Hepatocellular Carcinoma Sub-types in North-Central Nigeria: A Histological Review of Liver Biopsies.

Introduction: Hepatocellular carcinoma (HCC) is the 6th most common cancer worldwide and a greater burden of this disease is born by the hepatitis B virus (HBV) endemic and resource deficient sub-Sahara Africa. This investigation was carried out to determine the pattern of hepatocellular carcinoma sub-types in north-central Nigeria. Materials and Methods: Archival formalin fixed and paraffin embedded 374 liver biopsy specimen blocks were obtained, sectioned, re-stained and examined histologically. Classification of primary liver cancers was done according to standard World Health Organisation criteria. Results: Chronic HBV infection was found in 219 (58.6%) and cirrhosis in 29 (7.8%) cases. HCC occurred in 76 (20.3%) cases with background cirrhosis in 18 (23.7%) of the HCC. The HCC subtypes found were the trabecular 54 (71.1%), acinar 10 (13.2%) and mixed trabecular and acinar 6 (7.9%), clear cell 5 (6.6%) and fibrolamellar 1 (1.3%) respectively. Conclusion: HCC is the most common histologically diagnosed primary liver cell carcinoma with the trabecular subtype as the predominant variant in Nigeria, followed by the pseudoglandular and the mixed types.

Epidemiology of Gastric Cancer in Jos University Teaching Hospital Jos a 20 Year Review of Cases

Gastric cancer believed to be rare in the past in Africa; is now one of the leading cancer morbidity and mortality. It is now known gastric cancer is 2-3 times higher in males than females living in the same environment. We aim to describe the comprehensive histological characteristics of gastric cancer with age and sex distribution. Methods: The study site was Jos University Teaching Hospital situated in the capital of Plateau State. The hospital has a bed capacity of 530. The study materials were obtained from all stained specimens of gastric cancer recorded in the histopathology laboratory of the teaching hospital between 1985 to 2004. The biopsy site was noted. These were divided into the following groups: Cardia; body and an thrum/pyloric regions respectively. Or the information included age and sex of the patients. Results: There were a total of 205 gastric cancer histological confirmed; out of 5705 malignant tumours recorded in the same period. There were a total of 145 cases in male and 60 in females giving a male: female ratio 2.4:1. The highest frequencies of gastric cancers were located in the anthral and cardia regions which accounted for 79of all the tumours. Well differentiated adenocarcinoma (intestinal type) was the most frequent histological subtypes 51.2); this was followed by poorly and diffusely infiltrating carcinoma. Other cancers included signet ring carcinoma; Non- Hodgkin's lymphoma and leiomyosarcoma in that order. The study has also demonstrated H pylori at the background of intestinal type adenocarcinoma which was seen in the body and an thrum. Conclusion: The study has shown that gastric cancer is not only common but it occur more males than females. The high proportion of H pylori in our environment might indicate a possible aetiological association. Therefore eradication of H pylori might reduce the prevalence of gastric carcinoma

Descriptive pattern of Benign Salivary Gland Tumours in Jos University Teaching Hospital (JUTH); Jos: A ten-year retrospective study

Salivary gland tumours are common head and neck tumours which account for 2.8 to 10of all head and neck tumours in most African studies and 8.0 to 10.5in most western literature. Benign salivary gland tumours are the commonest form of salivary gland neoplasm; with the ratio of benign to malignant tumours ranging from 1.2:1 to 2:1. Objectives: This study is aimed at describing the histological pattern; age; sex and site distribution of benign salivary gland tumours in Jos University Teaching Hospital from January 1997 to December 2006. Methods: This was a descriptive study of all histotogically confirmed benign salivary gland tumours over a period of ten years. The slides were reported independently by four pathologists. Diagnosis was made and classification done according to the World Health Organization (WHO) classification of salivary gland tumours. Data such as age; sex and site of distribution of these tumours were obtained from the patient's case files. Results: Results show that benign salivary gland tumours had a higher distribution than malignant salivary gland tumours with a ratio of 1.7:1. Of these benign salivary gland tumours; male predominance over females was generally observed. Benign salivary gland tumours occurred more within the age range 4 to 49 years (table 1); with pleomorphic Adenoma accounting for the highest frequency (115) and basal cell adenoma for the lowest frequency (1) [table 2]. Parotid gland was also the commonest site of occurrence of most of these lesions except for basal cell adenoma which was found in the sublingual gland

