Tuberculous mastitis simulating carcinoma of the breast in a young Nigerian woman: a case report

Tuberculous mastitis is an uncommon disease even in countries where tuberculosis is highly endemic. It typically presents a diagnostic challenge masquerading as carcinoma or other primary disease of the breast. We report the case of a young multiparous Nigerian woman who presented with a tender left breast lump and enlargement of the left axillary lymph nodes for which a provisional diagnosis of carcinoma of the breast was made after clinical and radiological evaluation. The mass was pathologically diagnosed as tuberculous mastitis and anti-tuberculous therapy was instituted although she later absconded. This case shows that TM may present a diagnostic challenge on clinical, radiologic and microbiological investigation. Therefore, a high index of suspicion as well as FNAC and/or histological evaluation of tissue samples remain very important its diagnosis

Histopathology practice and training in Nigeria – a model

Objectives: Contemporary histopathology practice and training in Nigeria have been plagued by the fundamental issue of inadequate exposure to surgical pathology material by both trainees and trainers. This paper critically examines the factors that affect the discipline and profers practical solutions to aid its advancement.Materials and Method: This review is based on the authors experience and observations of histopathology practice in Nigeria.Results: The Nigerian health sector is plagued by many ills including poor funding, weak policies, dilapidated structures, disgruntled and frustrated practitioners, amongst others - and pathologists are not immune to all these. In recent times, there has been a proliferation of accredited training centres as well as medical graduates interested in the specialty of histopathology. The busiest histopathology laboratories in the country ascession between 2200 and 5500 surgical samples yearly. Thus there is inadequate exposure by histopathologists and trainee pathologists to surgical materials with the attendant consequences. Many centres still rely principally on routine haematoxylineosin stains. There are no nationally agreed standard reporting formats for most diseases.Conclusion: The development of a deanery or regional system of accredited histopathology laboratories may form the fulcrum for improving the overall quality of histopathological services and training in Nigeria. This will help develop local expertise and ensure adequate exposure to teaching aids and surgical materials. We hope that the proffered solutions will help encourage local pathologists to continue and increase their efforts to raise the profession up to enviable heights.Keywords: Histopathology, practice, training, nigeria, mode

The comparison between cytological and histological grading of breast cancers in a Nigerian tertiary hospital

Background: Breast cancer is one of the most common cancers in Nigeria. The tumour grade is an important prognostic factor and is also important in treatment of patients. Fine needle aspiration cytology can be used as an initial diagnostic tool for planning definitive management. Grading of tumours on cytology further guides therapeutic decisions. The aim of this study is to compare the correlation between the cytological and histological grading of malignant breast lumps using the Robinson's cytological grading system and Nottingham histological grading system respectively. The Objectives are, to determine the age distribution of breast cancer in our environment, to grade breast cancers cytologically using the Robinson's cytological grading system and to grade breast cancers histologically using the Nottingham histological grading system.Methods: This was a one year prospective study that involved 30 patients who had malignant smears on fine needle aspiration cytology of their breast lump. These smears were graded using the Robinson's cytological grading system and compared with the Nottingham histological grading systems of same lumps obtained from either tissue biopsies or mastectomies.Results: The mean age of the study participants was 50.23±10.11 years with a range of 35-70 years. Most (56.7%) malignat smears were of cytologic grade 3. The histological grade was 2 in 16(53.3%) and 3 in 14(46.7%) of the same breast tissue samples. The grade 2 tumours had the highest concordance rate of 83.3%. The absolute concordance rate between Robinson's cytological and Nottingham histological grading system of breast cancers was 73.3%.Conclusion: The Robinson's cytological and Nottingham histological grading systems showed good correlation.Keywords: Breast Cancer, fine needle aspiration cytology, cytological grading, histological gradin

Metastatic choriocarcinoma presenting as advanced renal cell carcinoma: A case report

Choriocarcinoma is an aggressive tumour arising as a malignant transformation of the gestational trophoblastic disease or rarely from the germ cells in the ovary and from testicular mixed germ cell tumour. Renal involvement due to Choriocarcinoma is rare we report here one of such rare cases. A 26yr old woman presented with painful right sided loin swelling with painless total haematuria of 3weeks duration .Abdominal Ultrasound and CT scan showed a solid Right kidney mass with a cystic component. She had right radical nephrectomy.Histopathological examination revealed metastatic choriocarcinoma. The challenges we faced in her management is highlightedand a brief review of literature on the subject is presented

Malignant tumors of the upper aerodigestive tract as seen in a Nigerian tertiary health institution

Background: Cancers of the upper aerodigestive tract constitute a diverse heterogeneous group of malignant neoplasms with unique epidemiological, pathological, and treatment considerations. Only few studies have been conducted so far on these tumors in Nigeria. This study aims to study in greater detail, the pathological features of these cancers in Nigerian patients.Materials and Methods: The surgical specimens of patients diagnosed with malignant tumors of the upper aerodigestive tracts in the Department of Morbid Anatomy and Forensic Medicine, Obafemi Awolowo University Teaching Hospital Complex (OAUTHC) in Ile‑Ife, Nigeria, over a 10‑year period, formed the basis of this study. Analysis was done for differences in proportion using the Chi‑square test (P is significant at < 0.05) by SPSS version 15.Results: There were a total of 62 cases. The overall mean age was 50.7 years, while the age range was from 3 years to 90 years. The male to female ratio was 3.1:1. A majority of the patients (67.7%) were older than 40 years. About 30.6, 27.4, and 16.1% of cases occurred in the larynx, nasopharynx, and nasal cavity, respectively, while 93.5% of the tumors were carcinomas. Squamous cell carcinoma was the most common histological variety. Nonepithelial tumors were not seen below the age of 20 years.Conclusion: This study shows that malignant upper aerodigestive tract tumors seen in our environment are mainly diseases of adulthood that tend to occur about seven to nine years earlier than in other populations. Squamous cell carcinoma is the predominant histological variety. Although the larynx is the most frequent anatomic site, the nasopharynx and nasal cavity are more commonly affected than the oral cavity unlike in other populations. Nonepithelial tumors are extremely rare below the age of 20 years.Key words: Malignant tumors, Nigeria, upper aerodigestive trac

Biopsy-proven renal disease in Ile-Ife, Nigeria: A histopathologic review

Although various patterns of renal diseases have been reported from different renal biopsy registries worldwide, data from Nigeria remain scanty. A 10-year retrospective review of renal biopsies was conducted in our tertiary health care facility. All cases were reclassified based on their light microscopic features after the application of standard histochemical stains. A total of 165 cases were reviewed with a male:female ratio of 1.8:1 and a mean age of 15.4 ± 12.0 years. About 69.7% of the cases were below the age of 16 years, while only 2.4% were older than 50 years. The most common indications for biopsy were nephrotic syndrome (72.1%) and acute renal failure of unknown etiology (11.5%). Overall, glomerulonephritis (80%) was the most common histologic category and occurred only in individuals younger than 50 years old. Minimal change disease (22.9%) and membranoproliferative glomerulonephritis (21.9%) were the most common varieties in children, while membranous glomerulonephritis (30.6%) and focal segmental glomerulosclerosis (27.8%) were the commonest among the adult population. The initial histologic diagnosis was revised in 18 cases while a diagnosis was arrived at in seven cases initially adjudged as inadequate for assessment. This study showed that renal biopsy was predominantly performed in children and adolescents. Although glomerulonephritis was the predominant disease, the predominant histologic patterns varied with the patient age. Despite the scarcity of advanced diagnostic tools in resource-poor environments, routine use of histochemical stains is helpful in the evaluation of renal biopsies