Hepatocellular Carcinoma in Port Harcourt, Nigeria: Clinicopathologic Study of 75 Cases

Background: Hepatocellular carcinoma (HCC) is a complication of liver cirrhosis caused by hepatitis B viral infection, fungal infection and genetic factors. This disease though having a silent course is associated with variable morbidity and mortality in this environment. Methods: Previously prepared histologic slides were retrieved and re-evaluated to confirm the diagnosis. Clinical data such as the age, sex, clinical presentations, histologic grading and cause of death were extracted from the case notes, histology request forms and autopsy protocol forms. Results: Seventy five cases were used for the study during the period under review. The youngest was a 14 year old male while the oldest was a 66 years old male. Male to female ratio was 2:1. Majority (28%) occurred in the age group 40-49 years. Upper abdominal mass was the most common clinical presentation (30.7%) and well differentiated hepatocellular carcinoma was the most common (64.0%) histologic grade. Trabecular / sinusoidal pattern (49.3%) was the most common histologic type (pattern) while upper gastro-intestinal bleeding (38.7%) was the most common cause of death at autopsy. Conclusion: Hepatocellular carcinoma is a notable malignancy of the liver associated with variable morbidities and mortality as it has an insidious onset and very aggressive course.Introduction: Carcinome H\ue9patocellulaire est une complication de la cirrhose caus\ue9e par l'infection d'H\ue9patite B virale, mycose, et des facteurs g\ue9n\ue9tiques. Cette maladie quioque sa cause est taciturne est li\ue9e avec un variable ayant rapport \ue0 la morbidit\ue9 et la mortalit\ue9 dans ce milieu. M\ue9thode: Des plaques histologique pr\ue9par\ue9es auparavant ont \ue9t\ue9 r\ue9cuper\ue9es et \ue9valu\ue9es de nouveau afin de confirmer des donn\ue9es cliniques diagnostiques telles que l'\ue2ge, sexe, pr\ue9sentation cliniques, classement histologique et la cause de la mort ont \ue9t\ue9 tir\ue9s du dossier m\ue9dical, formulaire du demande histologique, et des formulaires des protocole d'autopsie. R\ue9sultats: Soixante quinze cas ont \ue9t\ue9 utilis\ue9s pour l'\ue9tude au cours de la p\ue9riode de cette \ue9tude. Le plus jeune est du sexe masculin \ue2g\ue9 de 14 ans tandis que le plus \ue2g\ue9 est hun homme \ue2g\ue9 de 66 ans. Propotrtion sexe masculin et sexe f\ue9minin \ue9tait 2 :1. La majorit\ue9 28% arrive chez la tranche d'\ue2ge de 40-49 ans. Masse abdominale sup\ue9rieure \ue9tait la pr\ue9sentation clinique la plus ordinaire (30,7%) et le carcinome h\ue9patocellulaire bien d\ue9termin\ue9 \ue9tait le plus ordinaire (64,0%) classement histologique. La tendance trabeculaire/sinusoidale (49,3%) \ue9tait le type (tendance) histologique le plus ordinaire tandis que saigant gastro-intestinal sup\ue9rieur (38,7%) \ue9tait la cause de la mort la plus ordinaire pendant l'autopsie. Conclusion: Carcinome H\ue9patocellulaire est une malignit\ue9 remarquable du la foie li\ue9e avec des variables de la morbidit\ue9 et de la mortalit\ue9 parcequ'il a un debut insidieux et une \ue9volution tr\ue8s aggressive

