Adnexal Skin Tumors in Zaria, Nigeria

Background: Adnexal skin tumors share many features in common and differentiate along one line. Their detailed morphological classification is difficult because of the variety of tissue elements and patterns seen. They may be clinically confused with other cutaneous tumors. The aim of this report is to review and classify all adnexal tumors seen in a pathology department over a 16 year period. Method: A 16-year retrospective analysis of all adnexal skin tumors seen in a large University Teaching Hospital in Nigeria from January 1991- December 2006. All tissue specimens were fixed in 10% formalin, processed in paraffin wax and stained with Haematoxylin and Eosin. Histology slides were retrieved, studied and lesions characterized. Results: Fifty-two adnexal tumors were seen, accounting for 0.9% of all cutaneous tumors seen within the same period. The median age was 33 years (range: 4 days -70 years). Clinical presentations varied from discreet swellings and nodules to ulcerated masses. Five patients presented with recurrent lesions. Only two cases had a clinical diagnosis of adnexal tumor. Twenty-four (46%) of the lesions were distributed in the head and neck region. Duration of symptoms was 2 months to 15 years (median: 12 months). Tumours of the sweat gland were the commonest\u2013 41(78.8%); they comprised predominantly eccrine acrospiroma(17), characterized histologically by solid nests of round to polygonal cells with clear to eosinophilic cytoplasm, forming tubules in areas. Tumours of sebaceous gland were 7 (13.5%); they comprised mainly Nevus sebaceous of Jadassohn (6), composed of immature sebaceous glands and pilar structures microscopically and a solitary sebaceous adenoma. Tumours of hair follicle were 4 (7.7%) and included trichoepithelioma, characterized microscopically by multiple horn cysts and epithelial tracts connecting abortive pilar structures and a trichofolliculoma. Forty-six lesions (88.5%) were benign and six (11.5%) malignant. Conclusion: Adnexal skin tumors have distinct histological patterns which differentiates them from other cutaneous tumors. They are commonly distributed in the head, neck and trunk. The commonest variants are those of eccrine sweat gland origin. Malignant adnexal tumors are uncommon in our setting.Introduction: Adnezal tumeurs de la peau partagent pas mal de traits caract\ue9ristiques en commun et il y a des diff\ue9rences le long d'une ligne. Leur fiche de classification morphologique est difficile en raison de la vari\ue9t\ue9 des \ue9l\ue9ments des tissus et des tendances vues. Elles peuvent \ueatre cliniquement confondue avec d'autres tumeurs cutan\ue9es. L'objet de ce rapport est de passer en revue et de classifier tous les adnexal tumeurs vues dans un d\ue9partement de pathologie au cours d'une dur\ue9e de 16 ans. M\ue9thodes: Une analyse r\ue9trospective d'une dur\ue9e de 16 ans de l'assemble des tumeurs de la peau adnexal vues dans un grand centre hospitalier universitaire au Nig\ue9ria depuis janvier 1991 \u2013 d\ue9cembre2006. Tous les sp\ue9cimens des tissus ont \ue9t\ue9 fix\ue9s dans un formol 10%, trait\ue9 dans une paraffine solide et teint\ue9e avec l'h\ue9matoxyline et l'Eosine. Des plaques histologiques ont \ue9t\ue9 retrouv\ue9es, \ue9tudi\ue9es, et les l\ue9sions caract\ue9ris\ue9es. R\ue9sultats: Cinquante deux adnexal tumeurs ont \ue9t\ue9 observ\ue9es, ce qui repr\ue9sente 0,9% des tumeurs cutan\ue9es vues au cours de cette p\ue9riode. L'^\ue2ge m\ue9dian \ue9tait de 33 ans (groupe d'\ue2ge de 4 jours au 70 ans. Des pr\ue9sentations cliniques varient de gonflements et de nodules discret et des nodules aux masses ulc\ue9reuses. Cinq patients pr\ue9sentaient des l\ue9sions r\ue9currentes. Deux cas seulement ont eu un diagnostic clinique de adnexal tumeur. Vingt-quatre soit 46% des l\ue9sions ont \ue9t\ue9 distribu\ue9es dans la r\ue9gion de la t\ueate et du cou. La dur\ue9e des sympt\uf4mes \ue9tait de 2 mois \ue0 15 ans (m\ue9dians: 12 mois). Tumeurs de la glande sudoripare sont les plus communs. 41 soit 78.8%, ils comprenaient essentiellement encrine acrospirome (17), caract\ue9ris\ue9e histologiquement par de solides nids de round \ue0 polygonal cellules claires \ue0 cosonophilic cytoplasme, formant des tubes dans les r\ue9gions. Tumeurs des glandes s\ue9bac\ue9es \ue9taient 7 soit 13.5%, ils comprenaient surtout de Nevus s\ue9bac\ue9es de Jadassohn (6), compos\ue9 de glandes s\ue9bac\ue9es et immatur\ue9s structures de pilier au microscope et d'un ad\ue9nome solitaire s\ue9bac\ue9es. Tumeurs du follicule pileux \ue9taient 4 soit 7,7% et inclus trichoepitheliome, caract\ue9ris\ue9e microscopique ment par horn multiple kystes et appareil \ue9pith\ue9liaux reliant des structures des piliers avort\ue9s et un une trichofolliculome. Quarante six l\ue9sions soit 88,5% sont b\ue9nignes et six soit 11,5% malignes. Conclusion: Adnexal tumeurs de la peau ont des sch\ue9mas histologiques qui les diff\ue9rencie des autres tumeurs cutan\ue9es. Le plus souvent, ils sont distribu\ue9s dans la t\ueate, du cou et du tronc. Parmi les variantes sont celles des glandes sudoripares ecerine d'origine Adnexal tumeurs malignes sont rares dans notre milieu

