A Clinico-Pathological Study of Vulvo-Vaginal Disease at a Nigerian Tertiary Health Facility.

INTRODUCTION: The vulva and vagina are of great significance to womanhood owing to the myriads of specialized functions they perform. The diseases of this organ have physical, social, mental, and psychological ramifications. The aim of this work is to study the pathological pattern and clinical presentation of diseases of the vulva and vagina at the Department of Anatomical Pathology and Forensic Medicine of the Jos University Teaching Hospital between 1st January 2011 and December 31st, 2020. METHODOLOGY: This study is descriptive of all cases of histologically diagnosed vulval and vaginal lesions seen at the Center. Histological diagnosis, biodata, and clinical information of patients were retrieved from the medical records. Data realized were analyzed and presented in tables as simple frequencies, percentages, ranges, and measures of central tendencies. RESULTS: Two hundred and fifteen vulval and vaginal biopsies were included in the study. Squamous cell carcinoma was the commonest histologically diagnosed lesion accounting for 70(32.6%) cases of all lesions and 77.8% of all malignancies. The second commonest lesion and the most frequent benign pathology is the Condyloma acuminatum (viral warts) which accounted for 41(19.1%) cases. The age bracket 20 to 59 years constituted 79.5% of cases (171 cases). The age range, mean, median, and mode in years were 5.0-85.0, 39.5+15.9, 38.0, and 50.0 respectively. CONCLUSION: Squamous cell carcinoma and veneral warts are the commonest lesions of the vulva and vagina in our environment. Robust vaccination programs against the etiological agent, the human papilloma virus is highly recommended.

INTRODUCTION: La vulve et le vagin ont une importance considérable pour la féminité en raison des myriades de fonctions spécialisées qu'ils remplissent. Les maladies de cet organe ont des ramifications physiques, sociales, mentales et psychologiques. L'objectif de ce travail est d'étudier le modèle pathologique et la présentation clinique des maladies de la vulve et du vagin au département de pathologie anatomique et de médecine légale de l'hôpital universitaire de Jos entre le 1er janvier 2011 et le 31 décembre 2020. METHODOLOGIE: Cette étude est descriptive de tous les cas de lésions vulvaires et vaginales diagnostiquées histologiquement au Centre. Le diagnostic histologique, les données biologiques et les informations cliniques des patientes ont été extraits des dossiers médicaux. Les données obtenues ont été analysées et présentées dans des tableaux sous forme de fréquences simples, de pourcentages, d'intervalles et de mesures de tendances centrales. RÉSULTATS: Deux cent quinze biopsies vulvaires et vaginales ont été incluses dans l'étude. Le carcinome épidermoïde était la lésion histologiquement diagnostiquée la plus fréquente, représentant 70 (32,6 %) cas de toutes les lésions et 77,8 % de toutes les tumeurs malignes. La deuxième lésion la plus fréquente et la pathologie bénigne la plus fréquente est le condylome acuminé (verrues virales), qui représente 41 (19,1 %) cas. La tranche d'âge de 20 à 59 ans représentait 79,5 % des cas (171 cas). La fourchette d'âge, la moyenne, la médiane et le mode en années étaient respectivement de 5,0-85,0, 39,5+15,9, 38,0 et 50,0. CONCLUSION: le carcinome épidermoïde et les verrues générales sont les lésions les plus fréquentes de la vulve et du vagin dans notre environnement. Des programmes de vaccination robustes contre l'agent étiologique de cette pathologie, le virus du papillome humain, sont fortement recommandés. Mots clés: Vulve, Vagin, Cancer, Verrue.

Sarcomas in Nigerian Children in Jos North Central Nigeria.

BACKGROUND: There is a growing concern about childhood sarcomas, with recent studies suggesting an increase in the frequency of childhood sarcomas in sub-Saharan Africa. This study was carried out to determine the pattern of childhood sarcomas in Jos, North Central Nigeria and to compare the data obtained with other previous related studies. METHODS: Review of the Jos University Teaching Hospital cancer registry from January 2001 to December 2010. Data of all children (0-15 years) in the data base were retrieved for analysis. RESULTS: Two hundred and ten histological diagnosis of malignancies were made in children over the period, with 81 cases (39%) being childhood Sarcomas. The sarcomas occurred predominantly in males (54%) with male/female ratio of 2:1. The minimum age was 2 months and the maximum age was 15 years. Soft tissue sarcoma (STS) was the most predominant group which accounted for 73 cases (90%) of all sarcomas seen. Rhabdomyosarcoma (RMS) was the most common STS, it accounted for 65 cases (89%) of the STS and 80% of all the sarcomas. This is followed by Kaposi Sarcoma (KS) accounting for 6.9% of STS. There were 8 cases of Osteosarcoma which accounted for 10% of all the sarcomas. Embryonal RMS predominated in the very young children while all other sarcomas affected the older children. Extremities were the sites of predilection for most of the sarcomas (36%). Seventeen (17) cases of the RMS were of superior prognostic group, 34 (54%) were of intermediate prognostic group while 24 cases (37%) were of poor prognostic group. CONCLUSION: Childhood sarcomas are common in our environment and RMS is the single most common sarcoma while the non-rhabdomyosarcoma soft tissue sarcomas (NRSTS) are rare.

