Infections Mimicking Malignancy in Kano, Nigeria: A Teaching Hospital Experience

Objective: This study aimed to evaluate the pattern of presentation of infectious lesions mimicking malignancy. This will serve to heighten clinical indices of suspicion and prevent unwarranted aggressive management. Methods: This is a 19-year (1999-2017) audit review of all morphologically diagnosed infection-related lesions in which malignancy was primarily clinically suspected. Results: Fifty-six cases of infection-related mimics of malignancy were diagnosed in the study period: schistosomiasis related, 22 (39.2%); actinomycosis, 21(37.5%); tuberculosis-related, 10 (17.9%); fungi-related, 3(5.4%). Twenty-one cases of actinomycosis of the lower limbs and oropharynx were mistaken for melanoma, squamous cell carcinoma, sarcoma, and oropharyngeal carcinoma. The mean age was 33±17years.The 10 patients with atypical Mycobacterium tuberculosis-mimicking malignancy had mean age of 37±14 years and included three in the testes, testicular cases, one from the jaw, and two cases each from ovary, breast, and uterus. Of the three fungal lesions, there was a case each from the brain, skin, and bone. All were males with mean age of 21±7 years. Conclusion: For accurate diagnosis of infection-related mimics of malignancy, a high index of clinical suspicion, knowledge of and attention to characteristic radiological signs, and obtaining representative tissues for histopathologic and cytopathologic diagnoses are paramount

Humoral immunological kinetics of severe acute respiratory syndrome coronavirus 2 infection and diagnostic performance of serological assays for coronavirus disease 2019: an analysis of global reports

As the coronavirus disease 2019 (COVID-19) pandemic continues to rise and second waves are reported in some countries, serological test kits and strips are being considered to scale up an adequate laboratory response. This study provides an update on the kinetics of humoral immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and performance characteristics of serological protocols (lateral flow assay [LFA], chemiluminescence immunoassay [CLIA] and ELISA) used for evaluations of recent and past SARS-CoV-2 infection. A thorough and comprehensive review of suitable and eligible full-text articles was performed on PubMed, Scopus, Web of Science, Wordometer and medRxiv from 10 January to 16 July 2020. These articles were searched using the Medical Subject Headings terms 'COVID-19', 'Serological assay', 'Laboratory Diagnosis', 'Performance characteristics', 'POCT', 'LFA', 'CLIA', 'ELISA' and 'SARS-CoV-2'. Data from original research articles on SARS-CoV-2 antibody detection >= second day postinfection were included in this study. In total, there were 7938 published articles on humoral immune response and laboratory diagnosis of COVID-19. Of these, 74 were included in this study. The detection, peak and decline period of blood anti-SARS-CoV-2 IgM, IgG and total antibodies for point-of-care testing (POCT), ELISA and CLIA vary widely. The most promising of these assays for POCT detected anti-SARS-CoV-2 at day 3 postinfection and peaked on the 15th day; ELISA products detected anti-SARS-CoV-2 IgM and IgG at days 2 and 6 then peaked on the eighth day; and the most promising CLIA product detected anti-SARS-CoV-2 at day 1 and peaked on the 30th day. The most promising LFA, ELISA and CLIA that had the best performance characteristics were those targeting total SARS-CoV-2 antibodies followed by those targeting anti-SARS-CoV-2 IgG then IgM. Essentially, the CLIA-based SARS-CoV-2 tests had the best performance characteristics, followed by ELISA then POCT. Given the varied performance characteristics of all the serological assays, there is a need to continuously improve their detection thresholds, as well as to monitor and re-evaluate their performances to assure their significance and applicability for COVID-19 clinical and epidemiological purposes

Renal cell carcinoma in Nigeria: A systematic review

Literature on renal cell carcinoma (RCC) in Nigeria is characterized by lacunae in several important areas with resultant incomprehensiveness of data. This requires a review of the literature so as to streamline the data. Using internet search engines, data were extracted from a total of twelve studies reported in peer reviewed journals between 2000 and 2015 from various states of Nigeria including Kano. These were subsequently collated, analyzed, and then compared with those from other parts of the world. There is relatively low incidence rate of 0.3/100,000 population; slight male preponderance and affectation of younger age groups with average age at diagnosis of 45 ± 4 years. Significant smoking history, exposure to industrial dye, family history, and HIV associated immunodeficiency are major risk factors of RCC in Nigeria. A significant number of cases presented with triad of loin pain, hematuria, and loin mass; advanced disease and bulky tumors of up to 3.8 kg and 56 cm. The predominant histological subtypes were clear cell carcinoma 60%–85.7% and papillary carcinoma 23.8%–46.2%. In general, there has been poor overall outcome for RCC bearing patients in the country. RCC in Nigeria is characterized by earlier age at onset and poor outcome, thus necessitating more aggressive case identification at early stages so as to improve prognosis

