FACULTY OF BASIC MEDICAL SCIENCES
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Item Histopathological pattern of primary ovarian neoplasms in south‑western Nigeria(Association of Resident Doctors of Jos University, 2016) Ajani, M. A.; Aramide, K. O.; Salami, A. A.; Okolo, C. A.Background: Ovarian tumours are common forms of neoplasms in women. This study aims to determine the histopathological pattern of primary ovarian neoplasms in south-western Nigeria. Method: A retrospective study was undertaken to review the histopathology reports of all primary ovarian neoplasm specimens submitted to the Department of Pathology, University College Hospital, Ibadan from January 1991 to June 2013. Patients’ biodata were extracted from request forms and surgical day books. Results: There were 821 cases of primary ovarian neoplasms. Surface epithelial neoplasms accounted for 359 (43.7%) of cases and were found in patients aged 10–89 years. Germ cell tumours numbered 313 (38.0%) in patients aged 0–70 years, while sex cord stromal tumours numbered 146 (17.8%) in patients aged 0–99 years. Among benign ovarian neoplasms, Mature Cystic Teratoma was the most common (54.7%) with the 20–29 year age range having the highest frequency. Among primary malignant ovarian neoplasms, serous cystadenocarcinoma was the most common (33.2%) and most frequent in the 50–59 year age group. Conclusion: Surface epithelial tumours were the most common ovarian neoplasms followed by germ cell tumours. This histopathological pattern is observed in most parts of Nigeria, some African and Asian countries, and in the Western world.Item Childhood ovarian neoplasms in Ibadan,South‑western Nigeria(Wolters Kluwer – Medknow, 2016) Ajani, M. A.; Aramide, K. O.; Ajani, T. A.; Salami, A. A.; Okolo, C. A.Background: Childhood ovarian neoplasms are very rare. Little information is available on the relative pattern and frequency of these tumors in Nigerian children. Earlier study done in Ibadan involved ovarian neoplasms in children and adolescents. The aim of this study is to review cases of ovarian neoplasms in children <15 years over a 22½ year period. Materials and Methods: This was a retrospective study. Twenty‑four cases of childhood ovarian neoplasms were seen in patients <15 years of age. These cases were classified using the current World Health Organization histological classification of ovarian tumors. Results: Childhood ovarian neoplasms accounted for 2.8% of all cases of ovarian tumors seen in this period. Fourteen (58.3%) cases of childhood ovarian neoplasms were benign, and 10 (41.7%) were malignant. Mature cystic teratoma occurring in 13 (54.2%) was the most common childhood ovarian neoplasm and was most prevalent between 10 and 14 years of age. Burkitt lymphoma was the most common 4 (40%) malignant childhood ovarian tumor and prevalent between 5 and 14 years of age. Conclusion: Mature cystic teratoma remains the single most common childhood ovarian neoplasm, and Burkitt’s lymphoma is the most malignant childhood ovarian tumor in Ibadan, South‑western Nigeria.Item One year of breast cancer in Ibadan, Southwestern Nigeria: a histopathological review(African Journal of Open Libraries, 2021) Jimoh, M. A.; Ajani, M. A.; Folorunso, S. A.; Fatunla, E. O.; Aruah, C. S.; Abdus-Salam, A. A.; Ogunbiyi, J. O.Background: Breast cancer is a major public health problem in most low- to medium-income countries of the world because of its high morbidity and mortality rate. Histopathological features are vital in risk assessment, selection of treatment and prognostication in breast cancer patients. This study aimed to assess the histopathological features of all breast cancer cases seen in a tertiary hospital in the year 2018. Methods: This is a retrospective review of all breast cancer cases histologically diagnosed and confirmed by three Pathologists at the University College Hospital (UCH), Ibadan over a one-year period from 1st January 2018 to 31st December, 2018. Results: A total of 236 breast cancer cases were seen during this period, 234 (99.2%) were females while only 2 (0.8%) were male. 163 (69.7%) patients were between the fourth and sixth decades of life, 65 (27.8%) patients were above sixth decade while 6 (2.5%) patients were below fourth decade. Invasive ductal carcinoma of No Special Type (NST) was the commonest histological subtype 212 (89.8%). Grade 1 cases were 25 (10.6%), Grade 2 129 (54.7%) and Grade 3 cases were 40 (16.9%) while 42 (17.8%) were not graded. Lymphovascular invasion observed in 98 (41.5%) of the cases. 