Clinicopathological pattern of breast lesions in children and adolescents.

Background: Breast lesions are not common in children and adolescents. The aim of this study is to retrospectively survey the clinicopathological pattern of breast lesions in children and adolescents in our setting. Materials and method: This is a retrospective study of all breast specimens from children and adolescents that were histopathologically diagnosed in University of Uyo Teaching Hospital. Results: The youngest patients seen were 11 years old, with mean age of 17.1 ± 1.91. The commonest clinical diagnoses were fibroadenoma (n=134, 72.4%). Thirty-five-point seven percent of the patients presented within 6 months of noticing the lump. The mean size of the lumps was 6.2cm ± 3.9. Fibroadenoma was the most common benign diagnosis and the most common histopathologic diagnosis in this study. The mean age of patients with fibroadenoma was 17.15±1.83. Conclusion: The pattern of breast lesions in adolescents in Uyo is similar to that from other parts of Nigeria.

Tuberculosis of the Cervix Mimicking Cervical Carcinoma: A Case Report.

Tuberculosis of the cervix is reported to be very rare with clinical features that are indistinguishable from that of invasive cancer of the cervix. We report the case of a 31-year-old nulliparous lady that presented with intermenstrual bleeding and a persistent abnormal vaginal discharge after receiving several forms of treatment for cervical cancer. Vaginal examination revealed an extensive friable erythematous lesion affecting the entire ectocervix. Tuberculosis was confirmed following biopsy of the lesion, and the patient was successfully managed with a course of anti-tuberculosis medication.

Retrospective Study of Abandoned Dead Bodies in the Morgue of a Tertiary Health Institution: The Identified, Unidentified and Unclaimed.

Background: Dead bodies in a morgue can be grouped into any of the following: identified- but-not-abandoned, unidentified/unclaimed and identified-but-abandoned. The first group, usually poses no challenge. The unidentified/unclaimed group is always a challenge to every morgue management, while little or nothing is known about the identified-but-abandoned group. Methodology: This is a retrospective study of all the unidentified/unclaimed dead bodies and the identified-but-abandoned dead bodies seen in the morgue of University of Uyo Teaching Hospital (UUTH), Uyo, Akwa Ibom State, Nigeria. The information for this study were gotten from UUTH morgue register and the data obtained were analyzed using Standard Package for Social Science (SPSS) version 20. Results: 114 dead bodies deposited in the morgue were studied, 89 of these bodies were identified-but-abandoned, while 25 were unidentified/unclaimed.For the identified-but-abandoned, the youngest bodies were that of day old neonates and the oldest body was an 87 year old male giving a mean age of 37.01 ± 20.88. Males accounted for 57.3% (n=51), while females accounted for 42.7% (n=38), with a male to female ratio of 1.3:1. Age groups 0-39 years accounted for 60.7% of the identified-but-abandoned bodies.The 25 unidentified/unclaimed bodies include 22 males and 3 females giving a male to female sex ratio of 7.3:1. There ages were not known. About 73.7% of the study population (n=84) were in-patients on treatment in the various wards of the hospital and died during the course of treatment while 30 dead bodies (26.3%), were brought in dead (BID). Direct relatives of the deceased (siblings or parents or children or spouse) deposited the bodies in the morgue in 37.8% of occasions, potters (ward maids) in 23.7% and security/uniform agencies in 23.7%. Conclusion: Identified-but-abandoned dead bodies exist. Relatives should be made to understand that the only right a dead person has, is at least a decent burial.

Urine Cytology as Seen in Uyo, Nigeria: How Relevant Is It to Medical Practice?

