PROGRAMMED CELL DEATH LIGAND 1 (PD-L1) EXPRESSION IN TRIPLE NEGATIVE BREAST CANCER CASES IN BENIN CITY.

Background: Triple-negative breast cancers (TNBC) have been particularly challenging to manage due to their lack of intrinsic cellular receptors, with the resultant relatively higher morbidity and mortality. Recently, the programmed cell death 1/programmed cell death ligand 1 (PD-1/PD- L1) immune checkpoint pathway has become the focus of immunotherapy, especially for TNBCs. This study aimed to determine the pattern of expression of PD-L1 in TNBC cases in Benin City. Methods: It was a 3-year retrospective study that involved the PD-L1 immunostaining of the TNBC cases that were diagnosed in the Department of Anatomical Pathology, University of Benin Teaching Hospital, Benin City, from January 1, 2017 to December 31, 2019. Result: Ninety-two cases of TNBC were tested for PD-L1 expression. Thirteen (14.1%) of the TNBC cases were PDL1 positive to varying degrees on tumour and immune cells. Diffuse tumoural PD-L1 staining was seen in 4 (30.8%) of the PD-L1 positive cases. PD-L1 expression was significantly associated with increasing age up to the fifth decade (p =0.030). All the PD-L1 positive TNBC were invasive breast carcinoma of no special type and mostly grade 2 tumours; however, there was no significant association between PD-L1 expression and histological subtype or grade. Conclusion: PD-L1 expression was shown to occur at a relatively low rate among TNBC cases in this environment and was significantly associated with increasing age. This study has shown that 14.1% (1 in 7) of our TNBC patients could benefit from immune checkpoint inhibitor therapy.

An Update of the Histopathological Pattern of Liver Biopsies at the University of Benin Teaching Hospital.

BACKGROUND: Worldwide, liver disease is a leading cause of morbidity and mortality. Its pattern can be updated by periodic data collection and analysis. OBJECTIVE: To update the existing histopathological pattern of liver diseases at the University of Benin Teaching Hospital, Benin City, Edo state, Nigeria. MATERIALS AND METHODS: This was a descriptive cross-sectional retrospective study of all cases of liver biopsies diagnosed histologically between 1st of January, 2012 to 31st of December, 2019. Data was obtained from the surgical pathology register and the age, sex and pathological diagnoses of the lesions analysed. RESULTS: Liver biopsies were reported for a total of 68 patients during the 8-year study period. The ages of the patients ranged from 2 months to 75 years with a mean age and standard deviation of 28.88 ± 23.21 years. The 3 most common histopathological diagnoses were infectious liver disease (38.23%), malignant neoplastic lesions (26.47%) and cholestatic liver disease (16.17%), with the peak age of infectious liver disease (30-39years) preceding that of malignant liver disease (60-69years) by 3 decades. CONCLUSION: This study shows that chronic hepatitis B infection was the commonest histologic finding of liver biopsies at the University of Benin Teaching Hospital. Screening, vaccination and prompt treatment of hepatitis B infection are recommended to reduce the burden of liver disease. Liver biopsies have been updated to include biliary cirrhosis, biliary atresia, cystic liver diseases and glycogen storage disease thus expanding the scope of histopathological diagnosis that could be made on liver tissue biopsies in this environment.

CONTEXTE: À l'échelle mondiale, les maladies du foie sont l'une des principales causes de morbidité et de mortalité. Son modèle peut être mis à jour par la collecte et l'analyse périodiques de données. OBJECTIF: Mettre à jour le modèle histopathologique existant des maladies du foie à l'hôpital universitaire de l'Université du Bénin, à Benin City, dans l'État d'Edo, au Nigéria. MATÉRIELS ET MÉTHODES: Il s'agissait d'une étude rétrospective transversale descriptive de tous les cas de biopsies hépatiques diagnostiquées histologiquement entre le 1er janvier 2012 et le 31 décembre 2019. Les données ont été obtenues à partir du registre de pathologie chirurgicale et de l'âge, du sexe et des diagnostics pathologiques. des lésions analysées. RÉSULTATS: Des biopsies hépatiques ont été rapportées pour un total de 68 patients au cours de la période d'étude de 8 ans. L'âge des patients variait de 2 mois à 75 ans avec un âge moyen et un écart type de 28,88 ± 23,21 ans. Les 3 diagnostics histopathologiques les plus fréquents étaient une maladie hépatique infectieuse (38,23 %), des lésions néoplasiques malignes (26,47 %) et une maladie hépatique cholestatique (16,17 %), l'âge maximal de la maladie hépatique infectieuse (30-39 ans) précédant celui de la maladie hépatique maligne. (60-69 ans) par 3 décennies. CONCLUSION: Cette étude montre que l'infection chronique par l'hépatite B était la constatation histologique la plus fréquente des biopsies hépatiques au CHU de l'Université du Bénin. Le dépistage, la vaccination et le traitement rapide de l'hépatite B sont recommandés pour réduire le fardeau des maladies du foie. Les biopsies hépatiques ont été mises à jour pour inclure la cirrhose biliaire, l'atrésie biliaire, les maladies kystiques du foie et la maladie du stockage du glycogène, élargissant ainsi la portée du diagnostic histopathologique qui pourrait être effectué sur les biopsies des tissus hépatiques dans cet environnement. MOTS CLÉS: Biopsie hépatique, hépatite chronique, carcinome hépatocellulaire, cholangiocarcinome, atrésie biliaire, cirrhose biliaire, maladie du stockage du glycogène.

Skull Base Chordoma: A Case Presentation and Review of Literature.

Chordomas are rare, aggressive, bone cancers with notochordal differentiation, a marked predilection for the axial skeleton, and higher incidence in males. Approximately 30% of chordomas occur at the skull base where they make up 0.1-0.2% of all intracranial neoplasms, and 6-16% of skull base neoplasms. Skull base chordomas typically occur between 20 and 40 years of age. We report a case of skull base chordoma in a 35 year old man, who presented with a 10 year history of symptoms, and died before treatment could be instituted. Late presentation and delay in treatment are contributing factors in the demise of this patient. The need for a high index of suspicion, early imaging and prompt referral in patients with symptoms attributable to an intracranial tumor is emphasized.

Intestinal obstruction secondary to cecal endometriosis.

Endometriosis of the gastrointestinal tract is rare and occurs in <1% of all patients undergoing major gynecological surgeries. Bowel involvement has been reported in 3%-37% of all women of childbearing age with endometriosis. Total obstruction of the gastrointestinal tract occurs in <1% of cases of endometriosis with bowel obstruction. This case report is that of a 42-year-old female who presented with a 6-month history of change in bowel habits in favor of increasing constipation. This was associated with cyclical lower abdominal pains, abdominal swelling, and weight loss. Examination revealed hyperactive bowel sounds with scant fecal matter on rectal examination. An impression of intestinal obstruction was made and she had an emergency laparotomy. Dilated ileum and a hard, constricting cecal mass were found intraoperatively. She had a right hemicolectomy and ileo-transverse anastomosis, with progressive improvement postoperatively. Histology of the resected bowel segment confirmed cecal endometriosis. In conclusion, cecal endometriosis is a rare cause of intestinal obstruction. A high index of suspicion is required for diagnosis, especially if the woman is premenopausal with a history of abdominal pain that worsens with menstrual periods. Outcome is good with appropriate surgical intervention.