P57kip2 immunohistochemical marker as a diagnostic tool for cases of hydatidiform moles in a tertiary health facility in Southwestern Nigeria.

BACKGROUND: Hydatidiform mole (HM) is the most common gestational trophoblastic disease. P57kip2 has been reported to be helpful in differentiating between partial and complete HMs. OBJECTIVES: The study aims to evaluate the P57kip2 immunohistochemical (IHC) marker as a useful ancillary investigation to differentiate complete hydatidiform mole (CHM) from partial hydatidiform mole (PHM). MATERIALS AND METHODS: A retrospective study of all histologically diagnosed HM cases over a 20 year period was undertaken. Clinicopathological parameters were extracted from the surgical day book and medical record archives. Archival haematoxylin- and eosin-stained slides and formalin-fixed paraffin-embedded tissue blocks of all cases of HM diagnosed within the study period were retrieved and reviewed. Cases of HM were reclassified using the P57kip2 IHC marker. The data obtained were analysed using the SPSS version 23. RESULTS: One hundred cases of HMs were studied. CHM accounted for 68%, while PHM accounted for the remaining 32%. The incidence of HM was 2.98 cases per 1000 deliveries. The ratio of CHM to PHM was found to be 2.1:1. Seventy-two per cent of the cases were diagnosed in the first trimester, while the remaining 28% were diagnosed in the second trimester of pregnancy. Based on the P57kip2 IHC staining pattern, HM cases were finally reclassified into 68 cases of CHM and 32 cases of PHM. The age range for all the HM cases was 18-50 years with the majority of the cases seen in the third and fourth decades of life. CONCLUSION: P57kip2 could be useful as an ancillary investigation in confirming the diagnosis of CHM and differentiating it from PHM, particularly in difficult and challenging cases.

Hormonal Receptor Expression in Endometrial Carcinoma: A Retrospective Immunohistochemical Study in a Nigerian Tertiary Hospital.

Background: Endometrial carcinoma is the commonest genital tract malignancy in most developed nations, but it lags behind cervical carcinoma and ovarian cancers in most developing nations including Nigeria. Estrogen has been described as a promoter of endometrial carcinogenesis. Objectives: The aim of this study was to demonstrate the frequency of estrogen receptor (ER) and progesterone receptor (PR) expressions of endometrial carcinoma and to correlate it with tumour grade. Materials and Methods: Cases of endometrial carcinoma diagnosed in the Department of Pathology over a 10-year period were reviewed retrospectively. The paraffin-embedded blocks were retrieved, and immunohistochemistry for ER and PR was performed on them. Haematoxylin and eosin (H&E) slides were reviewed, and tumours were graded by three independent pathologists. Data were analysed using SPSS version 22. The level of significance was set at P ≤ 0.05. Results: There were 44 cases of endometrial carcinoma. ER and PR were positive in 29.5% and 18.2% of endometrial carcinoma, respectively. There was no significant association between ER (P = 0.361) and PR (P = 0.204) expressions and histological grade of the tumour. The most common histological grade was grade 3 with 70% of cases (36 cases), whereas 13 cases (26%) were grade 2 and only 2 cases (4%) were grade 1. Conclusion: The positive expressions of ER and PR in endometrial carcinoma suggest that steroid receptor studies may be of potential benefit in the management of some patients with endometrial carcinoma. Future studies employing larger sample size are therefore recommended.

Histopathological profile of childhood thyroid carcinoma in Ibadan, Southwestern Nigeria.

