Gastrointestinal stromal tumours at the University of Nigeria Teaching Hospital Enugu, Nigeria: an immunohistochemical study of GIT mesenchymal tumours.

Mesenchymal tumours of the gastrointestinal tract (GIT) are uncommon. Recent progress in the understanding of the biology and origin of these tumours has led to their reclassification. A new subclass designated Gastrointestinal Stromal Tumours (GIST) is diagnosed based on the presence of a mutational over expression of c-kit protein that is thought to be critical in the pathogenesis of these tumours. This new class oftumours may form the majority of gastrointestinal mesenchymal tumours. Even though the diagnosis of GIST is mainly based on positive staining with CD117, a minority of tumours with histological characteristics of GIST are CD117 negative and are classified as CD117 negative GIST. In this first review of mesenchymal GIT tumours from Nigeria, we present 11 cases ofmesenchymal tumours of the gastrointestinal tract seen within a six-year period at our centre. Immunohistochemistry was performed on 7 of them in which histological appearances suggested GIST. Only two cases had all the criteria defined in the consensus conference on the diagnosis of GIST. Our findings, albeit in a very small sample, contrasts with what obtains in developed countries in the proportion of GIT mesenchymal tumours that are truly GIST. This raises a question to be answered on the true nature and proportion of gastrointestinal strumal tumours among GIT tumours in Nigerian patients.

Gastrointestinal Stromal Tumours at the University of NigeriaTeaching Hospital Enugu; Nigeria: an Immunohistochemical Study of GITMesenchymal Tumours

Mesenchymal tumours of the gastrointestinal tract (GIT) are uncommon. Recent progress in the understanding of the biology and origin of these tumours has led to their reclassification. A new subclass designated Gastrointestinal Stromal Tumours (GIST) is diagnosed based on the presence of a mutational over expression of c-kit protein that is thought to be critical in the pathogenesis of these tumours.This newclass of tumoursmay form the majority of gastrointestinal mesenchymal tumours. Even though the diagnosis of GIST is mainly based on positive staining with CD117; a minority of tumours with histological characteristics of GIST are CD117 negative and are classified asCD117 negativeGIST. In this first reviewof mesenchymalGITtumours fromNigeria;we present 11 cases ofmesenchymal tumours of the gastrointestinal tract seen within a six-year period at our centre. Immunohistochemistry was performed on 7 of themin which histological appearances suggested GIST. Only two cases had all the criteria defined in the consensus conference on the diagnosis ofGIST. Our findings; albeit in a very small sample; contrastswith what obtains in developed countries in the proportion of GIT mesenchymal tumours that are truly GIST. This raises a question to be answered on the true nature and proportion of gastrointestinal strumal tumours among GITtumours inNigerian patients

Interstitial nephritis associated with perianeurysmal retroperitoneal fibrosis.

Renal failure in retroperitoneal fibrosis is usually secondary to ureteric obstruction. We report a patient whose renal failure did not improve following relief of obstruction. Renal biopsy showed an interstitial nephritis, and function improved with steroid therapy. We suggest that renal biopsy should be considered in cases of renal failure associated with retroperitoneal fibrosis that do not respond to the relief of ureteric obstruction.

Histopathology of orbito-ocular diseases seen at University of Benin Teaching Hospital, Benin City.

Ninety-three biopsied lesions of the orbito-ocular region seen over a fifteen year period at the Pathology department of the University of Benin Teaching Hospital (UBTH) Benin City were reviewed. The aim was to determine the morphological patterns and the age, sex and site distribution of these lesions. Majority of the lesions (43.3%) were found in children less than 15 years of age. There was no difference in frequency between the two sexes. 41.9% of the lesions were malignant while 58.1% were benign. The commonest site of orbito ocular lesions was conjunctival (55.9%), followed by intraocular lesions (24.7%). About 50% of the lesions of the orbit were inflammatory pseudotumours. Inflammatory pseudotumours also formed the majority (33.3%) of the lesions in the eyelid. However, squamous cell carcinomas were the commonest lesions of the conjunctiva seen accounting for 25% of these. Retinoblastomas formed 95.7% of the intra-ocular tumours seen.

Autopsy audit in a teaching hospital in Nigeria--the Benin experience.

A one year prospective study was carried out to compare clinical diagnosis antemortem with autopsy diagnosis post-mortem in all patients coming to autopsy. In the study period a total of 612 deaths occurred in the hospital out of which 179 came to autopsy representing an autopsy ratio of 29%. Of the 179 cases, 100 (56%) were cases referred to the coroner. A total of 143 cases were analyzed and the concordance rate between clinical and autopsy diagnosis was found to be 54%. We find the autopsy ratio abysmally low and recommend that all effort be made to increase it to 75% and that autopsy audit be officially adopted as a means of quality control in hospitals. We also believe that all concerned should work towards improving our clinical diagnostic ability in order to attain and maintain a concordance rate well above 90%.