Department of Anatomic and Molecular Pathology

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    Open Access
    Adhesion molecules and rejection of renal allografts
    (Kidney international, 1997) Solez, K; Racusen, LC; Abdulkareem, FB; Kemeny, E; Willebrand, EV; Truong, L D
    Adhesion molecules and rejection of renal allografts. Despite an increasing amount of immunohistochemical and molecular biology data relating to the pathogenesis of kidney transplant rejection, the pathological diagnosis of this condition still rests on routine light microscopy. The detection of changes in expression and distribution of adhesion molecules in renal allograft biopsies may open a new era of increased accuracy of rejection diagnosis. Of the various adhesion molecule reactivities, peritubular capillary VCAM-1 staining appears to be the most specific rinding for chronic rejection. This same staining reaction is seen in acute rejection, but may have less specificity in that setting.
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    Open Access
    Adult Lymphomas in Lagos Nigeria: A Fourteen Year Study
    (Nigerian Quarterly Hospital of Medicine, 2007) Anunobi, C C; Banjo, A A F; Abdulkareem, FB; Daramola, A O; Akinde, R O; Abudu, E K
    Objective: we present a 14 year retrospective histopathological study of 92 cases of adult lymphomas in Lagos. The aim is to document the histologic types, age and sex distribution. Materials and method: The materials consisted of slides and paraffin embedded blocks of all cases of lymphoma in adults above the age of 16 years seen between 1991 and 2004 at the Morbid Anatomy Department of Lagos University Teaching Hospital Idi-Araba Lagos. Results: Of ninety two cases of lymphoma studied, male and female patients accounted for 59(64%) and 33(36%) cases respectively, giving a M: F ratio of 1.8:1. The most frequently biopsied site is the cervical lymph node. Non-Hodgkin's lymphoma (NHL) which accounted for 60 cases occurred most frequently in the 46-55 years age group and gives a male: female ratio of 2:1. Intermediate grade, high grade and low grade variants of NHLs accounted for 39%, 34% and 27% respectively. Hodgkin's lymphoma mostly affected patients of younger age group, 25-35 years with a M:F ratio of 1.7:1. Mixed cellularity 17 (55%) was the commonest subtype of Hodgkin's lymphoma. Conclusion: Non-Hodgkin's lymphoma is commoner than Hodgkin's lymphoma. The age and sex distribution agrees with reports from other parts of Nigeria and Africa with minimal variations.
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    Open Access
    Allergenicity of dominant aeropollen in Nigeria: Part I
    (Current Allergy & Clinical Immunology, 2017-10) Adeniyi, Tiwalade Adeyemi; Adeonipekun, Peter Adegbenga; Olowokudejo, James Dele; Akande, Idowu
    Several pollen grains have been studied in detail for purification and characterisation of allergenic components in the advanced countries; however, many are yet to be studied in the tropics, including Nigeria. To close this gap, four pollen grains (Poaceae – Cynodon dactylon, Panicum maximum; Cyperaceae – Cyperus rotundus and Mariscus alternifolius) found dominant in the air from previous aeropalynological studies in Nigeria were selected. The pollen grains were harvested from fresh anthers and their proteins were extracted, quantified, separated and subjected to Western-blot analysis. The allergenic proteins were also identified. While C. dactylon had the highest protein content (17.09 mg/mL), M. alternifolius had the lowest (11.19 mg/mL). Western-blot analysis showed that individuals were most susceptible to the 35 kDa protein of C. dactylon (76%). Furthermore, only C. dactylon proteins of 14.5 kDa and 35 kDa were identified with their exact matches in the ProFound database (Cyn d 12 and Cyn d 1 respectively), whereas the peptide sequences of eight protein bands were newly added to the database. Of these, the Profilin protein group (14 kDa) is common to all studied pollen grains – an indication of veritable immunotherapeutic potential. This study is the first in Nigeria to record allergenic proteins in these pollen grains and to create a foundation for the development of immunotherapy drugs for allergy treatment in the country
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    Open Access
    Application of stool-PCR for the Diagnosis of Helicobacter Pylori From Stool in Nigeria- A Pilot Study
    (Springerplus, 2012) Smith, S; Fowora, MA; Lesi, OA; Agbebaku, E; Odeigah, P; Abdulkareem, FB; Onyekwere, CA; Agomo, CA; Contreras, M
    There are various methods for detection of Helicobacter pylori and the gold standard for non-invasive detection is the urea breath test (UBT). The aim of the study is therefore to detect H. pylori from the stool of patients with dyspepsia by PCR and compare results obtained with UBT. A total of 97 stool samples from patients presenting with dyspeptic symptoms in Lagos University Teaching Hospital (LUTH) were screened for urea breath test (UBT) and the presence of H. pylori DNA using stool-PCR. Out of 97 stool samples analysed, 38 (39.2%) were positive for Helicobacter spp. and 20 (20.6%) positive for H. pylori by PCR, through amplification of 16S rRNA and glmMgenes respectively. Of the 20 positive by glmM gene, the cagAgene was detected in 8 (40%) samples, while 47 (48.5%) out of 97 stool samples were positive for H. pylori by UBT. The sensitivity and specificity of the glmM gene compared with UBT as the gold standard is 42.6% and 100% respectively. The positive predictive value (PPV) was 100% while the negative predictive value (NPV) was 60%.The method may be useful for detecting H. pylori from stool amongst children especially where most hospitals lack endoscope for children although the method is expensive.