Pattern of Cutaneous Malignant Melanoma in Zaria, Nigeria

Background: Twenty percent of the world's melanoma is seen in Black Africans and Asians. Melanoma in Nigerians would appear to be arising from existing epidermal melanocytes and not from preexisting naevus cells. Methods: All diagnosed cases of cutaneous malignant melanoma in the Department of Pathology Ahmadu Bello University Teaching Hospital, Zaria, Nigeria over a ten-year study period (1991-2000) were reviewed. The age, sex and anatomical site of the lesion were obtained from the request forms. The histopathological patterns of distribution, presence of dark brown melanin pigments, nucleolar appearance and Clark's histological grading were studied. The data was analysed and tabulated into frequency tables. Results: Fifty four cases of cutaneous malignant melanoma were reviewed. The over all male: female sex ratio was 1.3:1.0 with a wide age distribution from the second to seventh decades and two peaks in fifth and sixth decades. The foot and lower limbs were the most common sites. Seventy two percent of the cases were of high histological grade (Clark's level III and IV); thirty-six cases were distributed predominantly in sheets while 50 cases had dark brown melanin pigments. All showed characteristic prominent eosinophilic nucleolus. Conclusion: Malignant melanoma is a common skin tumour in Zaria. It is commonest in the fifth and sixth decades. The feet and lower limbs are predominantly affected.Fond: Vingt pour cent du m\ue9lanome du monde se trouvent parmi les Africains noirs et les Asiatiques. Le m\ue9lanome parmi les Nig\ue9rians semblerait une cons\ue9quence des m\ue9lanocytes \ue9pidermiques existants et pas de la pr\ue9existence des cellules de naevus. M\ue9thodes : Tous les cas diagnostiqu\ue9s de m\ue9lanome malin cutan\ue9 dans le d\ue9partement de Pathologie \ue0 l'H\uf4pital d'Enseignement de l'Universit\ue9 d'Ahmadu Bello, Zaria, Nigerie pendant une p\ue9riode d'\ue9tude de dix ans ( 1991-2000 ) ont \ue9t\ue9 pass\ue9s en revue. L'\ue2ge, le sexe et l'emplacement anatomique de la l\ue9sion ont \ue9t\ue9 obtenus \ue0 partir des questionnaires remplis. Les mod\ue8les histopathologiques de la distribution, de la pr\ue9sence des colorants bruns fonc\ue9s de m\ue9lanine, de l'aspect nucl\ue9olaire et de l'\ue9valuation histologique de Clark ont \ue9t\ue9 \ue9tudi\ue9s. Les donn\ue9es ont \ue9t\ue9 analys\ue9es et tabul\ue9es dans des tables de fr\ue9quence. R\ue9sultats: Cinquante quatre cas de m\ue9lanome malin cutan\ue9 ont \ue9t\ue9 pass\ue9s en revue. Le sex ratio g\ue9n\ue9ral de m\ue2le : femelle \ue9tait 1,3 : 1,0 avec une distribution large d'\ue2ge du deuxi\ue8me au septi\ue8me d\ue9cennies et de deux ondes en cinqui\ue8me et en sixi\ue8me d\ue9cennies. Le pied et les membres inf\ue9rieurs \ue9taient les emplacements les plus communs. Soixante-douze pour cent des cas \ue9taient de la cat\ue9gorie histologique \ue9lev\ue9e (\ue9valuation histologique de Clark III et IV), trente-six cas ont \ue9t\ue9 distribu\ue9s principalement en feuilles tandis que 50 cas avaient les colorants bruns fonc\ue9s de m\ue9lanine. Tout a montr\ue9 la caract\ue9ristique pro\ue9minente de nucl\ue9ole \ue9osinophile. Conclusion: Le m\ue9lanome malin est une tumeur de peau commune \ue9 Zaria. Il est le plus commun dans le cinqui\ue8me et le sixi\ue8me d\ue9cennies. Les pieds et les membres inf\ue9rieurs sont principalement affect\ue9s

