Sensitivity of computed tomography-guided transthoracic biopsies in a Nigerian tertiary institution

Introduction: The indications for open biopsies for intrathoracic lesions have become almost negligible. This development was made possible by less invasive maneuvers such as computed tomography-guided (CT-guided) biopsy, thoracoscopy or video-assisted thoracoscopy, and bronchoscopy. CT-guided percutaneous lung biopsy was first reported in 1976. Aim of Study: The aim of the study is to report our experience with CT-guided transthoracic biopsy. Materials and Methods: Patients with clinical and radiological evidence of intrathoracic mass were counseled and consent obtained for the procedure. They were positioned in the gantry, either supine or prone. A scout scan of the entire chest was taken at 5 mm intervals. The procedure was carried out by the consultants and senior registrar. Following visualization of the lesion, its position in terms of depth and distance from the midline was measured with the machine in centimeter to determine the point of insertion of the trucut needle (14­18-G). The presumed site of the lesion was indicated with a metallic object held in place with two to three strips of plasters after cleaning the site with Povidone-iodine. After insertion, repeat scans were performed to confirm that the needle was within the mass. A minimum of 3 core cuts was taken to be certain that the samples were representative. The results were analyzed by the determination of means and percentages. Results: Twenty-six patients underwent this procedure between 2011 and 2015. There were 15 males and 11 females (M:F = 1.4:1). The age range was between 30 and 99 years with a mean of 55 years. Histological diagnosis was obtained in 24 of the patients giving sensitivity of 92.3%. There were 3 mild complications giving a rate of 11.5%. The complications included a case of mild hemoptysis and two patients who had mild pneumothoraces which did not require tube thoracostomy. Conclusion: CT-guided biopsy is a reliable procedure for obtaining deep-seated intrathoracic biopsies with high sensitivity and minimal complication rate

Safety of liver biopsy as a day procedure in Abuth Zaria, Nigeria

Chronic liver disease [CLD] is an important condition, diagnosed mainly by liver biopsy and is a leading cause of death among the working class group. It is a major burden in sub-Saharan Africa where it leads to hepatocellular carcinoma with a high mortality. This study was a retrospective one undertaken to determine the safety of performing liver biopsy procedure between January 2000 to January 2009 in terms of the frequency of indications and side effects. A total of 279 entries were found out of which 270 [96.77%] had a definitive liver biopsy histology result. The main indication for liver biopsy was chronic viral hepatitis in 150 patients [53.76%] while the commonest complication was the post-procedure pain that was seen in 16 patients [5.7%]. The average duration of hospital stay after biopsy was 6.08 +/- 0.52 hours

Gastrointestinal stromal tumour in a young adult

Gastrointestinal stromal tumour [GIST] is a type of tumour that occurs in gastrointestinal [GI] tract, and arises from stroma with no definite cell line of origin and varying pattern of differentiation, It is a type of soft tissue sarcomas. We report a case of a young adult female who was diagnosed with GIST which was found to be unresectable at surgery and was subsequently managed with Imatinib. Treatment with the drug has led to a significant improvement for about 2 years

Malignant tumours of childhood in Zaria

Background: The increased prevalence of hitherto uncommon tumours in children in our geographic setting formed the basis for this study. This study aimed to determine the current histopathologic distribution pattern of paediatric malignancies in Zaria. Materials and Methods : An eight year (2000-2007) consecutive analysis of malignant tumours in children ages 0 to 15 years in a referral University laboratory. All tissue biopsies were fixed in 10formalin and processed in wax. Tumours were characterised histologically into tissues of origin and categorised into three age groups; 1 year; 1-5 years and 6-15 years. Result : 189 children with malignant tumours were analysed. They showed a male preponderance (M: F; 1.2: 1.0) and their ages ranged from 5 days to 15 years. Tumours of mesenchymal origin were the commonest (115: 60.8) while epithelial tumours including germ cell tumours accounted for 74 (39.2) cases. The age group 1-5 years had the highest epithelial tumours while age group 6-15 years had the most tumours with 102 (54) cases overall. The five commonest tumours over-all were rhabdomyosarcoma; Burkitt lymphoma; retinoblastoma; non-Hodgkin's lymphoma and nephroblastoma. Germ cell tumours affected the ovary predominantly and two of the endodermal sinus tumour cases were seen in the testis of an eighteen month child and sacrococcygeum of a 5 year old girl; respectively. Of the six immature teratoma cases; four were cutaneous in distribution. The vascular tumours included epithelioid haemangioendothelioma; haemangioblastoma and Dabska tumour and they accounted for (5.8) of all tumours seen. The commonest sites of occurrence of these tumours were the oculo-orbital; jaw; head and neck regions with 82 cases (43.4) while lymph nodes were involved in 31 (16.4) cases. Conclusion : The distribution and occurrence of malignant tumours in children is age related. Lymphomas were the commonest tumours overall while retinoblastoma and Burkitt lymphoma were the commonest tumours affecting children below 5 years and 6-10 years old; respectively; in our centre. The head region and lymph nodes were the sites of predilection for majority of these tumours