A Ten-Year Pathological Study of Renal Tumours in Port Harcourt, Nigeria

Background/Objective: To determine the relative frequency of renal tumours with respect to age, sex and clinical presentation. Method: A retrospective review of histologic reports and clinical notes. Nephrectomy and renal specimens from autopsy were routinely processed and stained with hematoxylin and Eosin (H & E) stain. The completed slides were viewed under the light microscope for the diagnosis of the tumours. Results: Thirty nine specimens accounting for 0.5% of the total tumours satisfied the criteria for the study. Thirty seven tumours (94.9%) were malignant while 2(5.1%) were benign. The youngest was an 8 months old female while the oldest was a 65 year old female. A total of 24(61.5%) tumours occurred in males while 15(38.5%) in females giving a sex ratio of 1.6:1. Nephroblastoma (64.1%) was the commonest malignancy and majority occurred in children while renal cell carcinoma was the most common adult renal tumour. Haematuria was the most frequent clinical presentation. Conclusion: Renal tumours are rare in this environment but they may pose a significant morbidity and mortality. Though some present with severe clinical symptoms others may go unnoticed.Introduction/Objectif : D\ue9terminer la fr\ue9quence relative \ue0 la tumeur r\ue9nale par rapport \ue0 l'\ue2ge, sexe, et pr\ue9sentation clinique. M\ue9thode : Un bilan r\ue9trospectif des rapports histologiques et des notes cliniques. La n\ue9phrectomie et des sp\ue9cimens/\ue9chantillons r\ue9nals d'autopsie ont \ue9t\ue9 syst\ue9matiquement analys\ue9s et tach\ue9s avec h\ue9matoxyline et Eosine (H & E) tache. Des pr\ue9parations compl\ue8tes ont \ue9t\ue9 examin\ue9es \ue0 la loupe avec la lumi\ue8re pour le diagnostic des tumeurs. R\ue9sultats : Trente neuf \ue9chantillons contituent 0,5% de toutes les tumeurs ont satisfi\ue9 le crit\ue8re pour l'\ue9tude. Trente sept tumeurs soit 94,9% \ue9taient de la nature maligne tandis que 2 tumeurs soit 5,1% \ue9taient b\ue9nigne. La plus jeune \ue9tait une sujet du sexe f\ue9minin \ue2g\ue9e du 8 mois tandis que la plus vieille \ue9tait une femme \ue2g\ue9e de 65 ans. Un total de 24 soit 61,5% des tumeurs se sont produit chez des sujet du sexe masculin tandis que 15 soit 38,5% ont eu lieu chez du sexe f\ue9minin ce qui donne une proportion de 1,6 :1. N\ue9phroblastome 64,1% \ue9tait la malignit\ue9 la plus fr\ue9quente et la majorit\ue9 est arriv\ue9e chez des enfants tandis que carcinome cellule r\ue9nale \ue9tait la tumeur r\ue9nale des adultes la plus fr\ue9quente. L'h\ue9maturie \ue9tait une pr\ue9sentation clinique la plus fr\ue9quente. Conclusion : Des tumeurs r\ue9nales sont rare dans cette r\ue9gion mais pourraient provoguer une morbidit\ue9 et une mortalit\ue9 importante. Quoique quelqu'unes pr\ue9sentent des sympt\uf4mes cliniques graves des autres pourraient passer inaper\ue7u

Atypical presentation of colon adenocarcinoma: a case report

<p>Abstract</p> <p>Introduction</p> <p>Adenocarcinoma of the colon is the most common histopathological type of colorectal cancer. In Western Europe and the United States, it is the third most common type and accounts for 98% of cancers of the large intestine. In Uganda, as elsewhere in Africa, the majority of patients are elderly (at least 60 years old). However, more recently, it has been observed that younger patients (less than 40 years of age) are presenting with the disease. There is also an increase in its incidence and most patients present late, possibly because of the lack of a comprehensive national screening and preventive health-care program. We describe the clinicopathological features of colorectal carcinoma in the case of a young man in Kampala, Uganda.</p> <p>Case presentation</p> <p>A 27-year-old man from Kampala, Uganda, presented with gross abdominal distension, progressive loss of weight, and fever. He was initially screened for tuberculosis, hepatitis, and lymphoma, and human immunodeficiency virus/acquired immunodeficiency syndrome infection. After a battery of tests, a diagnosis of colorectal carcinoma was finally established with hematoxylin and eosin staining of a cell block made from the sediment of a liter of cytospun ascitic fluid, which showed atypical glands floating in abundant extracellular mucin, suggestive of adenocarcinoma. Ancillary tests with alcian blue/periodic acid Schiff and mucicarmine staining revealed that it was a mucinous adenocarcinoma. Immunohistochemistry showed strong positivity with CDX2, confirming that the origin of the tumor was the colon.</p> <p>Conclusions</p> <p>Colorectal carcinoma has been noted to occur with increasing frequency in young adults in Africa. Most patients have mucinous adenocarcinoma, present late, and have rapid disease progression and poor outcome. Therefore, colorectal malignancy should no longer be excluded from consideration only on the basis of a patient's age. A high index of suspicion is important in the diagnosis of colorectal malignancy in young African patients.</p

Testicular Tumors In Port Harcourt (A Ten-Year Review)

