Malignant skin tumors seen in Nigeria Nnamdi Azikiwe University Teaching Hospital Nnewi: A 10-year review (January 2008 to December 2017)

Background: Skin malignancy rank among the most common malignancies involving both sexes. Basal cell carcinoma is reported as the commonest malignancy even though studies have implicated Squamous cell carcinoma as the commonest especially in the tropic regions of the world. Aims and Objectives: This study aims at determining the base line data, frequency and trends of malignant skin tumours in Nnewi, Nigeria. It also implores the use of World Health Organization (WHO) in classification of skin malignancy. Materials and Methods: This study reviewed all histologically diagnosed skin malignancies at Histopathology department of Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria from 2008 to 2017 and classified them using 2021 World Health Organization (WHO) skin tumour book. Results: A total of 387 skin biopsies were received in the Histopathology department during the study period. Out of these, 110 cases were malignant skin lesions (28.4%) majority were benign lesions. Keratinocytic or epidermal tumours were the most common (n: 54 cases; 49.1%) with squamous cell carcinoma being the commonest in the group (n: 34; 30.9%) followed by mesenchymal or soft tissue neoplasm (n:31 cases; 28.1%), melanocytic tumours (19.1%), skin adnexal tumour (2.7%) and haematolymphoid tumour (0.9%). The head and neck region (n: 49; 44.5%) was the commonest site of occurence of cutaneous neoplasms followed by lower limb (n: 32; 29.1%), groin (n:10; 9.1%), upper limb and trunk with 6 cases each (5.5%) Four (4) cases of Albinos with skin malignancies were seen in this research with a frequency of 3.6%. Fifty nine cases (53.6%) out of 110 malignant skin tumour were seen in males, while 51 (46.4%) of them were females, therefore the male to female ratio was 1.2:1. The mean age of those with malignant skin tumours was 52.9 years. Patients above 60 years of age constituted 57.3% while those less than 30 years constituted 14.5 % of the total malignant skin tumours. Conclusion: The frequencies of different morphologic patterns of malignant skin tumours in our environment were different from those reported in western countries. However, it is similar to most studies done in the Midwestern Nigeria tertiary hospitals with squamous cell carcinoma being the commonest skin malignancy followed by kaposi sarcoma

Correlation of immunohistochemical expression of p16, Ki-67, and p53 with histopathological diagnosis of noninvasive cervical lesions: A multicenter study from South East Nigeria

Background: There is a high burden of cervical cancer in our environment. Most patients present late when the prognosis is guarded. Hence, accurate diagnosis of preinvasive lesions from cervical biopsies is important for clinical decisions and patient management. The aim of the study is to correlate the expression of p16INK4a, p53, and Ki-67 with histopathological diagnosis of noninvasive cervical lesions. Materials and Methods: The paraffin blocks of all cervical biopsies (excluding cases histologically diagnosed as invasive lesions) seen in two histopathology laboratories in Nnewi, Southeast Nigeria, over a 10-year period (2011–2020) were retrieved from the archives of both facilities. The cases were subjected to immunohistochemistry using p16INK4a, Ki-67, and p53 monoclonal antibodies. Results: There were 23 normal/reactive (45.1%), 6 low-grade squamous intraepithelial lesion (11.8%), and 22 hIL (43.1%). There is a very strong positive correlation between p16INK4a expression and the histopathological diagnosis (Spearman's correlation = 0.98). There is a strong positive correlation between Ki-67 expression and the histopathological diagnosis (Spearman's correlation = 0.70). There is a weak positive correlation between p53 expression and histopathological diagnosis (Spearman's correlation coefficient = 0.40). Conclusion: p16INK4a shows the best correlation with histopathological diagnosis of noninvasive cervical lesions and may be a very useful adjunct to H and E for diagnosing preinvasive cervical lesions. However, p53 correlates poorly with histopathologically diagnosed noninvasive cervical lesions and therefore may not be diagnostically useful

Audit of prostatic diseases diagnosed from Tru-Cut biopsies in Nnamdi Azikiwe University Teaching Hospital, Nnewi, using the P63 immunohistochemical marker