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    Open Access
    The Association Between Cancer Of The Breast And The Abo And Rhesus D Antigen Phenotypes In Lagos, Nigeria; A Case-Control Study
    (Nigerian Journal of Clinical Practice, 2002) Akammu, AS; Ajekighe, AT; Durusinmi-Etti, FAA; Akinsete, L; Emuveyan, EE; Abdul-Kaareem, FB; Ugwaudu, CS; Dawotola, DA
    Objective: To determine whether inheritance of ABO and Rhesus D antigen phenotypes constitute a risk factor for development of cancer of the breast. Design: A case-control study. Setting: Patients with histologically diagnosed cancer of the breast referred to Radiotherapy department of the Lagos University Teaching Hospital over a six-month period were included in the study (cases). Healthy blood donors at the Donors Clinic of the hospital over the same period of time were also studied (Control A). Women attending family planning clinic were also studied and referred to as Control B. Materials & Methods: Routine ABO and Rhesus D-phenotyping was carried out on washed red cell specimens of all cases and controls. The odds that cancer of the breast was due to presence of a given phenotype were determined (odds of cases). The odds that the given phenotype is present in the normal population without cancer of breast was also determined (odds of control). The Odds Ratio (OR) given by odds of cases/odds of control served as an estimate of the Relative Risk (RR) that the given phenotype is associated with the cancer of the breast. Result: 107 cases, 2.243 controls A and 122 controls B were studied. Of the cases, only one was a male, the others were females. Their ages ranged between 24 and 85 years with a median of 45 years. The controls A were all males with ages ranging between 22 and 55 years. Controls B were females with ages ranging between 21 and 47 years. A,B,O, AB, Rhesus D positive and Rhesus D negative phenotype distribution amongst the cases, controls. A and B were 28,22,54,3,97 and 10,589,440,1143,71,2142 and 101,27,25,70,.0,117 and 5 respectively. Of all the phenotypes, only the inheritance of Rhesus D antigen gave a relative risk (RR) significantly below unity. RR=0.45. Standard error=0.76 and p. <0.05 when cases were compared with controls A. RR=0.41,SE=0.56 and P>0.05 when cases were compared with control B. Conclusion: Negative association was established between inheritance of Rhesus D antigen and the development of cancer of the breast. Rhesus D antigen phenotype may be protective against cancer of the breast.