Background: Thyroid carcinoma is a common endocrine malignancy. It is however rare in childhood and often occurs as a result of radiation exposure or inherited genetic mutations. Most childhood thyroid carcinomas are well differentiated. There are very few epidemiological studies of this disease in Nigeria and our study aimed to determine the frequency in a subset of our population. The study aimed to determine the prevalence and histopathological characteristics of childhood thyroid carcinoma in our environment. Methods: This was a retrospective review of histopathologically diagnosed thyroid carcinoma in children less than 18 years of age in the Department of Pathology, University College Hospital, Ibadan over a 40-year period. Histopathological diagnosis, age, sex and other relevant clinical information were extracted from the hospital records and surgical pathology records of the department. All cases of patients under18 years old had their slides re-examined and reclassified by two pathologists according to the World Health Organization histopathological classification of thyroid tumours. Results: There were 25 cases of thyroid carcinomas seen in children within the study period. Papillary thyroid carcinoma was the most common, accounting for 80% of the cases. Follicular carcinoma accounted for 12%, and medullary and anaplastic carcinoma accounted for 4% each. The mean age at presentation was 13 years. There was a female preponderance with females accounting for 60% of cases. Tumours with distant metastasis made up 20% of the cases. Conclusion: Childhood thyroid carcinomas are rare in our environment, with a minority of cases presenting with metastases.

Inflammatory Pseudotumor: A 20-Year Single Institutional Experience.

BACKGROUND: Inflammatory pseudotumor (IPT) is a relatively rare benign disease. The aim of the study was to demonstrate the demographic distribution, clinical presentation, and histomorphological characteristics of IPT while highlighting its associated diagnostic challenges. MATERIALS AND METHODS: A retrospective cross-sectional review of all the IPT diagnosed in our institution between January 1999 and December 2018 was conducted. The samples were received from within and outside the hospital facility. The demographic data, clinical history, and histologic reports were reviewed. RESULTS: A total of 25 cases of histologically confirmed IPT were seen. Patients' age ranges from 7 to 74 years with a mean age of 38.96 years and standard deviation ± 17.94 years. There was a bimodal peak occurrence in the third and fifth decades. Most of the patients were adults (23, 92%), whereas only 2 (8%) were children. There was a female preponderance with a male-to-female ratio of 1:2.6. The head and neck had the highest number of cases (44%), followed by the gastrointestinal tract (GIT) (40%). Eight (73%) of head and neck cases occurred in the orbit. The presenting complaints depended on the site of the lesion with pain and swelling being the commonest symptoms irrespective of the site of the lesions. Two cases of bilateral IPT were observed. Immunohistochemistry was used in a certain condition of diagnostic dilemma. CONCLUSION: This study showed a female preponderance of IPT with the head and neck and GIT being the most common location. It is important to rule out other differentials in the diagnosis of IPT.

Pediatric Meningiomas in Southwestern Nigeria: A Single-Institutional Experience.

BACKGROUND: Meningiomas are the second commonest intracranial tumors in many places worldwide. They are rare in the pediatric age group, however, and most studies have been able to document only a few patients. Meningiomas in pediatric patients have also been shown to behave differently from those in the adult population. This study was done to examine histologic types of meningiomas seen in pediatric patients from a predominantly African population using the 2016 World Health Organization (WHO) grading system for intracranial tumors. METHODS: Data from the operating logs of patients and histology reports of the samples sent to the pathology department during the study period were extracted. The data obtained were the age, sex, location of the intracranial tumor, histologic diagnosis, WHO grade, and tumor recurrence. RESULTS: Nine pediatric age patients were found among the 166 surgically excised meningiomas received at the pathology department in our institution over a 19-year period. The age range was from 8 months to 17 years. There was a male-to-female ratio of 1:2 with a female predominance. Six tumors were basally located. All tumors were WHO grade I with transitional meningiomas being the commonest followed by meningothelial. There was no history of recurrence in any of the tumors after complete surgical excisions. CONCLUSIONS: Our study showed the rarity of meningiomas in the study population, and there was a predominance of basally located tumors.

Childhood ovarian neoplasms in Ibadan, South-western Nigeria.