AIM: The aim of this study is to know the pattern of urine cytology (UC) requests seen in Uyo and how relevant they were to the management of the patients. MATERIALS AND METHODS: This retrospective study was carried out in the Department of Pathology, University of Uyo Teaching Hospital. The extracted data from the cytology registers were analyzed using the Statistical Package for the Social Sciences version 17. RESULTS: A total of 46 patients did UC during the period. The patients were aged between 21 years and 90 years, with a mean age of 56.89 ± 14.65. Thirty (67.4%) were male. The age group of 60-69 years accounted for most cases (37.8%). Suspicion of bladder cancer was the most common indication as it was seen in 28.9% (n = 13) of cases. Thirty-eight cases (84.4%) were referred from urology clinic, 2 each (4.4%) from general outpatient clinic, general surgery clinic, and from gynecology clinic. In 44.4% (n = 20) of cases, the cytological diagnosis was inflammatory smear, while the UC was normal in 24.4% (n = 11) cases. Malignant cells were seen in 11.1% of (n = 5) cases. Of the 13 cases that the indication was suspected bladder cancer, only four were positive for malignant cells and one was suspicious on UC. No malignant cell or suspicious cell was seen in any of the UC specimens from patients that had prostate cancer, lower urinary tract outlet obstruction with hematuria due to prostatic enlargement. CONCLUSION: UC should not be requested for in prostatic diseases since the reports are always negative or at most inflammatory. The department should start using The Paris System of UC reporting to assist the managing physician/surgeon to take the best decision.

Profile of Medicolegal Deaths in Females: An Autopsy-Based Study.

BACKGROUND: The rate of female medicolegal deaths (MLD) due to homicides and road traffic accidents (RTAs) is the highest in Africa, compared to the rest of the world, though there is scanty literature locally on this subject. MATERIALS AND METHODS: The major sources of information reviewed in this study were the autopsy registers and autopsy reports of the police clinic, Benin City, Edo State, over 10 years. RESULTS: A total of 331 female medicolegal autopsies were performed, accounting for 21.8% of all cases. The mean age of cases was 40.11 ± 20.25. Age group of 30-39 years accounted for 22.1% (n = 73) of cases, closely followed by the age group of 20-29 years, which accounted for 20.5% (n = 68) of cases. Accidental deaths accounted for 36.9% (n = 122) of cases. RTA was the most common cause of accidental deaths (n = 105; 86%). The most common pattern of RTA was a vehicle knocking down a pedestrian as seen in 45 cases (42.9%). The most common age group involved in RTA was 20-29 years (n = 23; 22%). For homicides, shotguns were mainly used (n = 31; 31.6%), distantly followed by those caused by the use of sharp objects (n = 17; 17.3%) and most cases belonged to the age groups of 40-49 years and 30-39 years (21.5% and 19.5%, respectively). In 5 (71.4%) cases, hanging was the method of choice for suicide. A majority of suicide victims (n = 4; 57.1%) were aged between 30 and 39 years, with an average age of 36.3. Diseases of the cardiovascular system accounted for 41.8% (n = 41) of cases, whereas pregnancy-associated deaths (excluding criminal abortions) accounted for 29.6% (n = 29) of cases in the natural causes group. Preeclampsia/eclampsia (n = 9; 31%) followed by postpartum hemorrhage (n = 8; 27.6%) were the leading causes of maternal deaths. CONCLUSION: There is a need to provide basic infrastructure, formulate policies, and implement them, to reduce female MLD, which a significant number of them are preventable.

Histological Characteristics of Breast Lesions in Uyo, Nigeria.

BACKGROUND: The breast is a common site for pathologies which predominantly involves the female breast. While benign diseases are more common, malignancies are of utmost concern for the patient, clinician, and the pathologist. AIM: The aim of this study is to audit the clinical and pathological features of patients with breast lumps in a tertiary center in Nigeria. MATERIALS AND METHODS: This is a retrospective observational study of histologically diagnosed breast lumps over a period of 8 years. RESULTS: Lumps were common in the 20-39 years age group (>50%), with a mean age of 34.95 years. Females accounted for 759 (98.1%) of cases. In 467 (60.4%) cases, the lumps measured >5 cm and only 175 (22.6%) cases presented to the surgeon within 12 weeks of noticing a breast lump. Ninety-one (11.8%) cases also presented with axillary lymph nodes, breast pain 79 (10.2%), peau d' orange 56 (7.2%), and ulceration 47 (6.1%). Benign breast disease (BBD) occurred in 401 (51.8%) cases and malignant breast diseases (MBD) occurred in 344 (44.3%) of cases. CONCLUSION: BBD and MBD are common among the young in Uyo. Lumps are the primary complaint and late presentation is the norm.