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    Open Access
    Autopsy Study of the Liver in Adult Nigerians at Lagos University Teaching Hospital
    (West African Journal of Medicine, 2019) Obiajulu, FJ; Badmos, KB; Awolola, NA; Dawodu, OO; Adebayo, LA; Elesha, SO; Abdulkareem, FB
    Background: Liver diseases are one of the major causes of morbidity and mortality in Nigeria. Detection of liver involvement in many disease conditions is often delayed till after death when autopsy is conducted, hence the importance of this study. Study design and method: This was a prospective study to assess the pathologic findings in the liver of one hundred (100) consecutive adults (without pre-mortem diagnosis of liver disease) at autopsy, at the Lagos University Teaching Hospital (LUTH), Lagos, Nigeria. The organs were examined macroscopically, weighed and representative biopsies taken for histopathological assessment. Special histochemical stains to confirm diagnosis were carried out as appropriate. The biodata and other clinical information were obtained from the case notes. Analysis was carried using descriptive statistics. Results: One hundred cases were studied, comprising of 46 males and 54 females, with overall mean age 47±15.6 years. The mean weight of the liver was 1737±586.02 grams (normal 1200-1400gm). In 19.0% of the cases, the liver showed normal histology. Of the others with pathological findings (81%), the three most common pathologies were chronic venous congestion, steatosis, and metastatic tumours. There was significant correlation of liver pathologies diagnosed with causes of death at autopsy (p=0.001). Conclusion: In view of the fact that major liver diseases may be asymptomatic and may not be diagnosed until death, there is need for a high index of suspicion by clinicians. It is therefore important that clinicians properly assess the functional state of the liver to prevent, detect and promptly treat these disorders.
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    Open Access
    Benign Fibrous Histiocytoma of a Metacarpal Bone
    (BMJ case reports, 2011) Onovo, O D; Eyesan, SU; Abdulkareem, FB
    Benign fibrous histiocytoma (BFH) is a rare skeletal tumour. Its occurrence in the metacarpal bones is even rarer. The management in this location can be challenging, involving tumour resection and metacarpal reconstruction. The authors present a case of BFH involving the second metacarpal bone.
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    Open Access
    Bladder Cancer in Lagos: A 15 Year Histopathologic Review
    (The Nigerian postgraduate medical journal, 2010) Anunobi, C C; Banjo, A A F; Abdulkareem, FB; Daramola, A O; Akinde, O R; Elesha, S O
    Objective: To present a 15 year retrospective pathologic study of bladder cancers. The aim is to document histologic pattern, prevalence, sex and age distribution of urinary bladder cancer. Materials and methods: The materials consisted of slides, paraffin embedded tissue blocks and histology request forms of all urinary bladder biopsies received at the Morbid Anatomy department of Lagos University Teaching Hospital Idi-Araba, Lagos from 1991 to 2005. Each sample represents a different patient. The study did not include information regarding the clinical or pathological stage of the tumours. Results: Bladder malignancies comprised 39 (72.2 %) cases of all bladder biopsies and 0.86% of all diagnosed cancers in LUTH. The malignant lesions of the bladder showed a male preponderance with a M:F ratio of 4.6:1. The age range was 4-75 years with a mean age of 51.37 years and peak at 61-70 years age group. Transitional cell carcinoma was the commonest histological type accounting for 61.5% with a male to female ratio of 5:1 and mean age of 59 years. Squamous cell carcinoma accounted for 20.5% with a M:F ratio of 3:1 and showed a mean age of 47 years. Adenocarcinoma, anaplastic carcinoma and embryonal rhabdomyosarcoma accounted for 5.1%, 5.1% and 7.8% of cases respectively. Conclusion: Bladder cancer is not common in Lagos. The histopathologic pattern, prevalence, sex and age distribution of bladder cancer are similar to previous reports from schistosomiasis non endemic regions of Nigeria, Africa and the rest of the world.
