Pattern of histologic variants of ameloblastoma in a secondary health care facility in Lagos state a 5-year retrospective study

Ameloblastoma is a benign epithelial odontogenic neoplasm which is common amongst the Yoruba ethinc group. The various histologic types have been elucidated. Aim: This study aimed to assess the prevalent histologic types of ameloblastoma in a Lagos secondary health care facility. Methodology: A 5-year retrospective review of histopathologically diagnosed slides were retrieved. Data extracted include the age, gender, location, ethnicity and histologic variants were analysed by SPSS version 26. Percentages, ratio, mean, standard deviation and crude odd ratio were determined, and p-value ⩽ 0.05 is considered significant. Result: A total of seventy-seven histopathologically diagnosed ameloblastoma slides were retrieved. Males were more affected than females in ratio 1.2:1 with the mean age 33.61±13.3. Ameloblastoma was commonest in the third decade of life and more in the mandible than maxilla. Yoruba ethnic group was most affected. The commonest histologic type was the unicystic type with intraluminal subtype accounting for the largest proportion. There was significant association between histologic types and gender (p= 0.037). Crude odd ratio revealed the odds in the unicystic type between male and female {p=0.041; CI=95%, OR=2.649(1.042-6.733)} and in the follicular between male and female {p=0.013; CI=95%, OR=3.855(1.321-11.288)}. Conclusion: The unicystic histologic type of ameloblastoma was the commonest, occurring more in females and this was followed by the follicular histologic type which occurred more in males in this Lagos State secondary health care facility.

Combined use of immunohistochemical markers of basal and luminal subtypes in urothelial carcinoma of the bladder: Association with clinicopathological features and outcomes

OBJECTIVES: Whole genome expression profiles allow the stratification of bladder urothelial carcinoma into basal and luminal subtypes which differ in histological patterns and clinical behavior. Morpho-molecular studies have resulted in the discovery of immunohistochemical markers that might enable discrimination between these two major phenotypes of urothelial carcinoma. METHODS: We used two combinations of immunohistochemical markers, i.e., cytokeratin (CK) 5 with CK20 and CK5 with GATA3, to distinguish subtypes, and investigated their association with clinicopathological features, presence of histological variants, and outcomes. Upon searching for tumor heterogeneity, we compared the findings of primary tumors with their matched lymph node metastases. We collected data from 183 patients who underwent cystectomy for high-grade muscle-invasive urothelial carcinoma, and representative areas from the tumors and from 76 lymph node metastasis were organized in tissue microarrays. RESULTS: Basal immunohistochemical subtype (CK5 positive and CK20 negative, or CK5 positive and GATA3 negative) was associated with the squamous variant. The luminal immunohistochemical subtype (CK5 negative and CK20 positive, or CK5 negative and GATA3 positive) was associated with micropapillary and plasmacytoid variants. Remarkably, only moderate agreement was found between the immunohistochemical subtypes identified in bladder tumors and their lymph node metastasis. No significant difference in survival was observed when using either combination of the markers. CONCLUSION: This study demonstrates that these three routinely used immunohistochemical markers could be used to stratify urothelial carcinomas of the bladder into basal and luminal subtypes, which are associated with several differences in clinicopathological features.

Morphological features and prognostic significance of tip variant of focal segmental glomerulosclerosis: Study of an Indian cohort.

Context: Several attempts have been made to formulate a morphologic classification of focal segmental glomerulosclerosis (FSGS) variants with therapeutic and prognostic implications. Differences in study populations such as racial profile or therapy offered have hampered attempts to define prognostic variables in FSGS. Literature reveals conflicting results regarding the prognostic significance of tip variant of FSGS in different populations. Aims: To study the clinical and pathologic parameters in tip and not otherwise specified (NOS) variants of FSGS, in subjects from the Indian subcontinent with prognostic significance. Materials and Methods: First we performed a retrospective analysis of patients with biopsy proven primary FSGS, diagnosed between January 2004 and December 2008. Twenty cases of tip variant were encountered in adult population and similar numbers of adult cases of NOS variant were randomly selected. Renal biopsies were studied using light and immunofluorescence microscopy. Medical records for clinical data at presentation, biopsy and three monthly follow-up intervals were reviewed and compared between two groups. Results: At presentation, clinical profiles for the two groups were similar; however, significant differences in histological parameters and clinical outcome in tip and NOS variant cases were noted. Interstitial fibrosis and tubular atrophy were significantly higher in NOS variant. Greater response rate to steroid therapy was observed in tip variant cases while higher proportion of NOS variant cases showed renal failure. Conclusion: Analysis of histological parameters is important in assessing the outcome of tip and NOS variants. Tip variant signifies a better prognostic subset for a population of Indian origin affected by FSGS.