Foetal Chondrodysplasia: Intrauterine Diagnosis

Chondrodysplasias are rare occurrence. We present a case of short-limbed chondrodyplasia diagnosed in a 22 week fetus of a 28 year old. She was para 4+0 with two children alive. She had similar occurrences in her last two pregnancies. The index pregnancy and the last two eventful pregnancies were preceded with ingestion of trado-herbal drug to treat subfertility.Des chondrodysplasies arrivent tr\ue8s rarement. Il s'agit d'une \ue9tude d'un cas de la chondrodyplasie membres courts diagnostique chez un foetus \ue2g\ue9 de 22 semaines d'une femme \ue2g\ue9e de 28 ans. Elle \ue9tait para 4 + 0 avec deux enfants vivants. Elle avait eu des exp\ue9riences semblabes pendant sa derni\ue8re deux grossesses. L'index de la grossesse et les deux derni\ue8res grossesses \ue9taient pr\ue9c\ue9d\ue9es par l'ingestion de la drougue trado-herbal afin de soigner la sous fertilit\ue

Ovarian Pregnancy Presenting as Ovarian Tumour: Report of 2 Cases

We present 2 cases of ovarian masses diagnosed as tumours but turned out to be pregnancy. Ovarian pregnancy, a form of ectopic gestation has a distinct pathology though it can be a source of diagnostic difficulty clinically and intraoperatively. A total of 71 ectopic pregnancies were seen in the department from January 2001 to December 2005, of these only two were ovarian ectopics. Both patients were nulliparous and presented with lower abdominal pains, abdominal masses and menstrual irregularity. They both had laparotomy and total right salpingo-oophorectomy. Grossly, the ovaries were enlarged, grey tan and globular. Focal ruptures in the wall of the ovaries showed protruding fetal parts. Microscopy showed chorionic villi within and in continuity with ovarian stroma and corpus luteum. They were both diagnosed ovarian ectopics. A good knowledge and understanding of the gross pathology, combination of imaging studies and high index of suspicion should help in making an intra-operative diagnosis.Nous pr\ue9sentons deux cas de masse ovariennes diagnostiques cliniquement comme des tumeurs mais apr\ue8s histologiquement ce sont r\ue9v\ue8les \ueatre des grossesses ectopiques. Les grossesses ovariennes, une forme de grossesse ectopique as une pathologie distincte est es difficilement diagnostiqu\ue9e cliniquement. Un total de 71 grossesses ectopiques a \ue9t\ue9 vues au D\ue9partement de Pathologie entre Janvier 2001 et D\ue9cembre 2005. Deux grossesses \ue9taient des grossesses ovariennes. Les deux patientes \ue9taient nullipares et ce sont pr\ue9sent\ue9es avec des douleurs au bas ventre, des tumeurs abdominales et des menstruations irr\ue9guli\ue8res. Les deux ont eu une exploration abdominale suivie d'une salpingoovarectomie. Anatomiquement, les ovaires \ue9taient, gris, globulaire, et hypertrophier. Des ruptures de la paroi ovaire montrait des protrusions d'\ue9l\ue9ments foetal. Histologiquement les ovaires ont r\ue9v\ue9l\ue9s les villosit\ue9s chorioniques dans et en continuit\ue9 avec le stroma ovarien et le corpus luteum. Les deux ovaires ont \ue9taient diagnostiqu\ue9s comme grossesse ovarienne. Une bonne connaissance et un bon entendement de l'anatomie-pathologie, une combinaison de l'imagerie et un fort taux de suspicion aide a faire un diagnostique clinique

