The Role of Fine Needle Aspiration Cytology in the Diagnostic Evaluation of Palpable Breast Lesions Seen in a Low-resource Hospital Setting.

Background: Preliminary diagnosis of palpable breast lesions often requires the use of fine needle aspiration cytology (FNAC). The aim of this study was, therefore, to determine the diagnostic utility of this procedure in the evaluation of palpable breast masses seen at our institution. Methods: FNAC was performed on all patients who presented with palpable breast lesions over the period of one year. These were classified according to the United Kingdom National Health Services Breast Screening Programme (UKNHSBSP) and were compared with the corresponding histopathologic diagnosis in each case. The sensitivity, specificity, positive predictive value as well as negative predictive value were subsequently determined. Results: A total of 164 cytological reports were obtained from 153 patients during the study period. The patients seen during the study period were between the ages of 15-86 years (Mean 42.3±15.8 SD). The peak age range of presentation of benign lesions was 20-29 years while that for malignant was 40-49 years. Fifty (50.6%) were reported as benign (C2) and 31.7% were reported as malignant (C5). About 7.8% and 8.5% were reported as inadequate (C1) and suspicious for malignancy (C4) respectively. Histopathology was performed on 87 (biopsy rate of 53.0%). There was good correlation between the cytological and histological diagnosis with the sensitivity of FNAC for benign lesions being 97.3% while that for malignant lesions was 100%. The correlation between fine needle aspiration cytology of palpable breast lumps and histological diagnosis was found to be statistically significant. Conclusion: FNAC of palpable breast lesions has a high predictive value for the histologic diagnosis especially when performed by experienced cytopathologists.

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

Lymphoreticular diseases in Nigerians

Background: The lymphoreticular system plays a major role in both the innate and adaptive immune responses. This study reviews retrospectively cases of lymphoreticular disea-ses seen at a tertiary institution in Nigeria. Materials and Methods: This is a retrospective study in which biopsies from the bone marrow; spleen; lymph nodes and extra-nodal lymphoid tissues reported within a period of 16 years were reviewed with respect to age; sex and pathological diagnosis. Statistical analysis was performed for differences in proportion using Chi square by SPSS version 12. Results: Nine hundred and forty four cases comprising 559 biopsies from lymph nodes and extranodal lymphoid tissues; 272 bone marrow biopsies and 113 spleen biopsies were studied. Non Hodgkin's lymphoma (NHL) and tuberculosis were the most common lesions in lymph nodes and extranodal lymphoid tissues. The axillary and cervical nodes accounted for most cases of metastasis. Breast cancer accounted for the majority of metastasis to lymph nodes. The most common pathological changes in bone marrow were NHL and reactive hyperplasia. Patients with chronic lymphocytic leukaemia (CLL) had the highest mean age; which was significantly higher than in those with NHL (p=.001; 95confidence interval -27.91 to -7.76). The most common finding in the spleen was splenic rupture and haemoperitoneum from road traffic accident. Conclusion: NHL and tubercu- losis should be high on the list of differential diagnosis of lymphadenopathy in Nigerians. Whereas trauma from RTA was the major reason for splenectomy in Nigerians; in the elderly splenic biopsy would likely show CLL