Chromosomal abnormalities in couples with recurrent abortions in Lagos, Nigeria

The study was to investigate the prevalence of chromosomal abnormalities in  couples with two or more recurrent miscarriages of unknown cause. The study  population included 55 women and 32 male partners with medical history of 2 or  more consecutive abortions and primary infertility. The controls were 20 healthy  couples with at least one live delivery and without a history of pregnancy loss.  Individuals with medical disease or reproductive organic abnormality were excluded from the study. Chromosomal analysis was performed on peripheral blood   lymphocytes cultured for 72 hours, using Trypsin-Giemsa (GTG) banding. In all cases, at least 20 metaphases were analyzed and 2 karyotypes were prepared, using light microscopy. Out of 78 cases of karyotype analyzed, 6 cases (7.7%) of abnormal chromosome karyotypes and two (2) Y chromosome variants (2.56%) were seen. No case of structural anomaly was seen. There was no case of  chromosomal abnormality seen among the control group in this study. The median age and age range of couples with recurrent miscarriages were 33 years and 28-42 years respectively for the females and 37 and 31-51 years for the males. The male to female ratio is 1:1. The most frequent age group of involvement is 35-39  (44.9%) followed by 30-34 (33.3%) and then 40-44(14.1%) Chromosomal  alterations affected most commonly age group 30-34(3.84%) followed by group 40-44 (2.56%). All the groups have equal average number of pregnancy wastage of 4 per couple. Of the 6 abnormal cases, 1 case (1.28%) each of the mosaic  Kleinfelter syndrome (XXY) and Superman (XYY) as well as 2 cases of   translocations made up of reciprocal and Robertsonian types. Also seen are 1case (1.28%) each of mosaic Turners syndrome and trisomy X. An association between chromosomal abnormalities and recurrent miscarriage of pregnancy was observed inthe study. Etiologic identification of genetic factors represents important clinical information for genetic counseling and orientation of the couple about the risk for future pregnancies and decreases the number of investigations needed to elucidate the possible causes of miscarriages.Keywords: Chromosomal abnormalities, recurrent miscarriages, Genetic counselling

Morphological Pattern of Childhood Solid Tumours in Lagos University Teaching Hospital.

Background: There is a wide variation in the incidence of childhood tumors world wide. The relative incidence of childhood tumors in developing countries is increasing and might add significantly to the high childhood morbidity and mortality caused by infectious diseases. There is need to determine the incidence of childhood cancer in different centers of the country and contribute to the National cancer register Objective: The aim of this study is to determine the burden and patterns of childhood tumour in our environment. Methods: A retrospective review of histologically diagnosed cases of childhood tumours seen from January 2000 to 2007 from the records of the department of Morbid Anatomy of the Lagos University Teaching Hospital (LUTH), Nigeria was carried out. All the cases were analyzed for age and gender distribution as well as histological types Results: Malignant tumours constituted 30.50% of the tumours of which retinoblastoma is the most common. The most common benign tumour was fibroadenoma accounting for 36.2% of all benign tumours. The female to male ratio for malignant and benign tumours are 1:1 and 1:1.3 respectively. The peak age incidence was 11 – 15 years for benign and 1 – 5 for malignant tumours. . Conclusion: The study showed decrease in the annual incidence of childhood tumours in Lagos. There was however no difference in the pattern when compared with other centers in Nigeria and in other African countries.Keywords: Morphology, Pattern, Childhood, Solid tumour

Chronic invasive fungal granulomatous rhino-sinusitis: a case report with review of literature

Fungal Rhino-Sinusitis (FRS) is a relatively uncommon entity. The chronic invasive granulomatous form of FRS (FGRS) is a slowly progressive form of fungal infection characterized by chronic granulomatous process with a time course of longer than 12 weeks. The aim of this report is to draw the attention of colleagues to the clinical presentation and histopathological diagnosis of FGRS of the paranasal sinuses, as differential diagnosis in lesions of the maxillofacial region. We present a 30-year-old Nigerian undergraduate who had a four-year history of right nasal blockage. He also presented with a two-year history of proptosis of the right eye. Clinical and radiological findings were reported to be consistent with nasopharyngeal tumour. A trans-nasal biopsy was, initially, histologically, diagnosed as chronic granulomatous inflammation However, after a second opinion, at our centre, the granulomatous lesion was confirmed. Periodic Acid Schiff (PAS) and Gomori Methenamine Silver (GMS) stains showed presence of numerous septate fungal hyphae, within the giant cells and extracellularly. An assessment of FGRS was made. The patient was commenced on voriconazole, and there was a dramatic regression. Fungal infection should be considered in patients with chronic sinusitis and, if they present late with, orbital apex syndrome. If diagnosed and treated early, there is a rapid response rate. Effective collaboration between the Surgeon, Radiologist, Microbiologist and Histopathologist will ensure early diagnosis.Keywords: Invasive Fungal Granulomatous Rhino-Sinusitis, PAS, GMS, Naso-Pharyngeal Tumo