Role of parasites in cancer.

BACKGROUND: In areas of parasitic endemicity, the occurrence of cancer that is not frequent may be linked with parasitic infection. Epidemiological correlates between some parasitic infections and cancer is strong, suggesting a strong aetiological association. The common parasites associated with human cancers are schistosomiasis, malaria, liver flukes (Clonorchis sinenses, Opistorchis viverrini). OBJECTIVE: To review the pathology, literature and methods of diagnosis. METHOD: Literature review from peer reviewed Journals cited in PubMed and local journals. CONCLUSION: Parasites may serve as promoters of cancer in endemic areas of infection.

Histopathological analysis of endometrial biopsies in Jos University Teaching Hospital (JUTH), Nigeria. A 5-year critical review.

AIMS: This study is aimed at giving an insight into the pattern and age distribution of endometrial analysis as seen at Jos University Teaching Hospital. METHODS: This is a retrospective reviewed cases of endometrial biopsies diagnosed between January 1998 to December 2002 in the Histopathological Department ofJos University Teaching Hospital RESULTS: A review of endometrial biopsies slides from 556 patients revealed that pregnancy related diagnosis was the commonest, representing 302 (54.3%) of histopathological diagnosis, followed by endometrial hyperplasia, accounting for 97 cases (17.5%) and majority of which was categorised as mild hyperplasias. Hydatidiform mole, which ranked third, constituted 58 (10.4%) of the cases studied. Choriocarcinoma was the leading malignancy representing 10 cases (45%) of the malignant tumours and 1.8% of all the endometrial biopsies. Endometrial adenocarcinoma, stromal sarcoma and metastatic cancer constituted 6 (1.0%), 3 (0.5%) and 3 (0.5%), respectively. CONCLUSION: The commonest endometrial pattern seen in JUTH over the study period was products of conception which peak in the third decade of life; primary malignancies of the endometrium are uncommon in JUTH and they represented just about 2%.

Childhood rhabdomyosarcoma: a review of 35 cases and literature.

UNLABELLED: BCKGROUND: Rhabdomyosarcoma is one of the most frequent soft tissue sarcomas in children. It constitutes a unique group of soft tissue sarcomas found in children, primarily infants, toddlers and preschool pupils. OBJECTIVE: The purpose of this review is to examine all the cases of histologically confirmed childhood rhabdomyosarcomas; to re-examine the review pattern, and review recent advances in the biology of this neoplasm. MATERIALS AND METHODS: the sample consisted of 35 histologically confirmed rhabdomyosarcomas between January, 1996 and 2005. The specimens consisted of excision, incision and tru-cut biopsies. Fresh sections were cut from paraffin bedded tissue blocks and stained with haematoxylin and eosin. The slides were reviewed by three pathologists. The sites of biopsies were noted from the referral forms. RESULTS: Thirty five cases of paediatric rhabdomyosarcomas were recorded out of a total of 55 cases during the period of study. This represents 63.6% of all cases of rhabdomyosarcomas. The commonest anatomical sites were head and neck regions which accounted for 21 cases of the 35, while retroperitoneal, vagina and testis accounted for 8, 3 and 3 respectively. The highest proportion of cases occurred in ages 6-15 years. The embryonal subtype accounted for highest proportion, followed by alveolar, pleomorphic and spindle types respectively. CONCLUSION: This study shows that childhood rhabdomyosarcomas are prevalent in this region, and that the most prevalent of the variants is embryonal rhabdomyosarcoma. The commonest anatomical sites were head and neck regions and the highest proportion of cases occurred in ages 6-15 years.

Epidemiology of gastric cancer in Jos University Teaching Hospital Jos a 20 year review of cases.

BACKGROUND: 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 79% of 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.

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

Patterns of malignant salivary gland tumours in Jos University Teaching Hospital (JUTH), Jos: a ten-year retrospective study.