Pattern of HER2 Overexpression in Urinary Bladder Carcinomas in Kano, Nigeria

Background: The worldwide distribution of bladder cancer varies, conforming to differences in environmental and genetic risk factors. HER2 neu is overexpressed in many human cancers, including urinary bladder carcinomas. The aim of this study is therefore to evaluate the pattern of HER2 positivity, and correlate HER2 positivity of urinary bladder carcinomas with age, gender of patients, histological subtypes, and tumor grades. Methods: This is a 2-year retrospective study from January 2015 to December 2016. Patients’ clinicopathological information was extracted from their case folders and pathology reports. The histological subtyping using the WHO 2016 classification and grading was done and then reviewed by authors. HER2 scoring was done using the recommendations of the American Society of Clinical Oncology/College of American Pathologists. Results: Sixty cases of bladder cancer were diagnosed during the study period. HER2/neu positivity (3+) was observed in 24 (40%) of all the cases. Statistically significant association was observed between HER2 neu protein overexpression and increasing tumor grade (p≤ 0.001). Conclusion: This study recorded HER2 overexpression in 40% of study subjects. There is a statistically significant association between HER2 overexpression and increasing tumor grade

Perceived and Real Histopathology Turnaround Time: A Teaching Hospital Experience

Background: This study aims to audit analytic turnaround time (TAT) in a histopathology laboratory with a view to assessing the timeliness of its reports, identify causes of delay in its TAT, and compare this with client perception of its performance. Materials and Methods: Records of 1440 batches of specimens processed over a 5‑year period in the histopathology laboratory of a teaching hospital were retrieved from archives. From these, median and mean TATs were calculated and causes of delay identified. Questionnaires were also deployed to assess physicians’ perception of the laboratory’s performance. Results: Analytic TAT was 3.6 ± 2 days, with 86.7% of reports being ready within 5 working days. The delays in timeliness of report generation were due mainly to residency training‑related factors; tissue processing‑related factors, and inadequate clinical information among others. Client perception of TAT rated the laboratory below average by 18.4%; average by 57.5%; good by 20.7%, and excellent in its performance by 3.4% of respondents. Conclusion: Even though physicians perceived the laboratory’s TAT to be just average, its analytic TAT for reports is within acceptable international standards but with room for improvement in its performance.Keywords: Clients, histopathology, reports, turnaround tim

Histopathological Pattern of Testicular Lesions in Kano, Northwestern

Background: The global distribution of testicular disorders differs conforming with differences in demographic denominators. The diagnostic dictum for these disorders customarily adheres to findings at clinical assessment, relevant imaging, and laboratory evaluation. Histopathological confirmation remains the ultimate for the diagnosis of testicular malignancies and many testicular dysfunctions. The epidemiological review of the histological outcomes among Kano populace, however, is deficient. Objective: The aim of the study was to analyse histological pattern of testicular lesions in Kano, Nigeria. Methodology: The study is a 14-year retrospective review of testicular specimens subjected to histology in Kano from January 2003 to December 2016. The variables obtained were the age of patients, laterality, and histological diagnoses. These were collated and analyzed; the findings were presented as mean, patients' age range, and laterality ratio with frequency tables. Results: Three hundred and forty-three testicular tissues were assessed. The nonneoplastic lesions were 79.2% with patients' age range of 3–90 years. Atrophies and maturation arrests formed 29.4% and 18.0%, respectively. Specimens from the right were more with a ratio of 1.6:1. Neoplastic lesions were 3.5% and patients' age range from 3 to 65 years. Seminomas were the predominant neoplastic lesion and constituted 66.7%. The right testes were more commonly affected and have a ratio of 1.4:1. Conclusion: This appraisal affirms that testicular lesions could be found across a wide age range and majorities are nonneoplastic. The findings in this study concur with the published African and Asian conclusions

Perceived and real histopathology turnaround time: A teaching hospital experience

Background: This study aims to audit analytic turnaround time (TAT) in a histopathology laboratory with a view to assessing the timeliness of its reports, identify causes of delay in its TAT, and compare this with client perception of its performance. Materials and Methods: Records of 1440 batches of specimens processed over a 5-year period in the histopathology laboratory of a teaching hospital were retrieved from archives. From these, median and mean TATs were calculated and causes of delay identified. Questionnaires were also deployed to assess physicians' perception of the laboratory's performance. Results: Analytic TAT was 3.6 ± 2 days, with 86.7% of reports being ready within 5 working days. The delays in timeliness of report generation were due mainly to residency training-related factors; tissue processing-related factors, and inadequate clinical information among others. Client perception of TAT rated the laboratory below average by 18.4%; average by 57.5%; good by 20.7%, and excellent in its performance by 3.4% of respondents. Conclusion: Even though physicians perceived the laboratory's TAT to be just average, its analytic TAT for reports is within acceptable international standards but with room for improvement in its performance