The pathophysiology and pathology of SARS-CoV-2 infection

SARS-CoV-2 infection is a major pandemic that has involved all continents in the world. It has caused almost seven million deaths since its onset. SARS-CoV-2 commonly enters cells by binding to angiotensin-converting enzyme 2 (ACE2) molecules on the surface of cells in the human body. SARS-CoV-2 infection, although mild in many patients, has the potential to cause dysfunction of many organ systems in the body. The body response to the internalisation of the virus in the epithelial cells of the lungs can lead to alveolar epithelial inflammation, commonly referred to as the exudative phase of acute respiratory distress syndrome (ARDS). Cardiac symptoms shown by patients infected with SARS-CoV-2 include chest tightness/pain and palpitations. These features can be because of newly developed or worsening ischaemic heart disease and arrythmias, respectively. SARS-CoV-2 infection is known to cause a clinical condition known as COVID-19-associated nephropathy (COVAN), a disease quite similar to HIV-associated nephropathy (HIVAN). Like HIVAN, COVAN is relatively more common in people of African descent and is associated with the APOL1 variant gene. Researchers have not identified unique morphological changes that could be used to identify the infection in tissues. Hence, the use of RT-PCR for diagnosis is still very important

Spindle cell tumours of the female genital tract

Background: Our aim is to describe the clinicopathology features of spindle cell tumors of the female genital tract seen in our hospital and to compare the findings with what is seen in other parts of the world. Methods: We conducted a cross-sectional study of all spindle cell tumors diagnosed in the department of Morbid Anatomy and Forensic medicine of Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria from January 1, 2017, to December 31, 2022. Results: Leiomyoma was the most common spindle cell tumour seen. Only 570 cases met the inclusion criteria. Only one nodule was removed in 130 cases (22%) while greater than one nodule was excised in 432 cases (75.8%). The mean age of patients was 40.77 years while the age range was 19-79 years. About three-quarters of leiomyomas are removed in the age-group 31-50. There was no correlation between the number of nodules removed and the age of the patient. The next second most common spindle cell tumor seen was malignant mixed mullerian tumour. Eleven cases were seen in the study period, The average age was 57.7 years. The age range of cases was 27-72 years. Conclusions: Our study supports the general observation that leiomyomas commonly cause symptoms in the reproductive age group and that most patients with leiomyoma frequently have more than one nodule. Our study further reinforces the widely established knowledge that MMMT is found in older post-menopausal women and can occasionally be seen in younger pre-menopausal women

Fibroepithelial tumours of the breast seen in a tertiary health centre in southwestern Nigeria

Background: Fibroepithelial tumours of the breast are mainly fibroadenoma and phyllodes tumour. Our objective was to describe the clinical and pathological features of benign fibroepithelial tumours and then compare our findings with reports from other parts of the world. Methods: We carried out a retrospective study of all benign fibroepithelial tumours diagnosed in the Department of Morbid Anatomy and Forensic Medicine of Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Nigeria from January 1, 2018 to December 31, 2022. Results: A total of 538 cases of fibroadenoma were seen during the study period. Only 486 cases met the inclusion criteria and were then subsequently studied. Right sided tumour mass is seen in 203 (41.8%) patients, left sided masses in 173 (35.6%) patients and bilateral masses in 96 (19.8%) patients.  The age of the patients ranges from 11 to 75 years. The average duration of symptoms is 16 months. The maximum length of fibroadenoma nodule ranges from 0.9cm to 15cm. The number of nodules seen in a patient range from 1 to 15. There is no association between the size of a fibroadenoma, number of the masses or the duration of symptoms before removal of the mass, and the age of the patient. Nineteen cases of phyllodes tumour were seen during the study period. Conclusions: Our study shows that fibroadenoma is the most common fibroepithelial tumour of the breast. A sizeable proportion of patients have bilateral tumours. Phyllodes tumour is much less common.

Gross architecture of ovarian specimens from a southwest Nigerian tertiary healthcare facility

Background: The aim of our study is to describe the gross morphology of ovarian specimens and to see if some entities can be distinguished based on their gross morphology. Methods: We did a cross-sectional study of all ovarian specimen received by the department of morbid anatomy and forensic medicine of Obafemi Awolowo university teaching hospitals complex (OAUTHC), Ile-Ife, Nigeria from January 1, 2018, to December 31, 2022 (Five-year period). OAUTHC is situated in the southwestern part of Nigeria. Results: We examined 225 right ovarian specimens. Non- neoplastic lesions were the most common lesions of the right ovary accounting for 52 cases followed by malignant tumour accounting for 25 cases. We examined 233 specimens of the left ovary of which 133 were normal. Eighteen (72%) of malignant tumors of the left ovary had cystic cut surfaces. The spectrum of lesions of both ovaries has different average widest diameters with significant overlap in their distribution. Metastatic carcinoma is seen to involve both ovaries and found to mainly have a solid cut surface. We found that the average widest diameter of a normal left ovary is 3.6 cm while that of a normal right ovary is 4.9 cm. Conclusions: The ovarian lesions have different widest diameters and are usually larger than that of a normal ovary. Benign ovarian tumours are generally larger than their malignant counterparts but cannot be distinguished based on size alone. Metastatic carcinoma involved both ovaries and had a predominantly solid-cut surface. The normal left ovaries were smaller than the normal right ovaries

