Anatomic and Molecular Pathology- Scholarly Publications

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Browsing Anatomic and Molecular Pathology- Scholarly Publications by Author "Abdulkareem, F B"

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    Open Access
    Colorectal cancer molecular subtypes by immunohistochemistry in a patient cohort from Nigeria.
    (Journal of Clinical Oncology, 2019) Abdulkareem, F B; Khramtsova, G; Adedokun, Babatunde; Rotimi, O; Abudu, K; Badmos, K; Ibraheem, A F; Khramtsov, A; Sveen, Lise; Hurley, Ian; Masaya, H; Huo, D
    Colorectal cancer (CRC) classificationusesclinico-pathological characteristics. However, patients with similar histologic features and tumor stages have different clinical outcomes and drug responses. Studies of CRCmolecular heterogeneity have used genome-wide gene-expression data to classifypatients into four consensus molecular subtypes (CMS), but the complexity of analysis has limited its use in practice. Methods: With IRB approval, tissue microarray (TMA) blocks were constructed, IHC was performed and semi-quantitative scores completed. For the MMR proteins, MLH1 (Pierce), MSH2 (LifeTechnologies), MSH6 (Novex), PMS2 (Pierce) antibodies were used. Three markers were selected from transcriptomic analysis for IHC: CDX2 (LifeTechnologies), HTR2B (LifeTechnologies), and ZEB1 (eBioscience). Ki-67 (DAKO) proliferation rate was used as anequivalent marker for β-catenin activation.The CMS1 subtype was first separated using MSI/MSS status. A panel of CDX2, HTR2B, and ZEB1was then used to distinguish between CMS4 and CMS2/CMS3 subtypes, while Ki-67 was used to separate CMS2 from CMS3 subtype. Results: Of the total evaluable 75 CRC cases(mean age 44.8 years (SD = 16.1), 38% were <40 years old, and 60% were males. Of tumors with data on tumor grade (n=66), 62% were well differentiated. 59 patients (79%) had MSS, and the remaining16(21%) had MSI (i.e. CMS1). 22 (29%) patients with increased ZEB1 and lower CDX2 expression were classified as CMS4. 37 (49%) displayed increased CDX2 and lower ZEB1 expression and were classified as CMS2 (n=24) or CMS3 (n=13). HTR2B was universally expressed, but a higher median HTR2B score of 3 was observed in CMS4 cases compared to 1 for other subtypes (p=0.0001). The CMS4 subtype was significantly more likely to occur among young patients (p<0.001): in patients < 40 years, 70% of patients were CMS4 subtype, while in patients > 40, 7% were CMS4 subtype. Of the left-sided cancers, only 5% were CMS1 subtype, while CMS1 composed 75% of right-sided cancers (p<0.001). Conclusions: Using TMAs and a panel of antibodies, we show an association of a poorer prognostic subtype (CMS4) with younger age at diagnosis. IHC-based classification and screening could be a cost effective prognostic and predictive tool for Nigerian reference laboratories.
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    Open Access
    THE COMMONEST ORBITO-OCULAR TUMOURS OF CHILDREN IN LAGOS STATE, NIGERIA.
    (Pioneer Medical Journal Umuahia, 2011) Nnoli, M; Abdulkareem, F B; Banjo, A A F; Anunobi, C; Daramola, A; Nnoli, C
    The study was carried out as a ten (10) year review (January 1991 – December, 2000). A total of two hundred and ten orbito-ocular tumours were diagnosed, reviewed and analyzed at the Department of Morbid Anatomy of Lagos University Teaching Hospital Lagos, Nigeria. The study presented the total number of malignant orbito ocular tumours as one hundred and forty (67%) and the benign orbito-ocular tumours 70 (33%). Among the malignant tumours, retinoblastoma was the commonest orbito-ocular tumour and accounting for 26.2% (Table 1). These were compared with other major works conducted in other parts of Nigeria, Africa and the world. References were made to distribution by age, sex and geographical characteristics. The prevalence of these tumours in different populations and the differences found were noted. It was found that the commonest age at presentation of retinoblastoma was 0 – 4 years and the sex affected mostly was the female gender (Table 2). It is important to note that proptosis is the hallmark of the orbito ocular tumour as it is the commonest manifestation at first attendance, a fact which validates the late presentation of most of the patients. Objectives: To create awareness of the commonest tumour of the eye involving children and to inform the clinicians on the recent precautions /possible treatment modalities in our centre and other areas available. Methods: The study was a retrospective analysis spanning over ten years of children within 014 years seen in our Pathology department with orbito-ocular tumours. Results: Retinoblastoma was seen to be the commonest tumor in this study 55(26.2%) occurring at older age. It is more common in females than males with a ratio of 1.2:1.