54 (22.9%) had immunohistochemistry out of which 23 (43.4%) were triple negative while 8 (3.4%) were triple positive. Conclusion: Histopathological features suggesting aggressive disease was predominantly observed. Efforts should be made towards early diagnosis, adequate evaluation and prompt treatment. Cancer care should be fully incorporated in the National Health Insurance Scheme (NHIS).Item Patterns of inflammatory lesions of the appendix in a Nigerian Tertiary Health Facility(African Journal of Open Libraries, 2021) Ajani, M. A.; Awosusi, B. L.; Omenai, S. A.; Adegoke, O. O.; Ajani, T. A.Background: Appendicitis is most common between the ages of 10 and 20 years, although all ages can be affected. Acute appendicitis is the most common cause of acute surgical abdomen worldwide and its incidence varies with geographical location. The aim of this study was to review all the inflammatory lesions of the surgically removed appendix in University College Hospital, Ibadan, Nigeria and to describe the histopathological patterns of these lesions. Methods: This study was a retrospective review of all appendectomy specimens submitted to the Department of Pathology, University College Hospital, Ibadan, Nigeria from January 2009 to December 2018. Patients’ biodata, clinical parameters, and histological diagnoses were extracted from departmental surgical day books. The data were analyzed using IBM SPSS Statistics (version 23; IBM Corporation, Armonk, New York) and expressed as frequency distribution. Results: A total of 1071 appendectomy specimens were received in our laboratory during the 10-year study period, accounting for 3% of all specimens received. There were 1062 cases of inflammatory lesions, accounting for 99.2% of the cases. There was a male preponderance with male to female ratio of 1.2:1. The age was from 1 to 83 years. The most common histological diagnosis was acute suppurative appendicitis with peritonitis accounting for 47.6% of all the cases. Conclusion: The findings in our study supports the fact that acute suppurative appendicitis is the most common inflammatory disease of the appendix which is consistent with other similar studies that have been done in our environment and in the developed world.Item Prevalence and review of pathological anatomy of gestational choriocarcinoma in Ibadan(Journal Gurus, 2022) Awosusi, B. L.; Ajani, M. A.; Adegoke, O. O.; Salami, A. A.; Okolo, C. A.Objectives: Gestational choriocarcinoma (GCC) is a highly malignant epithelial tumor arising from the trophoblast of any type of gestational event, most often a complete hydatidiform mole. Choriocarcinoma is the most aggressive form of gestational trophoblastic neoplasia owing to their rapid growth and metastatic potential. This study reviewed all cases of GCC seen at the University College Hospital Ibadan. Methods: This was a 20 year retrospective hospital-based study designed to review all histologically diagnosed cases of choriocarcinoma registered at the Department of Pathology, University College Hospital (UCH), Ibadan, Nigeria, from 1st January, 1997 to 31st December, 2016. Clinicopathological data was extracted from the departmental surgical day book, Ward register, Department of Medical Records and Cancer Registry. The data was analyzed using the Statistical Package for Social Sciences, version 22. The results were presented in tables, relative frequencies and group percentages. Results: One hundred and eighty three cases of gestational trophoblastic disease were histologically diagnosed within the study period out of which 36 cases were GCC accounting for 19.7%. 55.6% of all the cases were received as endometrial biopsies, 33.3% as hysterectomy specimens, 8.3% as cervical biopsies and 2.8 as an anterior vaginal wall mass. Choriocarcinoma occurred in the age range 20 to 50 years with majority of cases occurring in the third decade of life. Conclusion: Gestational choriocarcinoma is still the most common gestational trophoblastic neoplasia seen in our environment. Awareness of this tumour with a high index of suspicion is needed for an accurate diagnosis and patient management.Item Histopathological profile of childhood thyroid carcinoma in Ibadan, Southwestern Nigeria(The National Postgraduate Medical College of Nigeria, 2020) Omenai, S. A.; Ezenkwa, U. S.; Ajani, M. A.Objectives: Diabetes mellitus (DM) is a global health problem with associated high morbidity and mortality. This study was a retrospective review of post mortem examination findings of hospitalised patients with DM for causes of death. Materials and Methods: A retrospective, cross sectional autopsy review of all the patients with DM in our hospital between January 2008 and December 2017 was conducted. The causes of death were classified into cardiovascular, cerebrovascular, acute diabetic emergencies, infection, cancers and unnatural deaths. The demographic data and clinicopathological parameters were extracted, and the data were analysed using