Rosai-Dorfman Disease: A Diagnostic Albatross in a Female Patient with Bilateral Persistent Neck Masses. A Case Report

RosaiDorfman disease (sinus histiocytosis with massive lymphadenopathy) is an uncommon benign and often self limiting lymphoproliferative disease of unknown aetiology which was first described by Rosai and Dorfman in 1969. It usually presents with a multiple progressive painless bilateral cervical lymphadenopathy, low grade fever, polyclonal hypergammaglobulinemia and raised erythrocyte sedimentation rate. Extranodal diseases are uncommon but have been documented. Due to the rarity of this condition, the diagnosis may not be suspected clinically and fine needle aspiration cytology of neck nodes may miss the diagnosis. In this study, we present a 24 year old female who presented with bilateral cervical lymphadenopathy and right breast lump since childhood

Is the Art of Renal Biopsy on the Decline in Nigeria?

Background: Renal biopsy remains the means by which definitive parenchymal kidney disease diagnoses are made. With the renal biopsy, the activity, progression and prognosis of renal parenchymal diseases can be studied with objectivity. We investigated the trend of renal histopathology request in a tertiary hospital in Nigeria over 31 years.Objective: To determine the trend of renal biopsy requests in one of the biggest tertiary hospitals in Nigeria over a 31-year period (1981- 2011).Methods: We retrospectively analysed all the renal biopsies submitted to the Department of Pathology, University College Hospital (UCH) Ibadan, South-West Nigeria over a 30 year period (1981-2011). Trend of requests of all the biopsies submitted from the Surgery, Paediatrics and Medicine departments was analysed using a test for linear  trend. Gender and age groups trends were also studied.Results: A significant reduction in the rates of renal biopsy request over the 31-year period (p=0.001) was noted which is attributed to diminution in requests from the Medicine and Paediatrics Departments (p<0.001), while the rates of requests from Surgery Department remain fairly uniform over this period (p=0.05). Decrease in biopsy requests significantly cuts across the ages in both genders. Conclusion: Lack of adequately trained manpower, poor health insurance scheme and lack of facilities may be contributory in renal biopsy requests decline. Adequate efforts should be made towards reviving this important investigative modality in Nigerian tertiary hospitals.Keywords: Kidney, Biopsy, Histology, Trend test, UCH Ibadan

Histological and biochemical effects of Arteethertm on the liver of wistar rats

ArteetherTM is among the recent drugs that are used to combat chloroquine-resistant malarial parasites. This study examined the effects of arteetherTM on enzyme biomarkers of the liver, serum protein concentrations, and liver morphology. Twenty (20) adult albino Wistar rats weighing 200 – 250 g were randomly divided into four groups (A, B, C and D) of five animals each, and used in this study. Group A rats were given intramuscular (i. m.) arteetherTM (3 mg/kg b. w.) daily for 3 days.Group B rats received i. m. arteetherTM (6 mg/kg b. w.) daily for 3 days. Group C rats were given i. m. arteetherTM (3 mg/kg b. w.) daily for 3 days. The same dose was repeated at two-weekly intervals for 4 further weeks, while group D rats which received normal saline (0.9 % w/ v, 3 ml/kg b.w.), served as controls. At the end of the experiment, the body weights of the animals were determined and recorded. Serum levels of alanine  transaminase (ALT), aspartate transaminase (ASP), alkaline phosphatase(ALP), total protein (TP) and albumin were assayed, and histological studies were performed. Results obtained show no significant difference (P<0.05) in liver enzymes (ALT, ASP, ALP). TP and albumin were significantly reduced in group C rats. Histological studies revealed no cyto-architectural changes. It is concluded that at therapeutic doses, arteetherTM is well tolerated in Wistar rats. .Key Words: ArteetherTM; Malaria; Liver enzymes; Serum protein concentrations; Morphology; Wistar rat

Causes of Death, other than that due to Prostatic Cancer, in Males as seen in Ibadan, South Western Nigeria: A Prospective Post-Mortem Study

Introduction: A Prospective cohort study was undertaken to determine causes of death, other than that due to prostatic cancer, in males.Patients and method: Seventy nine patients aged between 30 and 86 years who died of non-prostate related diseases were randomly selected for systematic examination of the prostate glands. In addition, full post-mortem examinations were performed on each case and the causes of death were determined. The only exclusion criterion was the presence of a clinical diagnosis of prostate cancer.Results: Amonst this cohort of men, cardiovascular diseases were the commonest cause of death as a group accounting for 38% of cases. This consisted of hypertensive heart disease, coronary artery disease and cardiomyopathy. Next were the violent death/unnatural death group (24.1%) which included severe head injury following road traffic accident, gunshot injury, burns, electrocution, traumatic rupture of the spleen with associated liver rupture during sporting activity, and severe haemorrhage following surgery. Other causes included neoplastic diseases (10.1%), gastrointestinal diseases (10.1%), metabolic/endocrine diseases (7.6%) and infection related causes (6.3%).Conclusion: In contrast to the previous teaching about infection in Africa, cardiac diseases appear to have become the number one cause of death in adult male Nigerians and neoplastic diseases as well as metabolic/endocrine disorders have also become rather important causes of mortality. All these causes have significant environmental association and suggest nagative adaptions in more recent times

Causes of death, other than that due to prostatic cancer, in males as seen in Ibadan, south western Nigeria: A prospective post-moterm study

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Germ Cell Tumours in Children: A Twenty-year Retrospective Study (January 1988 - December 2007) in Ibadan, South-West Nigeria

Background: There is a significant lack of studies of germ cell neoplasms in the paediatric age group from Nigeria and other parts of Africa.Objectives: The aim of this study was to determine the histological pattern of paediatric germ cell tumours in Ibadan, Nigeria.Method: This is a retrospective study of cases of germ cell neoplasms histologically diagnosed at the Department of Pathology, University College Hospital (UCH), Ibadan between January 1988 and December 2007 among children aged 0-14 years. Haematoxylin and eosin stained slides were reviewed and where necessary, the paraffin blocks were recut and stained. The World Health Organization Histological Classification of paediatric germ cell tumours of 2004 was used in this study.Result: Paediatric germ cell tumours comprised 0.05% of all surgical pathology specimens in the study period. There were 10 (25.6%) male and 29 (73.4%) female patients, giving a male to female gender ratio of 1:2.9. Extragonadal germ cell tumours constituted 25 (64.1%) and gonadal germ cell tumours 14 (35.9%) cases. Benign neoplasms accounted for 26 (66.7%) and malignant neoplasms accounted for 13 (33.3%) cases. Thirty-one (79.5%) of the 39 cases were teratomas, 7 (17.9%) were yolk sac tumours and one (2.6%) was a mixed germ cell tumour. The most common sites were the ovary (33.3%), sacrococcygeal region (20.5%) and neck (10.3%). There was a bimodal age distribution, with a first peak in infancy and a second peak between >5-10 years of age.Conclusion: In view of the paucity of studies on germ cell tumours from Nigeria and other parts of Africa, further studies of this unique group of neoplasms are required in order to validate the findings of this study.Keywords: Germ cell tumours, Children, Pathology, Nigeria