Adnexal Skin Tumors in Zaria, Nigeria

Background: Adnexal skin tumors share many features in common and differentiate along one line. Their detailed morphological classification is difficult because of the variety of tissue elements and patterns seen. They may be clinically confused with other cutaneous tumors. The aim of this report is to review and classify all adnexal tumors seen in a pathology department over a 16 year period. Method: A 16-year retrospective analysis of all adnexal skin tumors seen in a large University Teaching Hospital in Nigeria from January 1991- December 2006. All tissue specimens were fixed in 10% formalin, processed in paraffin wax and stained with Haematoxylin and Eosin. Histology slides were retrieved, studied and lesions characterized. Results: Fifty-two adnexal tumors were seen, accounting for 0.9% of all cutaneous tumors seen within the same period. The median age was 33 years (range: 4 days -70 years). Clinical presentations varied from discreet swellings and nodules to ulcerated masses. Five patients presented with recurrent lesions. Only two cases had a clinical diagnosis of adnexal tumor. Twenty-four (46%) of the lesions were distributed in the head and neck region. Duration of symptoms was 2 months to 15 years (median: 12 months). Tumours of the sweat gland were the commonest– 41(78.8%); they comprised predominantly eccrine acrospiroma(17), characterized histologically by solid nests of round to polygonal cells with clear to eosinophilic cytoplasm, forming tubules in areas. Tumours of sebaceous gland were 7 (13.5%); they comprised mainly Nevus sebaceous of Jadassohn (6), composed of immature sebaceous glands and pilar structures microscopically and a solitary sebaceous adenoma. Tumours of hair follicle were 4 (7.7%) and included trichoepithelioma, characterized microscopically by multiple horn cysts and epithelial tracts connecting abortive pilar structures and a trichofolliculoma. Forty-six lesions (88.5%) were benign and six (11.5%) malignant. Conclusion: Adnexal skin tumors have distinct histological patterns which differentiates them from other cutaneous tumors. They are commonly distributed in the head, neck and trunk. The commonest variants are those of eccrine sweat gland origin. Malignant adnexal tumors are uncommon in our setting.Introduction: Adnezal tumeurs de la peau partagent pas mal de traits caractéristiques en commun et il y a des différences le long d'une ligne. Leur fiche de classification morphologique est difficile en raison de la variété des éléments des tissus et des tendances vues. Elles peuvent être cliniquement confondue avec d'autres tumeurs cutanées. L'objet de ce rapport est de passer en revue et de classifier tous les adnexal tumeurs vues dans un département de pathologie au cours d'une durée de 16 ans. Méthodes: Une analyse rétrospective d'une durée de 16 ans de l'assemble des tumeurs de la peau adnexal vues dans un grand centre hospitalier universitaire au Nigéria depuis janvier 1991 – décembre2006. Tous les spécimens des tissus ont été fixés dans un formol 10%, traité dans une paraffine solide et teintée avec l'hématoxyline et l'Eosine. Des plaques histologiques ont été retrouvées, étudiées, et les lésions caractérisées. Résultats: Cinquante deux adnexal tumeurs ont été observées, ce qui représente 0,9% des tumeurs cutanées vues au cours de cette période. L'^âge médian était de 33 ans (groupe d'âge de 4 jours au 70 ans. Des présentations cliniques varient de gonflements et de nodules discret et des nodules aux masses ulcéreuses. Cinq patients présentaient des lésions récurrentes. Deux cas seulement ont eu un diagnostic clinique de adnexal tumeur. Vingt-quatre soit 46% des lésions ont été distribuées dans la région de la tête et du cou. La durée des symptômes était de 2 mois à 15 ans (médians: 12 mois). Tumeurs de la glande sudoripare sont les plus communs. 41 soit 78.8%, ils comprenaient essentiellement encrine acrospirome (17), caractérisée histologiquement par de solides nids de round à polygonal cellules claires à cosonophilic cytoplasme, formant des tubes dans les régions. Tumeurs des glandes sébacées étaient 7 soit 13.5%, ils comprenaient surtout de Nevus sébacées de Jadassohn (6), composé de glandes sébacées et immaturés structures de pilier au microscope et d'un adénome solitaire sébacées. Tumeurs du follicule pileux étaient 4 soit 7,7% et inclus trichoepitheliome, caractérisée microscopique ment par horn multiple kystes et appareil épithéliaux reliant des structures des piliers avortés et un une trichofolliculome. Quarante six lésions soit 88,5% sont bénignes et six soit 11,5% malignes. Conclusion: Adnexal tumeurs de la peau ont des schémas histologiques qui les différencie des autres tumeurs cutanées. Le plus souvent, ils sont distribués dans la tête, du cou et du tronc. Parmi les variantes sont celles des glandes sudoripares ecerine d'origine Adnexal tumeurs malignes sont rares dans notre milieu