Background: There is growing literature on the burden of prostatic lesions: both benign and malignant among men of West African ancestry. There are also some studies on the prostate in Anambra State and South-East Nigeria, but these are mainly on patterns and prevalence, without the use of immunohistochemistry. Aims and Objectives: The aim of this study is to determine the histological pattern of prostatic diseases diagnosed from Tru-Cut biopsies in Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, South-East Nigeria, using the p63 immunohistochemical marker. This will be a pioneer study in both the state and the geopolitical zone. Materials and Methods: This is a 2-year (January 2019 to December 2020) retrospective study of the immunohistochemical expression of p63 on the haematoxylin and eosin-diagnosed Tru-Cut biopsies of the prostate in the archives of the histopathology laboratory in NAUTH, Nnewi. A Purposive sampling method was used with a sample size of 151. Sections were made from the blocks, reviewed and stained using the p63 immunohistochemical marker. Results: There were 191 cases of prostate diseases histologically diagnosed, of which 151 met the inclusion criteria for the study. Of the 151 cases, 97 (64.2%) were diagnosed as benign and 54 (35.8%) were diagnosed as malignant. Following p63 immunohistochemistry, 97 cases were accurately diagnosed as benign and 54 cases accurately diagnosed as malignant with no misdiagnoses. The age of the patients ranged from 50 years to 90 years; however, the predominant population was in the sixth decade (31.8%) and seventh decade (35.1%), with a mean age of 75.3 years. There is no significant difference noted in the mean age of the non-neoplastic and neoplastic groups. Conclusion: This study shows that morphology alone is sufficient for the diagnosis of both Benign and prostatic lesions, as shown by the accuracy level (100%) in the haematoxylin and Eosin results. This is particularly important in resource-poor settings such as ours

Histopathological spectrum of skin lesions in the elderly: Experience from a tertiary hospital in Southeast Nigeria

Background: There are only a few epidemiological studies published on skin disorders in the elderly within the Nigerian context and none from the Southeast Region of the country. In addition, none of these studies has considered the pattern and frequency of histopathologically diagnosed geriatric skin lesions. Hence, we attempted to determine the frequency as well as the age and gender distributions of histologically diagnosed dermatological diseases in geriatric population from skin biopsies submitted to the histopathology department of a tertiary care hospital in Southeast Nigeria. Materials and Methods: This is a cross-sectional retrospective hospital-based study involving all skin biopsies of patients 60 years and above, received at the Department of Histopathology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria, from January 2004 to December 2019. Results: During the study period, 751 skin biopsies were received in the histopathology department. Of these, 142 were from patients who were older than 60 years. Thus, the overall share of geriatric patients was 18.9%. The mean age at presentation was 71.1 ± 8.6 years. The M: F was 1:1, and most of the patients belonged to the age group of 60–69 years (69 cases, 48.6%). The mean age of the male patients was 72.1 ± 9.5 years. In the female patients, it was 70.1 ± 7.5 years. The most common disease category was neoplasms (91, 64.1%). Most neoplasms were malignant. There were 67/142 (47.2%) malignant lesions. The most common was Squamous cell carcinoma (SCC) (30 cases) which is 21.1% of all geriatric skin biopsies and 44.8% of malignant skin biopsies. This is closely followed by melanoma (29 cases). Conclusion: Malignant neoplasms, benign neoplasms, and papulosquamous disorders are the three most common histologically diagnosed skin lesions in our geriatric population. The most common skin malignancies in this group of patients are SCC and malignant melanoma

An Assessment of Ovarian Cancer Histotypes Across the African Diaspora

ObjectiveOvarian cancer in Black women is common in many West African countries but is relatively rare in North America. Black women have worse survival outcomes when compared to White women. Ovarian cancer histotype, diagnosis, and age at presentation are known prognostic factors for outcome. We sought to conduct a preliminary comparative assessment of these factors across the African diaspora. MethodsPatients diagnosed with ovarian cancer (all histologies) between June 2016-December 2019 in Departments of Pathology at 25 participating sites in Nigeria were identified. Comparative population-based data, inclusive of Caribbean-born Blacks (CBB) and US-born Blacks (USB), were additionally captured from the International Agency for Research on Cancer and Florida Cancer Data Systems. Histology, country of birth, and age at diagnosis data were collected and evaluated across the three subgroups: USB, CBB and Nigerians. Statistical analyses were done using chi-square and student's t-test with significance set at pResultsNigerians had the highest proportion of germ cell tumor (GCT, 11.5%) and sex-cord stromal (SCST, 16.2%) ovarian cancers relative to CBB and USB (p=0.001). CBB (79.4%) and USB (77.3%) women were diagnosed with a larger proportion of serous ovarian cancer than Nigerians (60.4%) (p<0.0001). Nigerians were diagnosed with epithelial ovarian cancers at the youngest age (51.7 +/- 12.8 years) relative to USB (58.9 +/- 15.0) and CBB (59.0 +/- 13.0,p<0.001). Black women [CBB (25.2 +/- 15.0), Nigerians (29.5 +/- 15.1), and USB (33.9 +/- 17.9)] were diagnosed with GCT younger than White women (35.4 +/- 20.5, p=0.011). Black women [Nigerians (47.5 +/- 15.9), USB (50.9 +/- 18.3) and CBB (50.9 +/- 18.3)] were also diagnosed with SCST younger than White women (55.6 +/- 16.5, p<0.01). ConclusionThere is significant variation in age of diagnosis and distribution of ovarian cancer histotype/diagnosis across the African diaspora. The etiology of these findings requires further investigation