Histopathological study of soft tissue malignancies in a teaching hospital, Sagamu, South-West Nigeria.

No Abstract

Cystic poorly differentiated nephroblastoma: A case report and review of literature

Background: Cystic poorly differentiated nephroblastoma (CPDN) is a rare variant of nephroblastoma which follows a benign clinical course. Case diagnosis/treatment: In this report, we document a case of CPDN in a 2 year old boy who presented with recurrent gross painless hematuria and progressive abdominal distension. Abdominal ultrasound showed a multicystic lesion and CT scan features of Stage III Wilms tumour. Nephrectomy was done after two cycles of chemotherapy according to the SIOP Nephroblastoma therapeutic protocols. Histology showed blastemal cells in the wall of only one of the cysts, with no solid expansile nodules. The patient had to have five more cycles of chemotherapy and also radiotherapy for residual tumour. Conclusions: Surgery is curative in Stage I CPDN and adjuvant therapy is not required. Adequate sampling is critical to ensure accurate diagnosis and appropriate management. We suggest that a minimum of 2–3 tissue sections should be taken per centimetre of tumour diameter. Related entities including cystic nephroma, cystic Wilms tumour and completely necrotic nephroblastoma are discussed in the differential diagnosis

Errata: Histopathological analysis of salivary gland tumors over A 10-year period, Lagos University Teaching Hospital

Errata:  Histopathological Analysis of Salivary Gland Tumors OverA 10-year Period, Lagos University Teaching Hospital *Akinde OR1, Awolola NA1, Odukoya LA,1 Bamigboye B,2 Adebayo LA,1 Olawuyi AB3 and AJAYI O

Vasoformative Neoplasms in a Teaching Hospital, Sagamu, Ogun State: A Histopathological Review.

Objective: To determine the pattern of occurrence and histopathologic characteristics of vasoformative tumours in Sagamu, South- West Nigeria, over a period of four years. Design: A cross-sectional retrospective study from January 2003 to December 2006. Setting: Department of Morbid Anatomy & Histopathology of Olabisi Onabanjo University Teaching Hospital, Sagamu with efficient laboratory services. Methods: All the pathological reports and slides of submitted vasoformative tumour biopsies were retrieved and reviewed. The relevant clinical information from the case notes, histopathology registers and reports included biodata of the patients, site of the lesions, and histological types were retrieved and analyzed. Results: Vasoformative tumours constituted 1.4% of all surgical biopsies and 37.7 % of all soft tissue tumours. Among the vasoformative tumours, 90.0% were benign and 20.0% malignant tumours. The male to female sex distribution was 0.8:1 for benign tumours with slight female preponderance whilst male preponderance existed in malignant vasoformative tumours. The age of patient ranged from 11days to 60years with peak age incidence in the age group 0-10 years. The mean ages for benign and malignant neoplasms were 18.0 years and 41.5 years respectively. Haemangiomas were the predominating benign vasoformative tumours (94.4%), of which the majority is capillary haemangioma. Angiofibroma was also seen in 5.5 % cases and located in the nasopharynx. Malignant vasoformative tumours accounted for 20.0% of vasoformative tumours, of which all were angiosarcomas. However, there was no case of Kaposi , sarcoma. Head and neck region are the most vulnerable anatomic sites for both benign and malignant vasoformative tumours in 70.0% and 50.0% cases respectively. No multicentric tumours were found in this series. Conclusion: Vasoformative tumours were common soft tissue tumours of childhood in Sagamu, South –West Nigeria. Haemangiomas were the most common vasoformative tumours and they share similar characteristics with those seen elsewhere. Also, there seems to be no relationship between malignant vascular tumours and AIDS infection but further future investigations will unravel this misery.KEY WORDS: Histopathological review, Haemangioma, Angiosarcoma