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    Open Access
    Bone Malignancies in Orthopaedic Hospital Igbobi Lagos, Nigeria
    (Nigerian Postgraduate Medical Journal, 2014) Adeniran, JJ; Samuel, UE; Dike, OC; Olayinka, SO; Ayokunle, O; Nnodu, OE; Abdulkareem, FB
    Aims and objectives: To document the pattern of bone malignancies in a highly populated orthopaedic hospital in Lagos Nigeria; Patients and methods: A total of 21 cases of primary malignant bone tumours were studied. This comprised 12 cases of Osteosarcoma, 7 cases of Malignant Fibrous Histiocytoma (MFH) and 2 cases of Chondrosarcoma. Males (13) were affected more than females (8) giving a male to female ratio of 1.6 to 1. The age range was 7 to 45 years with a median age of 24 years. The diameter of the swelling ranged from 6 to 20 cm with a median of 12 cm. All patients had ablative surgery except for those with affectation of the ilium. Data was analysed using the Statistical Package for Social Sciences (SPSS 16). Enneking's classification was used to grade the tumour. The duration of symptoms of all the patients before presentation ranged from 3 weeks to 4 years with a mean of 7 months. The commonest site affected was around the knee (76.2%); distal femur had 42.9% and proximal tibia 33.3%. Results: Osteosarcoma was the most common malignant bone tumour in this series and accounted for 57.1%. The peak incidence was found in the 2nd decade of life. The youngest patient was 7 years old and the oldest 43 years. The tumour was found primarily around the knee. 7 cases were in the distal part of the femur, 4 in the proximal part of the tibia and 1 case was found in the distal radius. Out of the 12 patients with osteosarcoma, 8 had paraosteal type (5 high grade, 3 intermediate grade), the remaining 4 had periosteal (all high grade) Malignant Fibrous Histiocytoma was found in 7 patients and accounted for 33.3%. The peak incidence was found in 3rd and 4th decades. 4 out of the 7 patients were high grade pleomorphic osteosarcoma, 2 were myxoid high grade dedifferentiated and one was low grade giant cell tumour type. Chondrosarcoma was found in 2 patients, accounting for 9.5%. both cases were in the ilium Conclusion: Primary malignant bone tumours occurred in children and young adult in this study. It is commoner among males and most of the patients presented late to the hospital. Osteosarcoma is the commonest followed by Malignant Fibrous Histiocytoma, both occurred commonly around the knee and chondrosarcoma on the ilium.
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    Open Access
    Breast Cancer in a Lagos Facility-Implications for the Institution of a Cancer Screening Programme
    (Pathobiology, 2018) Ikeri, NZ; Oguntunde, OA; Igbokwe, U; Abdulkareem, FB; Banjo, AAF
    Objective: There are significant epidemiological and biological differences between breast cancer in blacks and whites which have wide-reaching implications for the institution of an effective cancer screening programme in Nigeria. The aim of this study was to describe the clinicopathologic features of breast cancer diagnosed in our facility and to discuss their implications for cancer screening. Methods: A retrospective review of the forms, slides, and results of breast cancer cases received in our facility over an 8-year period was carried out, as well as a systematic review of the characteristics of breast cancer in Nigeria, Africa, the US, and the UK. Result: A total of 832 cancers were seen with a mean age of 49 years. Most cases (97%) were invasive ductal carcinomas not otherwise specified, high grade (41.9%), and unassociated with ductal carcinoma in situ (52.3%). Triple-negative tumors were the commonest immunohistochemical type seen (42.1%), and these were less likely to have an intraductal component (p = 0.0048). Luminal-type tumours were more likely to be low grade (p = 0.0005). The majority of cases presented in advanced stages with no statistically significant difference among the different immunohistochemical subtypes (p = 0.7949). Conclusion: The significant epidemiological and biological differences between breast cancer in Lagos and in western populations are important for the establishment of an effective breast cancer screening programme uniquely tailored for the Nigerian population
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    Open Access
    Breast Cancer Reporting in Lagos, Nigeria-Implications for Training and Education in Africa
    (Journal of Global Oncology, 2016) Daramola, AO; Banjo, AAF; Abdulkareem, FB; Shaaban, AM
    Purpose: To assess the completeness and accuracy of breast cancer pathologic reporting in Nigeria. Materials and methods: The histologic parameters provided in breast cancer pathology reports at a large teaching hospital in Nigeria were assessed. The corresponding slides were reviewed after the United Kingdom Royal College of Pathologists guidelines, and results were compared. Results: Out of 115 breast cancer cases, histologic type of breast carcinoma was concordant with the review type in 53.1% of cases and discordant in 46.9%. Grading was stated in 89.62% of cases, of which 50.5% were correctly graded, 35.8% were under-graded, and 8.5% were over-graded. Poor fixation and omission of the mitotic count were the main reasons for discordant grades. A comment on lymph node status was included in 40% of cases, and lymphovascular invasion was not commented on in 97.4% of cases. Only 26% of the tumors had hormone receptors and/or HER2 tested. Conclusion: Some essential histologic parameters were absent from the histologic reports, and where present, a proportion were inaccurate. Attention to specimen fixation and method of grading and familiarity with uncommon breast cancer types are required; all can be facilitated by education and training. The use of a template/proforma is recommended to ensure cancer data set parameters are included in the pathology reports.