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    Open Access
    Diagnostic methods for the detection of Helicobacter pylori in Nigeria
    (Tropical Gastroenterology, 2010) Smith, S I; Omonigbehin, E A; Goodluck, H A; Abdulkareem, F B; Onyekwere, C A; Agomo, C; Ndububa, D A; Fowora, M A; Otegbayo, J A; Contreras, M; Haas, R; Rieder, G
    Helicobacter pylori is a curved, highly motile, gram-negative rod that colonizes the mucosa of the human stomach of more than half of the world’s population.1,2 Infection is mainly acquired in childhood and stays asymptomatic for decades in approximately 80% of cases.2 There are several diagnostic tests for the detection of H. pylori and are grouped into two categories: (I) invasive tests that require endoscopy such as culture, rapid urease test (RUT), histology, direct gram-stain of biopsies, and PCR; (II) non-invasive or minimally invasive tests such as serology, urea breath test (UBT), and H. pylori stool antigen tests (HpSA).3 Although culture is the gold standard, it is very much dependent on some infrastructure conditions and power supply. Therefore, the culturing of H. pylori can be unreliable especially for an environment like Nigeria where power outages are quite regular and lasting for days. This is also in addition to the problem of overgrowth or contamination with other microorganisms. Due to this situation, cultivation of H. pylori is not routinely applied for the detection of H. pylori in Nigeria. However, culture is necessary in treating cases with failure of primary attempt at H.pylori eradication. The study aimed at evaluating various methods for the diagnosis of H. pylori in developing countries where facilities for culture of H.pylori may not be easily available at all centres. Methods 167 patients with dyspepsia undergoing upper gastrointestinal endoscopy were included after informed consent. Patients on NSAIDs, PPIs, and antibiotics were excluded. A total of 835 stomach biopsy samples (three antrum and two corpus) were obtained from these patients during endoscopy. The study was carried out between January 2008 and December 2008. The biopsies were subjected to H. pylori culture, CLO test kit (Delta West pty, Australia), H. pylori stool antigen test (HpSA, Meridien UK) using stool samples or rectal swabs, serology test (Human, Germany), histology (Giemsa stain), and direct gram stain of smear from biopsy. Three biopsies from the antrum were used :- one each for CLO test, culture/ PCR, and histology. While the other two corpus biopsies were used only for histology and culture/PCR. All tests with kits were carried out according to their manufacturer’s instructions. The specimens were obtained from two centres in Nigeria: Lagos State University Teaching Hospital (LASUTH, Ikeja) and Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile Ife. Ethical approval was obtained from the NIMR-IRB before the study commenced.
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    Open Access
    Extremity Soft Tissue Sarcoma: A Review of 19 Cases.
    (Nigerian Journal of Orthopaedics and Trauma, 2007) Eyesan, S U; Idowu, O K; Chira, M K; Nnodu, O E; Abdulkareem, F B; Ketiku, K K
    Background: Although soft tissue sarcoma is a rare tumour, it accounts for a significant proportion of malignancies seen in many orthopaedic practices. The objectives of this study are to evaluate the pattern of presentation of extremity soft tissue sarcoma and the treatment outcome in our patients. Method: This is a 3 year prospective study in patients presenting with extremity soft tissue sarcoma at the oncology unit of the National Orthopedic Hospital Lagos. Data, such as age, sex, presenting complaints, anatomic location of lesions, histologic type of tumour, and treatment outcome were retrieved from prepared proforma. The average follow up period was 22.8 months. Results: Nineteen patients were studied. The age range of the patients was 3 to 69 years, male to female ratio of 1.7: 1. Most tumours were located in the thigh and the leg, and malignant fibrous histiocytoma was the most common histologic diagnosis. Whilst all the patients presented with stages II and III diseases, limb salvage was only possible in 52.6% of these patients. Surgery was always combined with adjuvant radiotherapy. A survival rate of 69% and a recurrence rate of 16% were recorded over the period of the study. Conclusion: Delayed presentation limited the scope of limb salvage surgery in centers such as ours, but appropriate tumour excision and adjuvant radiotherapy remains the mainstay of the management.