BACKGROUND: Salivary gland tumours are common head and neck tumours and more common in western world than Africans. Most salivary gland tumours are benign but the morbidity and mortality as expected is higher with malignant tumours. This study is aimed at describing the histological pattern, age, sex and site distribution of malignant salivary gland tumours in Jos University Teaching Hospital (JUTH) Jos from January 1998 to December 2007. METHODS: This is a descriptive study of all histologically confirmed malignant salivary gland tumours over a period of ten years. Fresh sections of tissue blocks of these lesions were made using the microtome (3 micrones). They were made into slides and stained with Hematoxylin and Eosin (H and E) and Periodic Acid Schiff (PAS) stains. The slides were reported independently by four pathologists. Diagnosis was made and classification done according to the World Health Organisation (WHO) classification of salivary gland tumours 3. Information such as age, sex and-site of distribution of these tumours was gotten from the patient's case files. The data was analyzed manually. RESULTS: Muco-epidermoid carcinoma accounted for the highest (32 cases) histologic type. Malignant salivary gland tumours occurred more within the age range 40 to 69 years with the age group 50-59 years accounting for the highest frequency (36 cases). Most of these malignant salivary gland tumours occurred more in the parotid gland, the minor salivary being the least site of occurrence. CONCLUSION: Mucoeperdermiod carcinoma is the commonest salivary gland tumour and that malignant salivary gland tumours in this study and it occurred more after the 5th decade of life.

Diagnostic oncology: role of the pathologist in surgical oncology--a review article.

The practice of surgical oncology requires a multidisciplinary approach involving the pathologist, surgeon, clinicians and other workers. The task of a pathologist is to provide adequate, and accurate diagnosis sufficient for the clinician to take decision for patient management. In the tropics, the practice of pathology is seriously challenged by infrastructural decay and in most cases clinicians rely on their clinical skills for management of cancer patients. With tremendous advance in the field of oncology, the diagnosis of cancers involve the understanding of biological behaviour of the cancer. The details of type and origin of the tumour, its differentiation, level of invasion, the number of lymph node(s) with and without metastasis, the presence or absence of receptors for hormones, activity of enzymes, ploidy, frequency of mitosis and percentage of cells in the S-phase may all be relevant in the pathological assessment of neoplastic tissue. The use of molecular biology has also enhanced our understanding of the neoplastic process. Examples include the use of nucleic acid probes with or without amplification, polymerase chain reaction to detect expression of specific tumour genes or gene mutations, but these have not yet become standard practice in this environment. The review is aimed at highlighting the role of the pathologist in the management of cancer.

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

Hepatocellular carcinoma in Jos, Nigeria.

BACKGROUND: Hepatocellular carcinoma (HCC) is the most common abdominal malignancy, representing 80-90% of primary liver malignancies around the world. There is a disturbing trend of increased incidence of HCC around the world. We therefore, determined the trend of HCC in Jos. METHODS: A ten-year retrospective review was done of all cases of HCC which diagnoses were histologically confirmed as recorded in the Cancer Registry of Jos University Teaching Hospital. The patients' clinical case notes (including surgical and radiological findings) were also reviewed. RESULTS: A total of 71 cases of HCC (31.3% of 227 liver biopsies in the same period) were diagnosed within the 10-year period. There were 46 males and 25 females with a male/female ratio of 1.8:1. The age range of the patients was 23 years to 75 years, with a mean age of 45.4 +/- 13.1 years. Seventy two percent (72%) of them were between ages 21 years and 50 years. Only 28% were between 51 years and 80 years. The highest rate of 12 (17.1%) was seen in the year 2004. CONCLUSION: The study showed that there was a high prevalence of HCC in Jos, and that HCC was more prevalent in the younger age group compared to what obtains in developed nations.

Relation between Helicobacter pylori, inflammatory (neutrophil) activity, chronic gastritis, gastric atrophy and intestinal metaplasia.