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    Open Access
    Cervical Cytology in an Urban Population in Lagos, Nigeria
    (Journal of Obstetrics and Gynaecology, 2003) Anorlu, R I; AbdulKareem, FB; Abudu, O O; Oyekan, T O
    Eight hundred and eighty-four consecutive women had cervical smears in a clinic in Lagos, Nigeria between September 1998 and 31 August 1999. Mean age was 36.6 - 11.6 years (range 16-81 years); 93.7% were first-time screening. Three hundred and twenty-five (36.5%) smears were normal, inflammatory smears 52.7%, mild dyskaryosis 2.4%, moderate dyskaryosis 1.5%, severe dyskaryosis 0.3% and probable malignancy (malignant cells) 0.8%. Abnormal smears were higher in symptomatic cases compared with asymptomatic cases (chi2=15.3, P< 0.01); 6.1% and 2.1% of symptomatic cases had dyskaryosis and carcinoma, respectively, compared with 3.4% and 0.1% for asymptomatic cases. In postcoital bleeding 9.3% and 1.9% had dyskaryosis and carcinoma, respectively. Fifty-six of 62 cases of cervical erosion had abnormal smears. In postmenopausal bleeding 13.0% and 4.3% had dyskaryosis and carcinoma, respectively. Prevalence of abnormal cervical smears is high in women who have genital tract disease. In places with no national screening programmes every effort should be made to screen such women.
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    Open Access
    Challenges in the Diagnosis and Management of Musculoskeletal Tumours in Nigeria
    (International Orthopaedics, 2009) Ladejobi, A. O.; Abdulkareem, FB; Nnodu, O. E.; Obalum, D. C.; Eyesan, S. U.
    The management of musculoskeletal tumours is important because of the high mortality rates associated with the available treatment modalities. A 5-year prospective study of bone and soft-tissue tumours is presented, along with the difficulties encountered in diagnosis and treatment. There were 71 patients (male:female ratio of 1.7:1, age range 5-85 years, mean age 32 years) with an average duration of 24.7 weeks (range 1 day to 34 years) before presentation. No patient had computed tomography (CT) scanning or magnetic resonance imaging (MRI) due to financial constraints, 95% had biopsies and X-rays, 15% could afford chemotherapy/ror chemotherapy is a sad consequence. 50% agreed to amputation. In the soft-tissue sarcoma group, only one of three patients could pay for limb-sparing surgery. In the benign group, 65% had limb-sparing surgeries and 15% had amputation. Fifty percent (50%) of patients were lost to follow up within 3 months and 39% of the malignant group died within the same period. Musculoskeletal tumours are a reality in our environment and a significant portion of our population have financial limitations. Ignorance and cultural beliefs promote late presentation to our hospitals, which are poorly equipped to give optimal care, despite the presence of trained personnel.
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    Open Access
    Challenges in the Diagnosis and Management of Musculoskeletal Tumours in Nigeria
    (International Orthopaedics, 2009) Eyesan, S U; Obalum, D C; Nnodu, O E; Abdulkareem, FB; Ladejobi, A O
    The management of musculoskeletal tumours is important because of the high mortality rates associated with the available treatment modalities. A 5-year prospective study of bone and soft-tissue tumours is presented, along with the difficulties encountered in diagnosis and treatment. There were 71 patients (male:female ratio of 1.7:1, age range 5-85 years, mean age 32 years) with an average duration of 24.7 weeks (range 1 day to 34 years) before presentation. No patient had computed tomography (CT) scanning or magnetic resonance imaging (MRI) due to financial constraints, 95% had biopsies and X-rays, 15% could afford chemotherapy/ror chemotherapy is a sad consequence. 50% agreed to amputation. In the soft-tissue sarcoma group, only one of three patients could pay for limb-sparing surgery. In the benign group, 65% had limb-sparing surgeries and 15% had amputation. Fifty percent (50%) of patients were lost to follow up within 3 months and 39% of the malignant group died within the same period. Musculoskeletal tumours are a reality in our environment and a significant portion of our population have financial limitations. Ignorance and cultural beliefs promote late presentation to our hospitals, which are poorly equipped to give optimal care, despite the presence of trained personnel.