Background: Primary testicular tumours are rare in this environment, affecting mainly children and are associated with maldescended testis, mumps infection and trauma. There is no obvious association with gas flaring and fumes emitted by industrial machines or occupational exposure. Objective: Highlighting the pattern of testicular tumours in Port Harcourt based on age of patients and histological types. Design: A retrospective descriptive study. Method: Twelve testicular tumours diagnosed in ten years (1991 - 2000) were studied in the University of Part Harcourt Teaching Hospital (UPTH) Port Harcourt. Histology slides previously stained with haematoxylin and eosin stains were used for the study. Special stains like phosphotongstic acid hematoxylin (PTAH) were also used to confirm diagnosis. Result: The tumours are rare in this environment as it accounted for 0.7% of total malignancies during the study period. The youngest was 3 years old while the eldest was 48 years old. Majority of (33.3%) cases occurred in the age group of 0-9 years and the least occurred in 40-49 years age group (8.3%). Germ cell tumours were commonest (75%) while the sexcord-stromal tumours, adnexial tumours and the lymphoid tumours were the least together accounting for 25% in equal proportions. There is an average distribution of 3 tumours in 2 years in this study and the tumour is commoner in the children of school age. Conclusion: Testicular tumours in Port Harcourt though very few in number, correlates well with the pattern in other parts of the world. Key Words: Testicular tumours, patterns, age, Port Harcourt. Nigerian Journal of Clinical Practice Vol. 7(2) 2004: 56-5

Pseudoangiomatous stromal hyperplasia (PASH)

No Abstract

A 23-year review of sudden natural death autopsies in the Niger Delta region of Nigeria

Background: Death occurring suddenly especially when the victim was active and recently fit, call for attention and thorough investigation to rule out secret homicide. Aim: To study the pattern of sudden natural death in the Niger Delta region of Nigeria.Methodology: The coroner's autopsy reports and hospital autopsy protocols of sudden deaths of 23 years (1986-2008) were reviewed. Sudden deaths due to natural causes were selected for this study and the variables considered were the age, gender, locations of death and the system bearing the disease that caused death at autopsyResults: A total of 445 deaths satisfied the criteria for this study. One hundred and fifty seven (35.3%) deaths occurred in children aged 17 years and below of which the&#160; highest frequency occurred in neonates of ages 0 - 4 weeks [82(18.4%)]. A total of 288 deaths occurred in adults, of which the highest frequency [82(18.4%)] occurred in the age group 58-67 years. Two hundred and ninety two deaths occurred in males and 153 in females giving ratio of 1.9:1. The urban setting had 267(60%) of cases while the rural areas had 178(40%) cases. Cardio-vascular death was the most common overall death [146(32.8%)] and this was found more in adults while respiratory death was commoner in childhood and second overall cause of death [97(21.8%)].Conclusion:&#160; Sudden death from natural cause calls for attention and thorough investigation since the victim was previously healthy and fit without the manifestation of underlying disease. This type of death is therefore viewed with suspicion

Case ReportKaposi's Sarcoma Of Rare Anatomical Site: A Report Of Two Cases

Kaposi's Sarcoma (KS) of unusual sites are commonly associated with immunodeficiency and it is therefore known as one of the AIDS defining tumors. KS of the conjunctiva and traumatized areas of the foot especially the sole are listed as some of the uncommon sites for this tumor. One of the patients developed oral thrush (moniliaisis) at the age of 60 years while the other developed diarrhoeal disease and desquamative skin lesions. Both of them are positive to human immunodeficiency virus (HIV) screening (retroviral screening). Key words: Kaposis Sarcoma, rare sites, immunodeficiency Highland Medical Research Journal Vol. 3 (1) 2005: 50-5

Homicide In Port Harcourt Rivers State

OBJECTIVE: A retrospective study of homicidal deaths in Rivers State METHOD: Based on the 610 autopsied bodies in the Anatomical Pathology department of the University of Port Harcourt Teaching Hospital (UPTH), the only referral hospital in Rivers State at the time of study, covering January 1st 1986 to December 31st 2000 inclusive, was carried out by the authors. RESULTS: There were 524 males (85.9%) and 86 (14.1%) female victims of homicide with a sex ration of 6:1. Homicide is commoner in the age range 20-40 years in which 59.0% of the victims were involved. Firearms were the commonest method employed and the least was drowning. Communal clashes and armed banditry were the commonest motivating factors in that order. Attempt at concealment of Homicide by various methods was a common finding. CONCLUSION: Homicide rate in this study is proportional to the level of poverty in the society. There is a recent upsurge in homicide in this environment. Nig Jnl Orthopaedics & Trauma Vol.2(2) 2003: 120-12

Electrocution attributed to supernatural forces in the Niger Delta region of Nigeria: A report of three cases

No Abstract. Nigerian Journal of Medicine Vol. 14(4) October-December 2005: 439-44