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    Open Access
    Histopathological characteristics of breast carcinomas at the Olabisi Onabanjo University Teaching Hospital, Sagamu Ogun State, Nigeria
    (Nigerian Journal of Health and Biomedical Sciences, 2008) Banjo, A A; Musa, O; Tade, A O; Ayoade, BA; Daramola, A O; Abdulkareem, F B; Abudu, E K; Agboola, AJ; Igbokwe, U
    This study examines the pathological grade as well as the estrogen progesterone receptor (ERPR) status in breast cancer materials from Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria. All histopathologically diagnosed tissue samples from the department of Histopathology of the Olabisi Onabanjo University Teaching Hospital, Sagamu seen from January 2003 to December 2004 were examined and graded using the Elston and Ellis Modification of the Scarff-Bloom –Richardson grading system1 and stained for their estrogen/progesterone receptor status. Forty- seven cases of breast carcinoma were seen during the period under study. Of these, 44(93.7%) were invasive ductal carcinoma, with majority being poorly differentiated. Their ages ranged from 25-75 years with majority in the age group 40-59years. The mean age was 47.3 years. Of the 27 cases that had their ERPR status analyzed, 21 cases (77.8%) were ERPR negative, while only 3 (11.1%) were ERPR positive. This study shows that there is a predominance of high grade invasive ductal carcinomas that are likely to be ERPR negative. These features suggest a biologically aggressive form of breast cancer in Nigeria with the possibility of poor response to hormonal therapy.
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    Open Access
    Management of Giant Cell Tumour: A Nigerian Experience
    (Nigerian Journal of Surgical Sciences, 2007) Eyesan, S U; Obalum, D C; Nnodu, O E; Abdulkareem, F B; Ladejobi, A O
    Giant cell tumours (GCT) are the commonest bone tumours worldwide. It is rarely malignant but when it does it progresses to fibrosarcoma with high mortality. Otherwise it causes poor cosmesis, disability and pathological fractures. A total of 19 cases of histologically established Giant cell tumour of the bone were reviewed prospectively in a 5 year study. 14 cases were benign, 4 malignant and one was a malignant transformation. Lesions around the knee accounted for 42.2% of the cases, but the radius was the commonest single bone affected with 26.3%. Eleven patients had curettage, five of them had autogenous bone grafting while the remaining six had bone grafting and plate augmentation. One patient had fore-quarter amputation while seven had tumour resection. There was no recurrence recorded among those that had currretage and autogenous bone grafting. 33% of those that had curettage and bone cementing as well as 16.6% of those that had resection presented with recurrence. One patient died within 3 months of surgery due to metastasis to the lungs, liver and spleen. Mean follow up was 9.2 months (range of 2 to 60 months). With early presentation, curretage and bone grafting is often effective; late presentation however has an increased risk of recurrence due to soft tissue involvement, dearth of investigative tools and financial constraints.
