Ochicha

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.

Pediatric malignancies in Kano, Northern Nigeria

BackgroundWith effective immunization control of several devastating childhood infections in the developing world, non-infectious diseases such as malignancies have become increasingly important causes of pediatric morbidity and mortality. Therefore this 10-year retrospective study was undertaken to evaluate and document the pattern of childhood cancers in our locality.MethodsWe reviewed 438 childhood (≤15 years) malignancies diagnosed at the histopathology and hematology laboratories of our teaching hospital in a 10-year period (2001–2010).ResultsThe 438 malignancies comprised 10.9% of all cancers. The maligancies frequently seen in early childhood (0–4 years) accounted for 46.1% and in late childhood (5–9 years) for 34.7%. Retinoblastoma (30.6%), Burkitt lymphoma (19.9%) and acute leukemia (16.9%) were the most common pediatric cancers. Unlike in most other parts of the world, acute myeloid leukemia was slightly more prevalent than acute lymphoblastic leukemia.ConclusionsAlthough there were notable differences, our fi ndings were in broad agreement with those of most other sub-Saharan African series, but differed markedly from those in the Western world and other high income countries. Further studies are required to identify the environmental factors for the high prevalence of nonfamilial retinoblastoma and possibly acute myeloid leukemia.

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.

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.

Bilateral synchronous mature ovarian teratoma and mucinous cystadenoma

Published reports of different synchronous tumours in both ovaries are scanty, and the few reported cases are mostly malignant. This report of synchronous benign tumors in both ovaries occurred in a 26 year old female who presented with one year history of painless abdominal swelling and two large multicystic masses on ultrasound scan. She had bilateral oophorectomy and histology revealed right sided benign cystic teratoma and left sided mucinous cystadenoma. Conclusion: Both tumours were benign and therefore potends no adverse consequences for the patient. Nonetheless, given the unusual presentation, she is being followed up.

A review of the utilization of fine needle aspiration in clinical practice and research in Nigeria

Background: Research and publications are critical to advancements in the quality of healthcare delivery. This article attempts to highlight the prospects and challenges of fine needle aspiration (FNA) cytology as a tool for research in Nigeria. Materials and Methods: Data available in local and international bibliographic databases for the period 1986–2005 (20 years) were collated and analyzed. Results: The theme of Nigerian FNA-focused studies correlated with the recognized disease patterns in the country which are tuberculous lymphadenitis, breast tumors and Burkitts lymphoma. The accuracy of FNA in these situations was high and comparable to the experience in developed countries. It was found that the total number of articles published during two contiguous periods (1986–1995 and 1996–2005) had increased from 5 to 18. Also, in majority of cases, the articles were not published in specialized pathology journals. Conclusions: The utilization of FNA is apparently lagging in Nigeria. Given its potential in resource-constrained settings, we are of the opinion that it should be used more often in clinical and translational research.

Update on bladder cancer in Kano, Northern Nigeria

Background: A pilot study of 89 cases published 13 years ago (2003) revealed that bladder cancer was the second most common urologic malignancy in Kano with squamous carcinoma as the most frequent type (53%), with the peak prevalence in 5th/6th decades and an overwhelming male preponderance (M:F = 5.2:1). This study endeavors to update on developments in bladder cancer profile since then. Materials and Methods: This was a 15-year (2001–2015) retrospective review of all histologically diagnosed bladder cancers at Aminu Kano Teaching Hospital, Kano. Results: Three hundred and twenty-seven bladder cancers were diagnosed during the study period. Peak age groups were the 5th and 6th decades, with a mean of 51.2 years (±SD 11.74) and a male preponderance (7.6:1). Urothelial carcinoma was the most common histological type (49.6%), followed by squamous carcinoma (44.6%). Conclusion: Larger more representative sample size (327 cases) in this study compared to the earlier one (89 cases) 13 years ago largely accounted for the observed modest changes in histologic types, age, and sex distribution. Although the changes are modest, the general trend is towards that of the developed world – increasing urothelial carcinomas and increasing age profile.

Skin adnexal tumours in Kano, Northern Nigeria

Background and Objective: Tumours of skin adnexae are an uncommon group of neoplasms that have not been formally studied in our locality. We undertook this review to document and evaluate the pattern in Kano, northern Nigeria. Materials and Methods: This is a 10-year (2004-13) retrospective study of all skin adnexal tumours diagnosed at the pathology department of Aminu Kano Teaching Hospital (AKTH), Kano. Results: Ninety-two skin adnexal tumours were diagnosed during the study period, and there was no significant gender predilection - males (49%), females (51%). The overwhelming majority were benign (86%), while malignancies comprised just 14%. Patients ranged from 4 to 90 years of age, peaking in the third and fifth decades. The most common histological types were nodular hidradenoma (17.4%), eccrine poroma (9.8%) and pilomatrixoma (9.8%), with sebaceous carcinoma (5.4%) as the most frequent adnexal malignancy. The tumours were most commonly located in the head and neck region (52%), followed by the trunk (25%) and extremities (23%). Conclusion: Skin adnexal tumours are relatively uncommon in Kano affecting predominantly people in the third and fifth decade without a definitive sex predilection. Most of the tumours showed sweat gland differentiation with nodular hidradenoma and sebaceous gland carcinoma being the most common benign and malignant tumours, respectively.

A pathologic review of ophthalmic tumors in Kano, Northern Nigeria

Background and Objective: Tumors of eye and ocular adnexa are reported to be common in Africa, but no formal study has been conducted here in Kano, the largest Northern Nigerian city. This study is a documentation of the pattern of ophthalmic tumors in our locality. Materials and Methods: This was a 12-year (1999-2010 inclusive) retrospective study of all orbito-ocular neoplasms diagnosed at the pathology department of a teaching hospital. Results : 438 ophthalmic tumors were diagnosed during the study period, of which 79.7% were malignant and 20.3% benign. Males were slightly more preponderant with M/F ratio of 1.3:1. Retinoblastoma and conjunctival squamous carcinoma were the commonest tumors respectively comprising 44.5% and 18.9%. These two ocular malignancies also largely accounted for the bimodal age distribution peaks of ophthalmic cancer in the 1 st and 4 th decades. Conjunctival squamous papilloma and hemangioma were the most prevalent benign ophthalmic tumors. Conclusion : Our findings were broadly similar to most other Nigerian and African studies but significantly at variance with those of the western world.

Inflammatory cervical smears and infection in Kano, Northern Nigeria

Background : Inflammation is commonly present in cervical smears for screening of pre-malignant lesions. This study was done to identify microbial pathogens responsible for the inflammation. Materials and Methods : This was a prospective study of cervical smears and endocervical swabs from patients at the gynecology, postnatal, and general outpatient clinics of Aminu Kano Teaching Hospital over a 4-month period. Results : A total of 421 women between the ages of 17 and 80 years were recruited for the study, but most (95%) were premenopausal ( Conclusion : As in most published studies, cervical inflammation did not correlate with infection as infection also commonly occurs in patients without inflammatory smears. This renders patient management problematic for gynecologists. Further research is, therefore, required to clarify the microbial and non-microbial causes of cervico-vaginal inflammation.