Lymphomas of the female genital tract in Ibadan

Context: Female genital tract cancers are second only to breast malignancies. Cervical cancer is the commonest while epithelial cancers constitute the major histologic type. Lymphoid neoplasms are extremely rare, with the Burkitt's variety accounting for majority of cases seen in the African female.Objective: This is a review of the obstetric/gynaecological patients seen at the University College Hospital, Ibadan between 1976 and 2005, predating the commencement of a nationwide research into non – Hodgkin's lymphoma funded by the Aboderin Foundation.Study Design: Records of subjects were analysed for their  sociodemographic and clinicopathological characteristics, recruiting only those who satisfy the criteria for diagnosing genital tract lymphomas according to Kosari et al1. Retrievable archival paraffin blocks of subjects were also analysed using immunophenotyping.Results: Fifteen cases were identified within the study period; the highest yearly incidence rate being 3 in 1977. In eighteen of the years studied no cases were seen. Most cases (80.0%) occurred in the ovaries. Eighty percent (12) of patients were 25 years or below and nulliparas and grandmultiparas formed 46.7 and 13.4% respectively. Unilateral orbilateral oophorectomy was the commonest surgical procedure (53.3%) while 20.0% had total abdominal hysterectomy with or without bilateral salpingoophorectomy. Data were unavailable concerning use of adjuvanttherapy and outcome of treatment. Four archival paraffin blocks were available for immunophenotyping using the affordable panel of CD20, CD10 and Bcl – 2 antibodies; all were Burkitt's lymphoma.Conclusion: Female genital lymphomas are very rare, affecting the young and nulliparous. The Burkitt's type is commonest

Anaesthesia and Sickle Cell Disease

A review of adult patients with Haemoglobinopathy who had anaesthesia and surgery at the University College Hospital, Ibadan over a three year period was carried out. The 53 patients constituted 1.2% of all surgical cases operated. Two thirds of the patients were ASA II with the rest being ASA III and ASA IV. The steady state PCV of all patients ranged from 22% to 31% with a mean of 26.4% and general anaesthesia was administered in 83% of the patients while the others had their operations under regional blocks. Peri-operative course was satisfactory in all but two patients (3.8%) who were admitted in the Intensive Care Unit for close observation because of excessive oozing from operation site. Adequate post-operative care including hydration, analgesia, warmth, and blood transfusion when appropriate, ensured minimal post operative morbidity. These observations emphasize the fact that surgical patients with sickle cell disease do have satisfactory outcome when meticulous attention is paid to details of their peri-operative care. Nigerian Quarterly Journal of Hospital Medicine Vol. 9, No. 1 (1999) pp. 21-2