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    Open Access
    Pathological Study of Bone Tumours at the National Orthopaedic Hospital, Lagos, Nigeria
    (West African Journal Of Medicine, 2007) Abdulkareem, F B; Eyesan, S U; Akinde, O R; Ezembakwe, M E; Nnodu, O E
    Background: Although primary bone tumours are relatively uncommon, they constitute the most important tumours in patients under 20 years. Objective: To update the literature on the relative frequency and clinico-pathologic characteristics of bone tumours in this environment. Materials and methods: The clinical and histopathological records of patients presenting with diagnosis of bone tumours between 1999 and 2004 and managed at the National Orthopaedic Hospital, Igbobi, (NOHI) Lagos, Nigeria were review and where necessary, new ones were prepared from the paraffin blocks and stained with routine haematoxylin and eosin stain. The clinical data such as the age, sex, presenting signs and symptoms, site distribution of lesions, radiological finding as well as the record of other investigation and management were extracted from the clinical case notes of patients. Results: Seventy-seven cases were recorded; 61 (79.2%) benign and 16 (15.6%) malignant. The male:female ratio for all tumours was 2:1. The commonest benign bone tumours were osteochondroma and giant cell tumour accounting for 52 (67%) of all cases with > 60% in males. The most common primary malignant bone tumour was osteosarcoma, all in males. The peak incidence was in the second and third decades and commonest sites were the distal femur and proximal tibia. Four (5.2%) cases of metastatic bone tumours located commonly in the proximal femur and humerus were also recorded. Conclusion: Osteochondroma and giant cell tumours are the commonest benign tumours while osteosarcoma is the most common primary bone tumour all occurring in the first two decades of life. The age and sex distribution and morphology are similar to those already established in the African and international literature.
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    Open Access
    Pattern of Osteochondromas in Lagos, Nigeria
    (Nigerian Quarterly Journal Hospital of Medicine, 2008) Obalum, D C; Eyesan, S U; Ezembakwe, M E; Abdulkareem, F B
    Osteochondromas are the most common benign tumours of bone. It is a problem of rapidly growing skeleton. Most of them are asymptomatic. The most common reason for presentation being perception of the lesion as a cosmetic blemish. This study aims to study the epidemiology of osteochondromas at National Orthopaedic Hospital, Igbobi (NOHI), Lagos, Nigeria. This is a five year prospective study of osteochondromas that presented at NOHI, Lagos, Nigeria. NOHI is the largest orthopaedic reference centre in Nigeria. This study was necessitated by the paucity of epidemiological data on the subject in Nigeria and the sudden increase in the number of cases presenting to us. Sixty eight patients with histologically established osteochondromas were studied. Clear majority (42) were males. Forty two patients (61.8%) were aged 20 years or less. An overwhelming majority were pedunculated (88.2%) and solitary (97.1%). The commonest reason for presentation and request for treatment by patients was the lesion being a cosmetic blemish (85.3%). They all had excision and 2 patients (2.9%) had recurrence with malignant transformation. The study showed that osteochondromas were preponderant in Nigerian males in the second decade of life. Excision was the treatment of choice.
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    Open Access
    Prevalence of Chronic Kidney Disease in HIV Positive Patients in Lagos, South-West Nigeria
    (Nephrology Research & Reviews, 2014) Umeizudike, T; Abdulkareem, F B; Mabayoje, M; Okany, C; Okubadejo, N; Adeyomoye, A; Okpechi, I
    The human immunodeficiency virus (HIV) pandemic is one of the leading causes of death in the developing world. Chronic kidney disease (CKD) and end-stage renal disease (ESRD) associated with HIV are major causes of morbidity and mortality in HIV-positive patients. This cross-sectional study was conducted to determine the prevalence and risk factors of CKD in HIV-positive, antiretroviral naïve patients at a single HIV clinic in Lagos, Nigeria. Of 402 patients, CKD was observed in 23.5% while among 146 controls, CKD was detected in 5.5% (odds ratio (OR) 5.34 [95% CI 2.4–12.2]; P<0.0001). Macroalbuminuria was seen in 20.1% of patients and 2.1% of controls, (OR 12 [95% CI 3.7–38.5]; P<0.0001). Most of the patients and controls were categorized into CKD stages 1 and 2, none among the control was in stage 4 or 5 CKD, while 2 and 2.2% of patients were in stages 4 and 5, respectively (P=0.005). Macroalbuminuria (P<0.0001) and HIV RNA viral load (P=0.010) correlated with CKD on multivariate linear regression analysis. Macroalbuminuria may, therefore, be a useful marker of degree of CKD in HIV seropositive patients. To reduce the burden of CKD and ESRD in populations with high prevalence of HIV, there is a need for increased screening and surveillance for CKD through performance of simple tests to estimate protein in the urine. One of the limitations of this is in using the abbreviated Modification of Diets in Renal Disease (MDRD) equation for estimating glomerular filtration rate.
