The Pathology of Breast Biopsies in a Sample of Nigerian Patients: Review and Analysis

Background: Histological tissue diagnosis of breast lumps plays an important role in patient management. Almost all breast pathology studies in Nigeria were conducted in government owned health facilities. This study aims to describe the histopathological pattern and of breast biopsies seen in Me Cure Healthcare Limited, a privately owned diagnostic centre.Methods: Histopathological reports of all breast specimens received and processed from August 2009 to December 2013 were retrieved from a computer database and entered into an Excel sheet and analyzed using SPSS version 17. Histological features were classified using 2003 WHO classification of breast diseases.Results: A total of 1205 breast specimens were reviewed. This formed 26% of 4,642 histology specimens received in the pathology laboratory. The youngest patient was 11 years and the oldest 88 years with a mean of 31.7 years and SD ±13.12. Females accounted for 97.8% with a female to male ratio of 43.4:1. The age group 20-29 years were most involved (n=362; 30%). Malignant lesions accounted for 21.3% while benign lesions accounted for 78.7%. Fibroadenoma was the commonest benign lesion and accounted for 61.7% of all benign lesions with a mean age of cases been 24,6 years. Age groups 40-49 and 30-39 years accounted for most malignant lesions (33.5% and 27.6% respectively) with invasive ductal carcinoma been the commonest.Conclusion: Benign breast lesions are more common generally, while invasive ductal carcinoma is the commonest malignant lesion involving mainly age groups 30-49 years in our environment. Women with cancers in our environment, usually present with grades II and III lesions.Keywords: Breast, Histopathology, Biops

Histologic Analysis of Gynaecologic Lesions in Nigerians

Background: Gynaecological neoplasms are a cause of significant morbidity and mortality in females all over the world.Objective: To determine the pattern of gynaecological lesions seen in Me Cure Healthcare, Lagos  Nigeria.Design: A descriptive retrospective study.Setting: Histopathology section of Me Cure Healthcare Limited from August 2009 to August 2014.Subjects: Histopathological reports and paraffin sections of gynaecologic lesions/ specimens which were diagnosed by Me Cure Healthcare.Results: A total of 691 gynaecologic specimens were received. The youngest patient was 14 years, while the oldest patient was 79 years with a mean age of 40.47 years and Std of ± 10.59. Eighty three percent  of specimens were benign neoplastic lesions, while 5.9% of specimens were malignant neoplastic   lesions. Uterine leiomyomas were the most common lesions and majority of them were seen in age  groups 30-39 and 40-49 years. Simple endometrial hyperplasia without atypia accounted for most   endometrial lesions (52,3%) and were seen more in age groups 30-39 and 40-49 years. Most ovarian  lesions (45.9%) were non neoplastic cysts and seen more in age groups 20-29 and 30-39 years. The  cancers seen were those of the cervix (56.1%), endometrium (22%), ovary (14.6%), uterus (4.9%) and choriocarcinoma (2.4%) in that order. Cervical cancer was seen in 36.5% of cervical lesions and involved mainly age groups; 30-39 years, 50-59 years and 60-69 years (each of these age groups had five cases). The mean age for cases of cancer of the cervix was 50 years Std ± 13.0 and all the age groups except 10-19 years were involved.Conclusion: Benign lesions were the most common with uterine leiomyoma accounting for most of them, while cervical carcinoma was the the common gynaecological cancer. Endometrial cancer cases were noted to be on the rise

A 20 year retrospective analysis of medicolegal deaths in a tertiary hospital setting in Nigeria

Objective: To determine and classify the various types of medicolegal deaths as seen at University of Benin Teaching Hospital (UBTH), Benin City, Nigeria.Materials and Methods: This is a retrospective study of all the medicolegal deaths seen in the Department of Histopathology, (UBTH, Benin City over a 20 year period (January 1990-December 2009) as recorded in the autopsy registers of the department.Result: A total of 5035 autopsies were done during the period, 89% of which were coroner cases. Four thousand, four hundred and eighty‑one coroner cases representing 12.5% of all bodies received by the mortuary during the period were studied. The male to female ratio was 1.9:1, with an overall mean age of 38.3 years. The ages ranged from 1 day to 101 years with a peak incidence in the 25-44 years age group. A total of 553 children and 3928 adults were involved. The commonest indication for coroner’s autopsy was sudden unexpected natural deaths (SUNDs) which accounted for 65.5% of the cases. Other causes of death were accidents, homicide, suicide, and undetermined causes representing 28.6, 5.0, 0.5, and 0.4%, respectively. Commonest cause of SUND was cardiovascular diseases with complications of hypertension being the most common CVS disease (26.9%). Road traffic accident was the commonest form of accident causing death (88.7%). Public enlightenment and health education about routine medical screening will help to reduce causes of natural deaths.Conclusion: This study shows the pattern of medicolegal autopsies in UBTH and this preliminary data will provide a baseline for future research and help in formulating policies to help in reduction of preventable causes of death.Keywords: Accidental death, homicide, medicolegal death, road traffic accident, sudden unexpected natural death suicideNigerian Journal of Clinical Practice • Oct-Dec 2013 • Vol 16 • Issue