Bone fragments in the cervix uteri

Bone fragments within the cervix uteri are a rare occurrence, however, they may be occasionally found within the endometrial cavity and body of the uterus.We report the case histories of two single, sexually active women who each presented with a history of repeated termination of pregnancy, dyspareunia, post-coital bleeding and penile bleeding in their partners. Examination revealed a hard sharp object embedded within the cervix uteri at the cervical os. Tissue histology confirmed bone fragments.O & G Forum Vol. 17 (4) 2007: pp. 123-12

Leiomyosarcoma uteri in a white woman

Sacroma of the corpus uteri should be considered as a differential diagnosis in postmenopausal women presenting with severe abdominal pain, thought to be due to degenerative changes of leiomyoma uteri. We present a rare case of leiomyosacroma in a postmenopausal White woman. Diagnosis was missed preoperatively for degenerating uterine fibroid

Leiomyosarcoma uteri in a white woman

Sacroma of the corpus uteri should be considered as a differential diagnosis in postmenopausal women presenting with severe abdominal pain, thought to be due to degenerative changes of leiomyoma uteri. We present a rare case of leiomyosacroma in a postmenopausal White woman. Diagnosis was missed preoperatively for degenerating uterine fibroid

Evaluation Of Cervical Punch Biopsy In The Diagnosis Of Cervical Cancer

Background: Cancer of the cervix uteri is the second leading cause of death in reproductive age women in developing countries. Its early detection and management can reduce the attendant mortality. Aim: To determine the adequacy of cervical punch biopsy technique in the diagnosis of cervical cancer. Methods: A consecutive five year clinico-pathological analysis of two hundred and fourteen cervical punch biopsies in the department of Pathology, Ahmadu Bello University Teaching Hospital, Zaria from January 2001 to December 2005. Results: Two hundred and fourteen (214) cervical punch biopsies were analysed. The age range of the patients was 22 to 85years, with a median age of 46 years and a mean age of 46.8years. Commonest presenting complaints were abnormal vaginal bleeding and offensive vaginal discharge. Out of the 214 biopsies, histological diagnosis was made in 190 (88.8%) cases. The spectrum of diagnosis comprised malignant tumours 164 (76.6%), cervical intraepithelial neoplasia (CIN)10 (4.7%), chronic cervicitis 9 (4.2%) and others 7(3.3%) including nabothian cysts, leiomyoma and a case of tuberculosis. The malignant tumours comprised predominantly squamous cell carcinoma 153(71.5%) with the large cell keratinizing histologic subtype accounting for 144 (99.1%), cervical Adenocarcinoma 5(2.3%), Adenosquamous 4 (1.9%), Leiomyosarcoma 1(0.5%) and malignant lymphoma 1(0.5%). Of the CIN cases, 7 had prior abnormal cervical smear cytology. 24 (11.2%) biopsies were considered inadequate for histological opinion due to extensive necrosis, obscuring haemorrhage and or scanty tissue. Conclusion: Cervical punch biopsy technique is an adequate procedure in the diagnosis of cervical cancer. Squamous cell carcinoma is the commonest histologic type and late presentation is the norm in our setting. Keywords: Punch Biopsy, Cancer Cervix, CytologyHighland Medical Research Journal Vol. 5 (1) 2007 pp. 33-3