Postmortem forensic imaging: An essential tool in contentious cases

Background: Traditional autopsy (TA) is employed towards determining the cause and manner of death. Over the last decade, virtual autopsy (VA), involving the application of forensic imaging techniques have gained prominence and, with great precision in developed countries. Aim: This is to compare the findings at post-mortem using forensic imaging techniques and, those of TA. Materials and Methods: Post-mortem CT-Scan and MRI techniques were employed in the present case and for the first time in Nigeria, to identify the fatal injuries and determine their causation. The examination was done prior to the TA; the latter was done by a team of pathologists without the prior knowledge of the imaging findings. The results, using both methods, were subsequently compared. Results: Most of the VA and TA findings were the same except for the areas that were not readily accessible to the pathology team because of prior embalmment of the body. The inexperience of the radiologist in the area of post-mortem forensic imaging also contributed to the few discrepancies. Conclusion: This is the first virtopsy to be conducted in Nigeria and, with impressive results. The findings compare favourably with those of TA and, have the added advantage of identifying minor injuries that might easily be missed using TA method. Success is however hinged on the expertise of the forensic radiologist and forensic pathologist. While VA can be employed to solve the problems of religious opposition to TA, the cost of the former is astronomical

Human bites as a weapon of violence: how common are they and do they constitute a significant medical evidence?

Objective: To document the pattern of HBM seen in police clinic Benin City Nigeria.Methods: This is a review of all the human bite mark (HBM) seen at the police clinic.Results:HBM were seen in 68 cases of assault and included 90 separate bites. The youngest victim was 10 years old while the oldest was 59 years with a mean age of 31.9±9.68. Age group 30-39 years accounted for most cases. Female victims were more in number both as victims and as assailants. About 94.1% of the assailants were known. The major events that lead to the use of human bite(HB) were quarrel and fights which accounted for 98.5% of cases.HB was mainly used in conjunction with other weapons. About 77.9% of the HB had single bite marks while complete tissue avulsion were seen in 1.5% of cases. The arm was the commonest site (17.8%), closely followed by the fingers (15.6%).Conclusion: This will serve as a baseline data in Nigeria, while we strongly advocate the development of a proforma for HBM examination following ABFO guideline and HIV PEP for victims with grade 4 HBM and above

A histopathological study of prostate lesions in Lagos, Nigeria: A private practice experience.

INTRODUCTION: Prostatic carcinoma (CaP) is globally the second most frequently diagnosed cancer and the sixth leading cause of cancer death in males. The aim of this study is to determine the pattern of histopathological types of prostatic lesions seen in a private laboratory in Lagos, Nigeria. MATERIALS AND METHODS: Histopathological reports of all prostate specimens, which were received and processed by histopathology section of a private laboratory in Lagos, Nigeria, from August 2009 to December 2013 were reviewed. RESULTS: A total of 304 prostatic tissue specimens were received and processed during the period under review. The youngest patient was 32 years old while the oldest patient was 99 years old with a mean of 67.8 years ± 9.5. The most common diagnosis was benign prostatic hyperplasia (BPH) (62.8%), distantly followed by CaP (29.3%), inadequate samples (6.6%), prostatic intraepithelial neoplasia (1%), and metastasis to the prostate (0.3%). The peak incidence was age group of 60-69 years, closely followed by 70-79 years accounting for 38.2% and 36.2%, respectively. Moderately differentiated CaP (Gleason scores [GSs] 5-7) accounted for 58.1% of the cases while GS 7 was the most common individual score and was seen in 32.3% of the CaP cases. CONCLUSION: In this private practice, BPH is the most common prostate lesion. CaP is relatively high and most of the cases have a high GS that portends high mortality in our population. Efforts should be made to increase awareness so as to reduce the mortality.