An audit of the diagnosis and reporting of soft tissue sarcomas at the Lagos University Teaching Hospital.

BACKGROUND: : The effective management of patients with cancer is predicated on the right diagnoses and other relevant parameters included in the pathology report. This is particularly important in soft tissue pathology where arriving at the right diagnosis is often challenging. The aim of this study, therefore, was to perform an audit of sarcoma diagnosis and reporting in our institution. METHODS: Slides of soft tissue sarcomas diagnosed in our institution over a 5-year period were reviewed with specialist soft tissue pathologists. Ancillary immunohistochemistry and fluorescent in situ hybridization were performed where necessary. The contents of the reports were assessed using a diagnostic checklist developed by the Association of Directors of Anatomic and Surgical Pathology. RESULTS: Fifty-five of the 62 patients studied (88.7%) were correctly identified as sarcomas. However, the correct diagnoses were made in only 27 patients (43.6%). Kaposi sarcoma and dermatofibrosarcoma protuberans were the most recognized sarcomas, while leiomyosarcoma, myxofibrosarcoma, and malignant peripheral nerve sheath tumor were the least recognized sarcomas. The most reported parameters included the histologic type (100%) and size (89.7%), while the percentage of necrosis (0%) and the stage (0%) were the least reported parameters. CONCLUSION: A pattern based approach is important for the accurate diagnosis of soft tissue sarcomas. Some essential prognostic parameters and information needed for management were not included in the histopathology reports. The adoption of a structured reporting format and multidisciplinary team meetings will help to ensure the inclusion of such important information in the pathology report.

An audit of endometrial hyperplasias at the Lagos University Teaching Hospital.

INTRODUCTION: There has been much controversy and confusion surrounding the endometrial hyperplasias stemming from the use of a wide variety of terminologies and also from the pathophysiologic mechanisms underlying the various entities. The current classification by the World Health Organization (WHO) published in 2014 clarifies these issues. OBJECTIVE: The aim of this study, therefore, was to audit and standardize cases of endometrial hyperplasia diagnosed in our institution from 2007 to 2011. MATERIALS AND METHODS: The slides and request forms of cases diagnosed as endometrial hyperplasias at the Department of Anatomic and Molecular Pathology from January 1, 2007, to December 31, 2011 were retrieved, reviewed, and reported according to the WHO 2014 classification scheme. RESULTS: Hyperplasia without atypia accounted for the vast majority of cases (95.5%) and was the most common in the 5th decade. Concordance rates of 74.5% and 100% were found between endometrial hyperplasias without atypia and atypical hyperplasias with their previous diagnoses, respectively. CONCLUSION: The WHO classification scheme standardizes and simplifies the terminology used in the diagnosis of endometrial hyperplasias, while reflecting, at the same time, the current understanding of genetic changes that provide information necessary for prognostication and treatment.

Knowledge of Secondary School Children in Edo State on Lassa Fever and its Implications for Prevention and Control.

INTRODUCTION: Removal of testicular tissue is often performed for the evaluation or treatment of testicular lesions. Orchiectomy is a proven treatment modality for prostatic cancer. Testicular biopsy is also of vital importance in the management of infertility especially relating to artificial reproductive technology. Histopathologic assessment of such specimens is therefore useful in the review of current urological practice. AIM AND OBJECTIVES: This study aims to characterize the histologic spectrum of testicular lesions relating them to the various surgical procedures by which they were taken with a view to reviewing the current clinical practice in our environment. METHODOLOGY: Records of all testicular specimen received in the Department of Anatomic and Molecular Pathology from 2005 to 2014 were retrieved. Data such as age, indication for biopsy, nature of surgical specimen and histologic diagnosis for all such cases were retrieved from these records. They were classified, analyzed and represented in tables and charts using Microsoft Excel 2007. RESULTS: A total of 173 testicular and paratesticular specimens were submitted during the study period constituting 0.7% of surgical specimens received during the study period. One hundred and sixty two (93.6%) were testicular while remaining 11 samples (6.4%) were paratesticular.The most common indication for the submission of testicular specimen was for the treatment of prostate cancer (42.2%) followed by presence of a mass (20.2%) and pain (19.7%). Orchiectomy specimens were the commonest samples received (79.8%). A significant proportion of orchiectomy cases (57.1%) wereperformed for benign lesions. Hypospermatogenesis with maturation arrest (57.8%), hypospermatogenesis (15.8%) and tubular hyalinization (15.8%) were the commonest histologic diagnoses of male infertility. Germ cell tumours were the commonest testicular neoplasms (62.5%). Seminoma was the commonest testicular malignancy (50%) while embryonal rhabdomyosarcoma was the only paratesticular malignancy seen. CONCLUSION: Treatment of prostate cancer was the commonest indication for testicular biopsies in our environment. Testicular tumours are not common. Twelve (57.1%) out of a total of 21 cases of testicular masses that had orchiectomy were benign lesions. With core needle biopsies and frozen section analysis, unnecessary orchiectomies can be avoided.

Congenital mesoblastic nephroma in a premature neonate: a case report and review of literature.

Congenital mesoblastic nephroma (CMN) is a renal stromal neoplasm of infancy. It comprises 3-10% of all pediatric renal tumors. We report a case of CMN in a 30 week old premature female neonate seen at autopsy who was born to a 26-year-old woman by emergency cesarean section on account of polyhydramnios.