the SPSS software version 23. Results: A total of 1092 cases of autopsy were done within the study period, of which 91 cases were on patients with diabetes accounting for 8.3%. Infections with sepsis were the major cause of death, accounting for 51.6% followed by cardiovascular diseases(16.5%), cancers(14.3%), acute diabetic emergencies (6.6%) and cerebrovascular accidents (6.6%), with renal complications and road traffic accidents accounting for 2.2% each. Patients’ age ranged from 31 to 84 years, with a modal age of 57 years. There was a male predominance with a male to female ratio of 1.5:1. Systemic hypertension co morbidity was statistically significantly more common in patients aged 60 and above (P = 0.035). The most common lesion observed in the kidneys was benign nephrosclerosis (43.2%). Conclusions: This study suggests that majority of our patients with diabetes mellitus die from infections with attendant sepsis. Older patients appear to have co morbid systemic hypertension. Patient education on infection prevention and prompt treatment might be life saving.Item Overexpression of human epidermal growth factor receptor 2 protein in urothelial carcinoma of the urinary bladder in Ibadan: a single-institutional experience(Faculty of pathology, national postgraduate medical college of nigeria, 2020) Fatunla, E. O.; Ajani, M. A.; Onakpoma, F. A.; Takure, A. O.; Okolo, C. A.Background: Overexpression of human epidermal growth factor receptor 2 (HER 2) protein has been shown to have both prognostic and therapeutic values in several malignancies including urothelial carcinoma of urinary bladder (UCB). Aims: This study aimed to determine HER 2 protein overexpression and evaluate its correlation with clinico pathological parameters in UCB. Materials and Methods: This was a descriptive-analytical study involving the immunohistochemical review of all histologically diagnosed urinary bladder malignancy in the Department of Pathology, University College Hospital, Ibadan, between January 2002 and December 2016. Urinary bladder malignancies whose tissue blocks could not be found and/or demographic data were not available were excluded. Immunohistochemistry analysis was done using rabbit anti HER 2 antibody (Biocare) and American Society of Clinical Oncology/College of American Pathologists guidelines established for breast cancer were used for HER 2 status scoring. The statistical analysis was carried out usingthe Statistical Package for the Social Sciences, version 22 (SPSS Inc, Chicago, Illinois, USA). Results: HER 2 overexpression was found in four (6.3%) cases. All the HER 2 positive cases were males. One (2.9%) of the 35 high grade UCB showed positive HER 2 overexpression, whereas three (10.7%) of the 28 low grade tumor were positive for HER 2 protein overexpression.There was no statistically significant association between HER 2 protein overexpression and histological grades of UCB and muscle invasion by the tumor. Conclusion: Our study demonstrated the low percentage of HER 2 overexpression in UCB with no significant association with tumor grades and muscle invasion. Larger samples involving multiple centers can provide more robust information and further evaluate HER 2 overexpression in urothelial carcinoma in our environment.Item P57kip2 immunohistochemical marker as a diagnostic tool for cases of hydatidiform moles in a tertiary health facility in southwestern Nigeria(National Postgraduate Medical Journal, 2020) Awosusi, B. L.; Ajani, M. A.; Adegoke, O. O.; Salami, A. A.; Okolo, C. A.Background: Hydatidiform mole (HM) is the most common gestational trophoblastic disease. P57kip2 has been reported to be helpful in differentiating between partial and complete HMs. Objectives: The study aims to evaluate the P57kip2 immunohistochemical (IHC) marker as a useful ancillary investigation to differentiate complete hydatidiform mole (CHM) from partial hydatidiform mole (PHM). Materials andMethods: Aretrospective study of all histologically diagnosed HM cases over a 20 year period was undertaken. Clinicopathological parameters were extracted from the surgical day book and medical record archives. Archival haematoxylin- and eosin-stained slides and formalin fixed paraffin embedded tissue blocks of all cases of HM diagnosed within the study period were retrieved and reviewed. Cases of HM were reclassified using the P57kip2 IHC marker. The data obtained were analysed using the SPSS version 23. Results: One hundred cases of HMs were studied. CHM accounted for 68%, while PHM accounted for the remaining 32%. The incidence of HM was 2.98 cases per 1000 deliveries. The ratio of CHM to PHM was found to be 2.1:1. Seventy two per cent of the cases were diagnosed in the first trimester, while the remaining 28% were