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    Open Access
    Review of the Histopathologic Patterns of Superficial Lymph Node Diseases, in Lagos (1991-2004)
    (Nigerian Postgraduate Medical Journal, 2008) Anunobi, C C; Banjo, A A F; Abdulkareem, F B; Daramola, A O; Abudu, E K
    Objective: This is a 14-year retrospective histopathologic study of 720 lymph node biopsies. The aim is to document the causes of lymphadenopathy, the age and sex distribution in Lagos. Materials and methods: The materials consisted of slides and paraffin embedded blocks of all lymph node biopsy specimens received from within and outside Lagos University Teaching Hospital, Lagos. Results: A total of 720 biopsies from 276 males and 444 females were analysed. Chronic non specific lymphadenitis 245 (34%), tuberculosis 125 (17.4%), metastatic lymph node lesions 242 (33.6%), and lymphomas 102(14.2%) were the common causes of lymph node enlargement. The commonest lymph node group affected was the cervical 283 (39.3%). Conclusion: Malignancy (47.8%) is the most common cause of superficial lymphadenopathy in Lagos metropolis. The age, sex and site prevalence agree with reports from other parts of Nigeria and Africa with minimal variations.
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    Open Access
    Surgery of Parotid Gland Tumours in Lagos: A 12 Year Review
    (Nigerian Postgraduate Medical Journal, 2007) Somefun, O A; Oyeneyin, J O; Abdulkareem, F B; da Lilly-Tariah, O B; Nimkur, L T; Esan, O O
    Background/aim: Tumours of the parotid gland are not common. Parotid tumours can pose a challenge both in diagnosis and treatment. Various factors contribute to the management difficulties of parotid tumours for the Head neck surgeon. The aim of the study is to determine the presentation and management of parotid tumours requiring surgery at the Burns and Plastic and Otolaryngology (ORL) units of the hospital. Materials and methods: This is a retrospective study carried out at the Lagos University Teaching Hospital from January 1994- December 2005. The medical case notes were reviewed for information on age, sex, clinical presentation, surgical management, histological diagnosis and outcome. Results: A total of 58 patients with parotid tumours were seen with ages ranging from 25-65 years. Male to Female ratio was 1.4:1. Forty-two (72.4%) presented with firm preauricular swelling, 1.7% as dumb bell tumour and post surgical recurrence tumour respectively, 6.8% as tail of parotid tumour and 3.5% as bilateral disease. 93.13% had superficial parotidectomy. Histological diagnosis confirmed 65.5% as pleomorphic adenoma, 20.72% as carcinomas of which adenoidcystic and mucoepidermoid tumours were the commonest,3.45% as lymphoma and 1.7% as Sjogrens syndrome, oxyphil and Warthins tumour respectively. Immediate post surgical facial nerve palsy was seen in 69% and recovery was seen in 62% within 3-9months. Post surgical radiotherapy was given to 8.6%. Conclusion: The commonest parotid salivary gland tumour requiring surgery is pleomorphic adenoma, presenting as a pre-auricular mass and the commonest post- surgical complication was facial nerve palsy involving the mandibular branch. A good knowledge of the surgical anatomy of the gland, clinical behaviour and biologic nature of the tumours will ensure better surgical management.
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    Open Access
    Testicular schistosomiasis mimicking hydrocele in a child: a case report
    (The Pan African Medical Journal, 2020) Ajibola, O O; Ikhisemojie, S; Esse, S S; Oyebode, A; Abdulkareem, F B
    Schistosomiasis is a disease of profound public health importance worldwide. Testicular schistosomiasis (TS) is however still considered as a rare entity despite the burden of the disease. We report a case of a 9 year old male who presented with features suggestive of testicular hydrocele. The spermatic cord and testis were seen as thickened lesion on examination and a biopsy taken revealed calcified ova of Schistosoma haematobium . This is being reported to enhance increased suspicion amongst surgeons in cases of testicular masses within endemic settings like Nigeria