The Pattern and Distribution of Cancers in Akwa Ibom State, Nigeria

Introduction: The pattern of cancer is known to vary by location based on people’s lifestyle and socioeconomic development status. Aim: The aim of this study is to describe the pattern of cancers seen in University of Uyo Teaching Hospital. Materials and Methods: This is a retrospective study of all cancer cases that were histologically diagnosed in the Histopathology Department of University of Uyo Teaching Hospital for 9 years (January 2007–December 2015). Results: There were 1186 cases, identified and included in this study. Females accounted for 59.7% of cases while males accounted for 40.3% of cases, with the mean ages for females and males being 45.69 ± 14.38 and 59.63 ± 17.77 years, respectively. Age group 60–69 years accounted for most cases (20.4%). The common cancers in both sexes were breast (33%), prostate (25.8%), cervix (11.1%), skin (4.9%), sarcoma (4.8%), and colorectal (3.8%). Conclusion: There is a variation between the pattern of cancer in Akwa Ibom and other regions of Nigeria warranting further clinicopathological evaluation, and these results will be useful in the overall context of planning and evaluation of cancer control activities in Akwa Ibom State. A population‑based cancer registration in Uyo is suggested.Keywords: Akwa Ibom, cancer, patter

Pattern of hormone receptors and human epidermal growth factor receptor 2 status in sub‑Saharan breast cancer cases: Private practice experience

Introduction: Breast cancer is the most common cancer among women globally. With immunohistochemistry (IHC), breast cancer is classified into four groups based on IHC profile of estrogen receptor (ER)/progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2/neu) expression, positive (+) and/or negative (−). The IHC classification correlates well with intrinsic gene expression microarray categorization. ER‑positive tumors may benefit from being treated with selective ER modulators and aromatase inhibitors, whereas patients with HER2/neu positive tumors have been shown to experience a significant survival advantage when treated with humanized monoclonal antibodies against HER2/neu.Objective: To determine ER/PR, HER2/neu expression and their association with histological prognostic markers in female breast carcinomas seen in a private diagnostic laboratory based in Lagos.Materials and Methods: Immunohistochemistry reports of breast cancer patients, which were diagnosed by histopathology section of a private diagnostic laboratory based in Lagos, Nigeria from August 2009 to August 2014.Results: About 18.7% of breast cancers had IHC (ER, PR and HER2) done on them and were all females. The mean age of all subjects was 49.5 years (standard deviation, 13.2; range, 29–78 years). Most (95.8%) of the breast cancers were of invasive ductal carcinoma type, with 77.4% of them been >5 cm. IHC pattern was as follows:ER/PR+, HER2− = 19 (39.6%), ER/PR−, HER2− (triple negative [TN]) = 14 (29.2%), ER/PR+, HER2+ = 9 (18.8%), ER/ PR−, HER2+ = 6 (12.5%), corresponding to Lumina A, TN/basal‑like, Lumina B and HER2 over expressed respectively.Conclusion: Triple negative breast cancers are common in our environment and affect young females most and could be contributory to the poorer prognosis of breast cancer in our environment.Keywords: Breast cancer, human epidermal growth factor receptor 2/neu, immunohistochemistry, steroid receptor

Cytological diagnosis of ascitic fluid in Benin City, Nigeria

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Assessment of Pattern of Cigarette Smoking and Associated Factors among Male Students in Public Secondary Schools in Anambra State, Nigeria

Background: The WHO has estimated that there are about 1,300 million smokers globally and about 75% of these are in the developing countries. It is also predicted that if the current pattern of smoking continues, by 2020, there will be 10 million tobacco-related deaths annually worldwide and seven million (70%) of these deaths will occur in the developing countries. The objective of the study was to assess the cigarette smoking pattern and associated factors among male students in public secondary schools in Anambra State. Methods: The setting was public secondary schools in Anambra State. The study was in April 2008. It was a cross-sectional survey involving six schools, selected by multistage sampling technique. Eight hundred and fifty male students participated in the study. A semi-structured self-administered questionnaire was used. Qualitative data were collected using Focus group discussion (FGD). Results: The mean age of respondents was 16±2.1 years. The ever-smoked and current smoking prevalence were 13.1% and 8.7% respectively. Mean age of commencement of cigarette smoking was 13.7±2.6 years. Among smokers, 37.8% were daily smokers. Television (40.7%) and radio (33.3%) were the main sources of advertisement. Peer influence (34.2%) was the main reason for uptake of cigarette smoking. Major reason for not smoking among non-smokers was health concerns (57.9%). There were significant associations between smoking status and age of respondents (2=25.08; P= <0.05), father's smoking status (2=158.77, P < 0.05), awareness of health hazards of smoking (2= 5.13, P = 0.023) and advertisement on television (2= 4.05, P = 0.044) and billboards (2= 44.39, P<0.05). Conclusion: Cigarette smoking prevalence among secondary school boys in Anambra State is high. Health education and strict implementation of anti-smoking policies of the Federal Government of Nigeria is recommended. Keywords: Cigarette smoking, Anambra state, male students, health education, smoking prevalenc