diagnosed in the second trimester of pregnancy. Based on the P57kip2 IHC staining pattern, HM cases were finally reclassified into 68 cases of CHM and 32 cases of PHM. The age range for all the HM cases was 18–50 years with the majority of the cases seen in the third and fourth decades of life. Conclusion: P57kip2 could be useful as an ancillary investigation in confirming the diagnosis of CHM and differentiating it from PHM, particularly in difficult and challenging cases.Item Secondary ovarian neoplasms in a tertiary hospital in South-Western Nigeria(Association of Resident Doctors, University College Hospital, Ibadan, Nigeria, 2019) Ajani, M. A.; Iyapo, O.; Salami, A.; Okolo, C. A.Background: The ovary is a common site of involvement for metastases constituting 5-30% of all malignant ovarian neoplasms. Over half of these tumours are bilateral. The commonest sources are stomach, large bowel, appendix, breast, uterus (corpus and cervix) and lung. Aim: The aim of this study was to determine the histopathological pattern of metastases to the ovary at the University College Hospital, Ibadan, South western Nigeria. Material and Methods: This was a retrospective study. All histologically confirmed cases of metastases to the ovary from the records and files of the Department of Pathology, University College Hospital (UCH), Ibadan between January 1991 and June 2013 were used for the study. These were cases diagnosed following total abdominal hysterectomy, total abdominal hystero-salpingo oophorectomy, bilateral salpingo-oophorectomy, omentectomy, and multiple peritoneal biopsies and post-mortems at the University College Hospital between January 1991 and June 2013. Cases with inadequate clinical data and whose blocks and or slides could not be retrieved were excluded from the study. The data obtained were analysed using the Statistical Package for Social Sciences version 20 Results: There were 46 cases of metastases to the ovary constituting 5.3% of total ovarian neoplasms. Thirty (63.9%) cases were metastatic carcinomas with the affected patients’ age range of 20-79 years, and peak incidence within the age group of 30-39 years. Nineteen out of 30 cases of metastatic carcinomas were from adenocarcinoma of colon, 6 cases were from the gastric carcinoma while the remaining five cases were from the squamous cell carcinoma of the uterine cervix. Fifteen (31.9%) cases of Burkitt Lymphoma were found with patients with age range of 0-39 years, and the peak age of occurrence at the 2nd decade. The only case of metastatic Malignant Mixed Mullerian Tumour and metastatic Leiomyosarcoma were found in the 3rd and 4th decades of life respectively Conclusion: This study has shown that metastases to the ovary occur in younger age groups in our environment. Therefore this study emphasizes that in young females with ovarian masses, the likelihood of metastatic tumours should not be discarded because, correct and precise diagnosis of secondary ovarian malignancy is critical as it has significant implication on the patients’ choice of management and prognosis.Item Distribution and characteristics of endometriotic lesions in South- Western Nigeria: A single institutional experience(African Journals OnLine, 2019) Ajani, M. A.; Salami, A.; Nwanji, I. D.; Olusanya, A. A.; Fatunla, O. E.Background: Endometriosis poses a significant burden mainly to women of child bearing age. Historically, endometriosis was thought to be of low prevalence among African women. However, recent studies have documented an increased prevalence than previously thought. This study aimed to determine the distribution and characteristics of endometriotic lesions among Nigerian women. Methods: A retrospective study of all histologically diagnosed cases of endometriosis from the records of the Department of Pathology, University College Hospital, Ibadan from 1st January, 1997 to 31st October, 2018.The age of the women, location and distribution of the lesions were analysed. Results: A total of 85 cases of endometriosis were diagnosed histologically in the period under review. The mean age was 35 years with an age range of 18 to 52 years. The most commonly affected age groups were those between 30-39 years (47.1%) and 20-29 years (30.6%). The most commonly affected site was the ovary (58.8%) followed by the umbilicus (11.9%) and fallopian tubes (9.4%). Fourteen patients (28%) had bilateral ovarian involvement. Left sided ovarian lesions predominated (61.1% versus 38.9%). Eighteen (21.2%) patients had lesions at more than one site frequently involving both ovaries. Conclusion: Endometriosis affected mainly women of childbearing age with particular predilection for the ovaries. Endometriosis affecting the umbilicus is not uncommon among Nigerian women.