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    Open Access
    Childhood Renal Neoplasms in Lagos Nigera- A 28 Year Review
    (Nigerian Quarterly Journal of Hospital Medicine, 1999) Elesha, SO; Abdulkareem, FB
    Out of 131 nephretomies received at the Morbid Anatomy Department of the Lagos University Teaching Hospital, there were 63 cases of childhood renal cancer representing 48% of total renal neoplasm seen over a period of 1970-1997. The ages range from 21/2 months - 11 years; over 75% of the cases were found under 5 years with only 3.2% occurring above 10 years. The male female ratio is 1:1. Of the cancers, there were 42 cases of classical nephroblastoma and 10 cases of the blastema type of nephroblastoma. We had 7 cases of purely sarcomatous nephroblastoma one of which is a rhabdomyosarcoma and the remaining 6 were undifferentiated sarcoma. There was one case of anaplastic carcinoma. Also seen was a case of mesoblastic nephroma in a 21/2 months male infant. In this study, neither benign neoplasm nor congenital tumour (angiomyolipoma) was encountered, in all cases, there was no age nor sex disparity. Most of the patients presented with abdominal mass with a unilaterally enlarged kidney, abdominal pain, haematuria and weight loss. All of them had nephrectomy as initial treatment followed by radiotherapy and chemotherapy.
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    Open Access
    Clinical and Autopsy Parameters of Acute Medical Deaths in an Emergency Facility in South-West Nigeria
    (Journal of clinical sciences, 2013) Ajuluchukwu, JNA; Abdulkareem, FB; Achusi, IB; Mbakwem, AC
    Background: Acute medical deaths are usually consequences of acute critical diseases, or acute exacerbations of chronic diseases. Thus, autopsy – confirmed characteristics would provide support for future management strategies. Objectives: To examine clinical and autopsy parameters including causes of death (COD) and mechanisms of death (MOD) among acute medical deaths. Methods: A 5-year (2005–2009) retrospective analysis was undertaken of Emergency Department (ED) related medical deaths occurring <24 hours after presentation. Case-notes provided clinical details while autopsy records supplied the COD and MOD respectively. Results: Decedents were 250 males (58.5%) and 177 females (41.5%), (male: female ratio=1.4: 1), predominantly (78%) young; with mean age of 43.7±16.6 years. In 22.8%, symptom duration was <1 day but >4 days in 42.8%. Coma –36%, and dyspnoea –10% prompted early presentation; but late presentation (>4days) characterised cough (4%), fever (10%), and body swelling (19%). Of the total, 23% presented after 10 pm, 16% were “dead on arrival” (DOA), and 40% died within six hours of arrival. Three commonest CODs were circulatory-cardiovascular disease [CVD](36%), infections/ septicaemia (18%), and malignancies (8.4%). CVD subset was older (52 years), with significant male preponderance (62.5% vs 37.5%; p<0.05); but comparable mean age in both sexes. Common MODs were cerebral dysfunction (29%) – including sub-types of intra-cerebral haemorrhage (51.8%) and tonsillar herniation (33.3%), heart failure (19%), and septicaemia (15%). Conclusion: The highlights were late presentation, early demise from communicable and noncommunicable diseases; and common “exit” mechanisms of septicaemia, heart failure and cerebral dysfunction. These data will guide management and preventive strategies.
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    Open Access
    Clinico-pathologic Patterns of Extremity Liposarcoma
    (The Nigerian Postgraduate Medical Journal, 2010) Eyesan, S U; Obalum, D C; Onovo, D O; Ketiku, K K; Abdulkareem, FB
    Background: Liposarcoma is a tumour derived from primitive cells that undergo adipose differentiation. Objective: To describe the clinico-pathological pattern of extremity liposarcoma in Lagos, Nigeria. Methods: This is a descriptive study of patients with histologically established liposarcoma affecting the extremities seen at the Oncology unit of the National Orthopaedic Hospital, Lagos Nigeria. Demographic and clinical data ( including age, gender, presenting complaints anatomic location of lesions ), histologic type, clinical stage and treatment outcome were collected using a prepared proforma and analysed. Results: Liposarcoma accounted for 6 [27.3%] of 22 cases of soft tissue sarcomas seen within the study period. All 6 were males with a M:F of 6:0. The age range was 36- 59 years. Lesions were mostly located in the thigh 5/6 (83.3%). The most common histologic type was myxoid seen in 3/6 [50%]. All presented at stage T2bNoMo. Five (83.3%) had limb salvage surgery with adjuvant radiotherapy while one had ablative surgery. Survival and recurrent rates could not be determined as all patients were lost to follow-up soon after surgery. Conclusion: Liposarcoma is the commonest extremity soft tissue sarcoma seen in our centre, the myxoid type being the commonest histologic subtype.