BACKGROUND: Childhood ovarian neoplasms are very rare. Little information is available on the relative pattern and frequency of these tumors in Nigerian children. Earlier study done in Ibadan involved ovarian neoplasms in children and adolescents. The aim of this study is to review cases of ovarian neoplasms in children <15 years over a 22½ years period. MATERIALS AND METHODS: This was a retrospective study. Twenty-four cases of childhood ovarian neoplasms were seen in patients <15 years of age. These cases were classified using the current World Health Organization histological classification of ovarian tumors. RESULTS: Childhood ovarian neoplasms accounted for 2.8% of all cases of ovarian tumors seen in this period. Fourteen (58.3%) cases of childhood ovarian neoplasms were benign, and 10 (41.7%) were malignant. Mature cystic teratoma occurring in 13 (54.2%) was the most common childhood ovarian neoplasm and was most prevalent between 10 and 14 years of age. Burkitt lymphoma was the most common 4 (40%) malignant childhood ovarian tumor and prevalent between 5 and 14 years of age. CONCLUSION: Mature cystic teratoma remains the single most common childhood ovarian neoplasms, and Burkitt's lymphoma is the most malignant childhood ovarian tumor in Ibadan, South-western Nigeria.

A Comparison of the Effect of Chlorhexidine, Tap Water and Normal Saline on Healing Wounds / Comparación del Efecto de Clorhexidina, Agua Corriente y Suero Salino en Curación de Heridas

Many researchers have advocated in recent times that antiseptic use in healing wounds should be discouraged. Antiseptics have been found to retard healing of wounds. Innocuous solutions like normal saline and tap water are being considered as better alternatives to antiseptics. Chlorhexidine, a commonly used antiseptic, is known to be less toxic on granulation cells. We decided to compare the effect of chlorhexidine, normal saline and tap water on healing wounds. Three groups of wistar rats had 2 by 2cm full thickness wounds made on their right dorsolateral flanks. The wounds were dressed with either chlorhexidine, normal saline or tap water. Wounds were examined at three-day intervals and measurements of area covered were taken on the first day of study and the ninth day. Wound contraction on the ninth day and number of days for healing to take place in the different groups was taken and statistical analysis using student t-test was done to compare the values. Gross morphology of the wounds was also observed. The result showed an inhibitory effect of chlorhexidine on healing wounds. The wound contraction in the antiseptic group was less than the tap water and saline group on day nine. The average number of days for wound healing to be completed in the antiseptic group was more than the other two. These results were statistically significant when compared with the other two groups. There was no statistical difference in the wound contraction values and rate of healing of the saline and tap water dressed wounds. Grossly, all the wounds dressed with antiseptic also had greenish exudates on their surface by day nine with pale looking granulation tissue, and there was greater mortality in this group.

En la actualidad, diversos investigadores han propagado que el uso de antisépticos en heridas en cicatrización debería, ser abandonado. Se ha encontrado que los antisépticos retardan la cicatrización. Soluciones inocuas, tales como, suero salino y agua corriente, están siendo consideradas como mejores alternativas para efectos antisépticos. La clorhexidina, un antiséptico comúnmente usado, es conocida por ser menos tóxica sobre las células granulares. Basado en lo anterior, comparamos los efectos de la clorhexidina, suero salino y agua corriente en heridas en cicatrización. A tres grupos de ratas Wistar se les infirió heridas de 2 x 2 cm de grosor, en su flanco dorsolateral derecho. La heridas fueron cubiertas (pinceladas) con clorhexidina, solución salina o agua corriente, según el caso. Estas heridas fueronn examinadas cada tres días y las mediciones del área cubierta fueron registradas desde el primero al noveno día. La contracción de la herida al noveno día y el número de días que llevó para cicatrizar se regsitraron en los diversos grupos, analizando los resultados esatadísticamente, usando el test t- student para comparar los valores. La morfología macroscópica también fue observada. Los resultados mostraron un efecto inhibidor de la clorhexidina sobre la cicatrización. La contracción de la herida en el grupo con antiséptico fue menor que en los grupos con suero salino y agua corriente. El promedio de días para cicatrizar, fue mayor en el grupo con antiséptico. Estos resultados fueron estadísticamente significativos al compararlos con los otros dos grupos. No hubo diferencias estadísticamente significativas en los valores de contracción de la herida y rango de cicatrización en el grupo tratado con suero salino normal y en el con agua corriente. Desde el punto de vista macroscópico, las heridas tratadas con el antiséptico también tuvieron un exudado verdoso sobre su superficie al día noveno con un tejido granular pálido y hubo mayor ...