BACKGROUND: To determine the relation of Helicobacter pylori infection with chronic inflammation, atrophy, activity level and intestinal metaplasia. PATIENTS AND METHODS: A cross-sectional study of 100 consecutive patients with dyspepsia. These patients were fasted for 12 hours and gastroscopic biopsy specimens were obtained from their gastric mucosae. The specimens were histologically evaluated for H. pylori, inflammatory activity, chronic inflammation, gastric atrophy and intestinal metaplasia. RESULTS: There were 50 (50%) females and 50 (50%) males. The average ages of women and men were 36.3 +/- 11.5 and 42.9 +/- 12.8 respectively. Helicobacter pylori was found in 79%. Neutrophil activity was observed in 83%. Inflammation was found in 95%, glandular atrophy in 38%, intestinal metaplasia in 28% of the cases. Incidental (early gastric) cancer was found in 3%, dysplasia in 2% and reactive gastropathy in 7% of the cases. A statistically significant relationship was found between Helicobacter pylori colonization intensity and the degrees ofneutrophil activity, chronic inflammation and intestinal metaplasia. CONCLUSION: We concluded that Helicobacter pylori infection results in neutrophil activation and chronic gastritis, and that it has a role in the development of intestinal metaplasia. The greater the intensity of Helicobacter pylori infection, the greater the degrees of neutrophil activation, chronic gastritis and intestinal metaplasia.

Epidemiology of soft tissue sarcomas in Jos, North Central Nigeria.

BACKGROUND: Soft tissue sarcomas are a complex heterogeneous group of tumours that often cause a diagnostic problem. Special stains are often employed for further differentiation of these tumours. As a group, soft tissue sarcomas are not uncommon as previously believed. OBJECTIVE: To undertake a ten year retrospective study of soft tissue sarcomas in a Nigerian Teaching Hospital and to also discuss the pathology of the disease. METHODS: The study consisted of all records of histologically confirmed cases of soft tissue sarcomas from 1994 2003, seen at JUTH. The slides were retrieved and read separately by two pathologists. Special stain such as Reticulin, PTAH, Oilred O, were used to demonstrate basement membrane, muscle striation and lipids respectively. These aided confirmation of the diagnosis. Information extracted from patients' records included age, site of lesion and sex. RESULTS: A total number of 266 cases of soft tissue sarcomas were recorded out of 2353 histologically confirmed cancers. These accounted for 11.3% of all cancers. One hundred and eighty three occurred in males and 83 in females, with male, female ratio of 2:1. Kaposi sarcoma (KS), Rhabdomyosarcoma (RMS), Malignant Fibrous Histiocytoma (MFH), and Fibrosarcoma (FS) were the commonest histological subtypes accounting for 69 (25.9%), 63 (23.7%), 56 (21.1%) and 49 (18.4%) respectively; with Rhabdomyosarcoma occurring more in paediatric and adolescent age groups, while the rest subtypes were more prevalent in adults. The commonest sites affected were leg/foot 71 (26.7%), head/neck 68 (25.6%) and thigh 50 (19%). CONCLUSION: Soft tissue sarcomas constituted a significant proportion of cancers in our centre and are not uncommon as previously reported in the literature.

Hepatitis B surface antigen, hepatitis C and HIV antibodies in a low-risk blood donor group, Nigeria.

We investigated the seroprevalence of human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) infection among 258 clergymen-in-training (age range 18-39 years) who represented a donor population that fulfilled the criteria for safe blood transfusion. In all, 15.1% of the men were positive for HBsAg, 4.3% were positive for anti-HCV and 2.7% were HIV-positive; 22.1% were infected with at least one of these viruses. Co-infection with HIV and HBV was found in 0.4% of the subjects, HBV and HCV in 0.4%, and HIV and HCV in 0%. This underscores the importance of routine screening of blood before transfusion, regardless of the donor background.

Gastric histopathological findings in mucosal biopsies of symptomatic patients in jos central Nigeria.

BACKGROUND: Dyspepsia is a common disease worldwide. It is a cause of great absenteeism from work with a lot of economic loss. In Jos, it is one of the most common complaints encountered in both general outpatient and specialist clinics. AIM: To evaluate the histopathological changes in gastric mucosa of patients presenting with symptoms of dyspepsia. METHODS: Cross sectional study. Gastric endoscopic biopsy specimens from 100 consecutive patients with symptoms of dyspepsia were histologically evaluated using the criteria of the updated Sydney system. RESULTS: There were 50 males and 50 females. Their overall mean age was 39.6 +/- 12.2 (S.D). The prevalence of Helicobacter pylori colonization was 79%. Males were 53.2% and females 46.8% respectively giving a sex ratio of 1.4:1. Gastritis, neutrophil activity, glandular atrophy and intestinal metaplasia were observed in 95%, 83%, 38% and 28% respectively. Gastric carcinoma was found in 3% ofthe patients. CONCLUSION: From our study, we conclude that the majority of our patients with dyspeptic symptoms have significant histopathological changes in their gastric mucosa with implications for the development of further gastric lesions, and that the most common cause of dyspepsia in our environment is Helicobacter pylori infection.