Conjunctival reactive epithelial hyperplasia in a black African patient– a case report

Background: Reactive hyperplasia can occur in any part of the body but of concern is occurrence adjacent to certain neoplasm such as cutaneous fibrous histiocytoma, granular cell tumor, spitz nevus and melanoma. Ocular reactive epithelial hyperplasia is not as common as ocular reactive lymphoid hyperplasia. This is the first reported case in our environment. The patient was concerned about his cosmetic appearance, comments of friends and fear of eye problem in future. We report the case of a 32 year old patient with painless, progressive swelling of the conjunctiva following stone injury to the eye while on a bike 5 years earlier. A traumatic conjunctival cyst to rule out melanoma was the initial diagnosis. We therefore, managed the case by excision biopsy and histology report was in keeping with conjunctival reactive epithelial hyperplasia. One year after removal, he was free of any swelling and had no complaints. Conclusion: Excision biopsy is effective and it will assist in ruling out neoplasm and taking care of the patient’s cosmetic problem

Histopathologic profile of bone and joint lesions in a tertiary health institution in Southeast Nigeria: A nine-year review

Background: The human skeletal system is composed of all the bones, joints, cartilage, ligaments, and tendons. The lesions of this system were thought to be uncommon in our environment and like lesions in any other part of the body are better managed when early presentations and correct diagnosis are made. The paucity of research on these lesions has prompted the need to study the topic. Aims: We aimed to study the bone and joint lesions, with a view to determining the most common types, the most involved sites of the body, the sex, and the age of presentations. Materials and Methods: This was a retrospective study carried out at the Histopathology Department of Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria, from 2011 to 2019. Results: Eighty-four cases of bone and joint lesions were diagnosed in the study period, and they had a slight male preponderance with a M: F ratio of 1.4:1 and a mean age of 38.7 ± 22.0 years. Nonneoplastic lesions were more common 58.3% (49/84) than neoplastic tumours 41.7% (35/84). Benign tumours were however more common 27.4% (23/84) than malignant tumours 14.3% (12/84). Nonneoplastic lesions and benign tumours were seen in the first and second decades of life while malignant tumours occurred in the third and fourth decades. Of the 84 lesions, 47 cases were bone lesions while 37 were joint lesions. Osteomyelitis was the most common nonneoplastic bone lesion (7/47; 14.9%) while osteochondroma and giant cell tumours were the most common and only benign bone tumours seen and accounted for 14.9% (7/47) of cases each. Metastatic bone diseases (5/47; 10.6%) and osteosarcoma (4/47; 8.5%) were the most common malignant bone tumours, with osteosarcoma being the most common primary bone malignant tumours (4/7; 57.1%). Ganglion cysts were the most common lesions in all accounting for 23.8% (20/84) and the most common nonneoplastic (20/49; 40.8%) and joint lesions (20/37; 54.1%). Nodular tenosynovitis was the most common benign joint tumour and accounted for 10.8% (4/37) of cases; there is no malignant joint tumour. Skull was the most common anatomic site for bone lesions while the humerus was the most common anatomic site for bone tumours whereas wrist was the most common site for joint lesions. Conclusion: Nonneoplastic bone and joint lesions were more common than neoplastic lesions in our environment, with ganglion cysts being the most common joint lesions while osteomyelitis, osteochondroma, and giant cell tumours were the most common bone lesions. There is no malignant joint tumour observed in this study

SUMOylation Is Associated with Aggressive Behavior in Chondrosarcoma of Bone

Multiple components of the SUMOylation machinery are deregulated in various cancers and could represent potential therapeutic targets. Understanding the role of SUMOylation in tumor progression and aggressiveness would increase our insight in the role of SUMO in cancer and clarify its potential as a therapeutic target. Here we investigate SUMO in relation to conventional chondrosarcomas, which are malignant cartilage forming tumors of the bone. Aggressiveness of chondrosarcoma increases with increasing histological grade, and a multistep progression model is assumed. High-grade chondrosarcomas have acquired an increased number of genetic alterations. Using immunohistochemistry on tissue microarrays (TMA) containing 137 chondrosarcomas, we showed that higher expression of SUMO1 and SUMO2/3 correlates with increased histological grade. In addition, high SUMO2/3 expression was associated with decreased overall survival chances (p = 0. 0312) in chondrosarcoma patients as determined by log-rank analysis and Cox regression. Various chondrosarcoma cell lines (n = 7), especially those derived from dedifferentiated chondrosarcoma, were sensitive to SUMO inhibition in vitro. Mechanistically, we found that SUMO E1 inhibition interferes with cell division and as a consequence DNA bridges are frequently formed between daughter cells. In conclusion, SUMO expression could potentially serve as a prognostic biomarker