ABSTRACT
Context: Sub-epithelial myofibroblasts are known to influence the biology (proliferation, differentiation and apoptosis) of overlying epithelia. In the intestine, myofibroblasts have been demonstrated to be essential for epithelial differentiation. It is therefore hypothesized that myofibroblasts may also be involved in intestinal metaplasia that is characteristic of Barrett esophagus. Objective: This study endeavors to immunohistologically evaluate epithelial-myofibroblast interaction in Barrett's metaplasia. Materials and Methods: Nineteen archival esophageal endoscopic biopsies of Barrett's metaplasia were immune-phenotyped for the following epithelial and myofibroblast antigens - cytokeratins (CK) 8, 13, 18, CDX2 (Caudal type homeobox 2), a-smooth muscle actin (SMA). Results: α-SMA immunostaining revealed close association between myofibroblasts and metaplastic Barrett's epithelium but not with normal esophageal squamous epithelium. Myofibroblasts were more prominent in dysplastic than in non-dysplastic Barrett metaplasia. CDX2 and CK 8/18, indicators of intestinal differentiation were expressed in Barrett metaplasia but not normal esophageal squamous epithelium, while the reverse was the case for CK 13, which only stained normal esophageal squamous epithelium. Conclusion: Although their precise role is yet to be clearly defined, sub-epithelial myofibroblasts are very likely involved in the pathogenesis of Barrett's metaplasia.
ABSTRACT
Cancer is an occasional incidental finding in nodular goiter; but there has been no formal study on this disease in our locality. To determine the occurrence of histologically diagnosed malignancy in patients who presentwith nodular goiters. This is a 7- year (2000-2006) retrospective study of all histologically diagnosed malignancies within nodular goiters atAminuKanoTeachingHospital;Kano There were 160 multinodular goiters during the study period; out of which 24 (15.0) had histologically diagnosed cancer; and 1 out of the thirteen patients with solitary thyroid nodule (7.6) had carcinoma. The ages of the patients with carcinoma ranged from 16 to 65 years; with amean age of 38.8 years. Eighteen (72) were females; and 7(28) were males. Six out of the 25 cases of carcinoma were detected preoperatively by fine needle aspiration cytology. Well differentiated follicular carcinoma was the predominant histological type in 13(52) cases; followed by papillary in 10(40); medullary carcinoma in 1(4) and anaplastic carcinoma in 1(4) patient. One-seventh of nodular goiters in our center harbouredmalignancy; and follicular carcinomawas the prevalent histological type. This is consistent with the findings elsewhere in endemic goitrous regions. Ultrasound guided fine needle aspirationwould improve preoperative diagnosis and guide appropriate surgical management
Subject(s)
Goiter , Thyroid NeoplasmsABSTRACT
Background: Cancer is a major health problem in developed countries and epidemiological evidence shows the emergence of a similar tend in developing countries; particularly in sub-Saharan Africa where HIV/AIDS is predicted to augment the cancer burden. The present study analyses the profile of cancers recorded in the first decade (1995-2004) of establishment of the Kano cancer registry (KCR) a histology/ cytology-based registry in Kano; Nigeria. Methods: Records of cancer cases diagnosed based on histology or cytology and entered into the registry were retrieved and categorized by type/ organ sites affected according to International Classification of Diseases for Oncology.Results: There was a steady rise in frequency of cancer over the period where a total of 1990 cancer cases were recorded comprising of 1001 (50.3) males and 989 (49.7) females. Cancers of the cervix (22.9); Breast (18.9); Ovary (8.2); non-melanoma skin cancer (6.3); and Uterus (6.2) were the most frequent female cancers. In males; cancer of the prostate (16.5); bladder (10.2); non-melanoma skin (9.9); colorectum (9.3) and connective tissue (6.3) were most common.Burkits lymphoma (31.4); other lymphoreticular cancers (23.8) and retinoblastoma (20) predominated in children. Conclusion: The KCR supports existing predictions of an increase in incidence of cancers in developing countries. There is need for establishment of comprehensive cancer control programmes in developing countries for the common cancers of the cervix; breast; prostate; bladder; skin and colorectum which are amenable to prevention; early detection and cure