Histopathological analysis of non-squamous cell malignancies of the uterine cervix in Maiduguri, Nigeria.

Carcinoma of the uterine cervix is the most common gynaecological malignancy in the developing world despite being largely preventable. The non-squamous cancers of the cervix have not been properly documented in our setting. This study is aimed at reviewing the histological types ofnon-squamous cell cancers of the uterine cervix in relation to the age of presentation, and to analyze some of the histopathological features of adenocarcinomas. Cases of cancer of the cervix histologically diagnosed between January 1989 and December 2004 were extracted from the cancer register of the University of Maiduguri Teaching Hospital. The request forms, slides, and some tissue blocks were retrieved from the archives of the Histopathology Department. The cases were histologically reviewed and the data analyzed using simple statistical methods. A total of 491 cases of cervical cancers were diagnosed. Of these, 432(88.0%) cases were squamous cell carcinomas while 59(12.0%) were non-squamous cell malignancies. Out of the 59 non-squamous cervical cancers, 42(71.2%) were endocervical-type adenocarcinomas, while serous papillary, clear cell, and adenosquamous carcinomas comprised 2(3.4%) cases each. Seven (11.9%) cases were metastatic choriocarcinomas. Over 60% of these cases occurred within the third and fourth decades of life. Adenocarcinomas are the most common non-squamous malignancies of the cervix and their age of presentation was similar to that of their squamous cell counterpart. Haemorrhage and lymphocytic infiltrates were significantly associated with tumour grade while necrosis was independent of tumour grade.

Bone marrow macrophage iron stores in patients with HIV infection and AIDS-associated Kaposi's sarcoma.

Several observations have been made suggesting that excess iron is harmful to patients with HIV/AIDS disease. Bone marrow macrophage iron stores of 30 anaemic HIV infected patients (median age 32.7 years) and 20 anaemic AIDS-associated Kaposi's sarcoma patients (median age 37 years) were studied at the haematology department of the University of Maiduguri Teaching Hospital. Macrophage iron stores were assessed as either normal, decreased or increased by using grades ranging from 0 to 6. Marrow iron stores was increased in 16 (80%) of the patients with Kaposi's sarcoma and normal in 4 (20%) patients. Three of the 4 patients with normal iron stores were females of reproductive age. Regression analysis of iron status and opportunistic infection showed a positive correlation (p-value=0.001). Of the 30 patients with HIV infection, 22 (73.3%) had normal iron stores and 8 (26.7%) had decreased iron stores. All the 8 (26.7%) patients with no stainable iron in the marrow were females of reproductive age group. Iron deficiency anaemia can complicate anaemia of HIV infected patients. In view of the documented risk associated with iron supplementation in anaemic patients with HIV/AIDS disease, little caution should be exercise as regards the use of haematinics and/or blood tonics in anaemic HIV-infected or AIDS-associated Kaposi's sarcoma patients. The fact that noninvasive evaluation for iron deficiency is compromised in many individuals due to the presence of chronic inflammatory process and/or malignancy, bone marrow evaluation for iron stores still remains an important tool often underutilized by many clinicians attending to patients living with HIV/AIDS.

Correlation between histopathologic and fine needle aspiration cytology diagnosis of palpable breast lesions: a five-year review.

Fine needle aspiration cytology (FNAC) of the breast has been used as an initial investigative procedure of palpable breast lesions. The purpose of this study is to evaluate our experience with Fine Needle Aspiration Cytology (FNAC) and to correlate between histopathologic and FNAC diagnoses of palpable breast lesions. A 5-year retrospective study was performed using records of all patients who had had both FNAC and histopathologic results of breast lumps. This is a retrospective study of 220 diagnosed cases of breast lesion at the University of Maiduguri Teaching Hospital (UMTH), Nigeria between the periods of January 2001 and December 2005. The results of the FNAC were interpreted as inflammatory, benign, suspicious or malignant. A total of 220 patients had both cytopathologic and histopathologic diagnoses and therefore fulfilled the criteria for this study. There were 11 (5%) cases of inflammatory, 140 (63.6%) cases of benign and 69 (31.4%) cases of malignancy. There were two cases that were suspicious of malignancy and for the purpose of this study were considered as malignant. There were five (5) cases of cytologically interpreted errors which were three cases of false negative and two cases of false positive. The diagnostic accuracy was 97.7%, sensitivity was 95.7%: and specificity was 98.7%. The false negative and false positive rates were 2.9% and 1.9% respectively. FNAC of breast lesions is sensitive, specific, and highly accurate as the initial investigation of palpable breast lesions in our tertiary hospital. We therefore implore clinicians to embrace this procedure in the management of patients.

Post-thyroidectomy metastatic thyroid cancer.

BACKGROUND: The objective of this paper is to highlight the importance of tissue biopsy for histopathological diagnosis. METHOD: A report of a 46-year-old farmer with post-thyroidectomy metastatic thyroid cancer. RESULT: A post-thyroidectomy patient presenting with extensive skull and lumbar spine metastasis, paraparesis, huge occipital swelling and good healed scar without tumour residue. The thyroidectomy specimen was not subjected to histopathological diagnosis. Fine needle aspiration cytology of the occipital swelling revealed metastatic follicular carcinoma. Patient was placed on thyroxine 0.5mg daily with great improvement of lower limb muscle power. CONCLUSION: These bony metastases could have been reduced if proper investigation was done. There is need for continuous medical education for all clinical medical personnel.

Fine needle aspiration cytology diagnosis of liver diseases in the University of Maiduguri Teaching Hospital, Maiduguri.

The study is aimed at classifying liver diseases diagnosed by fine needle aspiration cytology (FNAC) in our environment and to emphasize the importance of the procedure for management of our patients. Forty-two patients were referred by the physicians for fine needle aspiration cytology diagnosis in Histopathology Department, University of Maiduguri Teaching Hospital between January 2001 and December 2003. There were 30 males and 12 females (2.5:1) with mean age of 44.7 years. The peak age is in the 5th decade of life. The commonest hepatic disease is primary hepatic malignancy, which accounted for 78.6% (33 patients); 3 suspicious of malignancy, one case each of metastatic carcinoma, amoebic liver abscess; liver storage disease and large cell dysplasia. The technique has gained popularity in our center because it is cheap, convenient, minimally invasive, quick and has high precision in obtaining samples. We therefore recommend this procedure in centers where liver diseases are common as a means of initial investigation.