Primary head and neck cancers in Jos; Nigeria: A re-visit

Background: To document the pattern of primary head and neck cancers in Jos; Nigeria. Study Design: A record-based study of head and neck cancers histologically diagnosed at the Jos University Teaching Hospital (JUTH); Jos; between January 1987 and December 2002. Results: A total of 710 cases (over 44 cases per year) were diagnosed; with a rising trend. The most common sites for cancer were the eyes (15.4); lymph nodes (12.4); thyroid gland (11.8) and the oral cavity (7.6). Carcinomas 432(60.8); lymphomas 119(16.8) and sarcomas 105(14.8) were the commonly reported cancers. Carcinomas were most commonly reported in the thyroid gland (19.2); oral cavity (10.2) and the eyes (9.5). AIDS-related cancers constituted 12.3of all head and neck cancers and were commonly reported in the 3rd decade of life. This is higher than the 10.9and 7.6previously reported for Jos (p=0.89) and Maiduguri (p=0.034) respectively. Carcinomas were associated with alcohol use and tobacco smoking (p0.001); while kaposi sarcoma was more associated with HIV-positive patients than squamous cell carcinoma (p

Pattern of First-Aid Measures Used by Snake-bite Patients and Clinical Outcome at Zamko Comprehensive Health Centre; Langtang; Plateau State

The use of first aid measures in the management of snake bite by patients in rural communities in Africa is a popular practice. Records of 103 snake bite patients admitted at Zamko Comprehensive Health Centre; were retrieved and reviewed. 84 (81.6) of the 103 cases with snake bite used first aid measures. Common first aid measures employed include tourniquet (ropes; pieces of cloth); use of the black stone; application of traditional medicine and incision of site of bites. The use of first aid measure did not prevent spread of the venom. There was no significant increase in the proportion of patients with tissue necrosis between patient that used tourniquet and those that did not (7.9 vs 5.3). Patients that did not employ first aid measures required significantly higher doses (mls) of antivenom compared to those who used tourniquet (39.33 Vs 24.52 P 0.01); those who use traditional medicine (39.33 Vs 27.5 P 0.01); and those who used black stone (39.33 Vs 28.75 P 0.01). Also those who used the black stone required significantly higher quantity of antivenom as compared to those that used the tourniquet (28.75 vs 24.52 P 0.05). The use of the tourniquet; traditional herbs and the black stone appears to have beneficial effects by reducing the average antivenom requirement of patients and more studies are needed to identify the most appropriate approaches to their use

Description of age; sex and site distribution of large bowel cancer in the middle belt of Nigeria

Aims/Objective: To determine the distribution of bowel cancer with special emphasis on age; sex and site. Methods: One hundred and sixty cases of histologically confirmed large bowel cancers at Jos University Teaching Hospital between January 1991-December 2000 were reviewed. The records were collected from the registry of histopathology laboratory. Information regarding sex; age and site of cancers in the large bowel were extracted from referral forms and case notes. Results: The cancers occurred more commonly between the ages of 31 and 60 years. The site distribution showed that more men were affected than women. The rectum was the commonest site; which accounted for 56.9 followed by colon 32; caecum 8 and anal canal 3. The colonic cancers were more common in female than male; accounting for 56.9 and 43.1 respectively. Adenocarcinoma was the commonest histological type occurring in 90 percent of cases. None of the resected specimens could reveal a case of familial polyposis. Two cases of non-Hodgkin's lymphoma were recorded and one was in the youngest patient aged 10 years. There was histological evidence of schistosomiasis in two caecal and one rectal adenocarcinoma in this series. Conclusion: This study showed that bowel cancers are not rare as previously believed. The patients also present at a younger age in our population. Routine screening for bowel cancer in all risk patients should be carried out regularly so as to detect cancer early