rhabdomyosarcoma with 54 (20.5%) cases, dermatofibrosarcoma with 52 (19.7%) cases and liposarcoma with 32 (12.0%) cases. The most common site of affectation was the lower limb with 73 (27.7%) cases, followed by the trunk with 66 (25.0%) cases, head and neck with 45 (17.0%) cases and upper limb with 35 (13.3%) cases. Two hundred and eight cases satisfied the criteria for grading, out of which 34.1% were classified in grade I, 32.2% in grade II and 33.7% in grade III. Conclusion: Soft tissue sarcomas accounted for 8.8% of malignant tumours seen over the review period and Kaposi sarcoma was the predominant histological subtype commonly affecting young adults in our centre.

Histopathological review of breast tumors in Kano, Northern Nigeria

Context: Breast tumors are common worldwide, and various reports suggest an increasing incidence in Nigeria, which necessitates an urgent need to differentiate benign from malignant tumors. Aims: To classify, grade and to determine the changing pattern, frequency, age and sex distribution of breast tumors seen in a tertiary hospital. Materials and Methods: This was a 10-year retrospective study of all breast tumors diagnosed at the Pathology Department of a Teaching Hospital from 1 January 2001 to 31 December 2010. Results: A total of 1,566 breast tumors were diagnosed during the study period, of which 1035 (66.1%) were benign, and 531 (33.9%) were malignant. Fibroadenoma was the commonest benign breast tumor followed by fibrocystic change, and they accounted for 47.1% and 25.4% of benign breast tumors respectively. Out of the 531 malignant cases reviewed; 496 (93.4%) were females, and 35 (6.6%) were males with a female to male:ratio of 14.2:1.0. The age range of malignant cases was between 21 and 79 years with a mean age of 42.0 years. Invasive ductal carcinoma was the predominant histological type with 316 cases (59.5%). This was followed by medullary carcinoma with 61 (11.5%) cases, invasive lobular carcinoma and invasive papillary carcinoma each with 37 (6.9%) cases. Three hundred and ninety-eight cases satisfied the criteria for grading, out of which 237 (59.5%) cases were classified in Grade 1, 133 (33.4%) cases in Grade 2 and 28 (7.1%) cases in Grade 2. Conclusions: Breast tumors are quite common which are mostly benign and are seen in both sexes with a striking female preponderance. The findings are generally similar to most previous studies from Nigeria, Africa and western world with minimal variations.

Leiomyoma of the thyroid gland with psammoma bodies

We report a rare case of leiomyoma of the thyroid gland associated with psammoma bodies. The patient was a 9-year-old black African boy. Prior to this, only five cases of primary thyroid leiomyoma have been reported. Histologically, thyroid leiomyoma was characterised by bundles of spindle smooth muscle cells with blunt-ended nuclei. Psammoma bodies were widely distributed within the tumour. Immunohistochemistry showed positive immunoreactivity for smooth muscle actin, vimentin and desmin, but was negative for a cytokeratin cocktail. Further reports of similar cases is required to ascertain the clinical significance of this lesion.