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    Open Access
    Clinico-pathological Review of Malignant Gastric Tumours in Lagos, Nigeria
    (Nigerian Quarterly Journal Hospital of Medicine, 2010) Abdulkareem, FB; Onyekwere, CA; Awolola, NA; Ajekigbe, AT
    Background: Gastric cancer is one of the most common cancers and the 2d most common cause of cancer deaths worldwide. Contrary to earlier reports from Africa, prevalence of this cancer has been found to be comparable to that of other parts of the world. Objective: To describe the clinico-pathological features of gastric cancer diagnosed in Lagos and determine the prevalence of H. pylori infection in gastric adenocarcinoma. Methods: This was a retrospective histopathological study of all gastric cancer seen between 1995 and 2007 in the Morbid Anatomy Department of Lagos University Teaching Hospital as well as two other private histopathology laboratories in Lagos (2002-2007). The blocks and slides of gastric cancer tissue were the materials used for the study. The patients' bio data and relevant clinical details were extracted from the demographic records. Results: There were 105 cases of gastric cancer (M:F = 2:1, mean age-55.3 years), 81% of which occurred above 45 yrs. There were 95 cases (90%) of adenocarcinomas, 8 (7.6%) mesenchymal tumours with one case each of small cell non-Hodgkin's lymphoma and carcinoid tumour. H. pylori was detected in 15.5% of 45 cases of adenocarcinoma with 36% showing evidence of chronic gastritis in adjacent non cancerous gastric tissue. All patients with clinical data had one or more alarm features; most recurring being abdominal fullness, recurrent vomiting, anorexia and weight loss. Conclusion: This study suggests that gastric malignancies are not uncommon in Lagos and often manifest with alarm features which should raise a suspicion particularly in our setting with poor diagnostic endoscopic facilities.
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    Open Access
    The Clinicopathologic Pattern of Prostatic Carcinoma in Lagos, Nigeria
    (North American Journal of Medicine and Science, 2013) Odubanjo, MO; Banjo, AAF; Ayoola, S; Abdulkareem, FB; Anunobi, CC; Olayinka, AA
    This is a review of the clinicopathological pattern of prostatic carcinoma in Lagos, Nigeria. The mean age was 68.48 years. 20% of our patients were asymptomatic at presentation, significantly higher than values from most previous Nigerian studies, likely due to an established PSA screening program. This however did not appear to translate to better disease outcomes, likely because radical prostatectomy was not offered as a treatment option for early disease. 68.6% of symptomatic patients presented with lower urinary tract symptoms, and 4.4% had a family history of prostate cancer. The median PSA value at presentation was 58.90ng/ml. Clinical stages II and III disease were most common, 42.5 and 30% respectively. Gleason scores 6 and 8 were the most common (23.3 and 20% respectively). The clinical stage and the age showed the best correlation with disease progression evidenced by increased PSA 2 months after treatment (PSA progression) and metastasis during follow up. The Gleason score also showed good correlation with these parameters while the pre-treatment PSA showed poor correlation, possibly due to the high incidence of urogenital infections and prostatitis in this environment. The incidence of PSA progression and metastasis were 0.35 and 0.54 per patient year of follow up respectively.
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    Open Access
    A Clinicopathologic Review of Oesophageal Carcinoma in Lagos
    (Nigerian Quarterly Journal of Medicine, 2008) Abdulkareem, FB; Onyekwere, C A; Awolola, N A; Banjo, A A F
    Background: Oesophageal cancer is the 6th most common cause of cancer death world wide. While the incidence is low in some parts of Africa such as Nigeria accounting for 0.4-0.6% of all malignant tumours, it is endemic in Transkei, in South Africa, which is regarded as an epicentre of the disease in Africa. Objective: To document the age and sex distribution, clinical as well as histopathological characteristics of oesophageal carcinoma in Lagos, SW Nigeria, Methods: The paraffin embedded blocks and slides as well as pathology reports of oesophageal carcinoma collected between 1995 and 2007 from Morbid Anatomy Department of the Lagos University Teaching Hospital and between 2002 and 2007 from two private histopathology laboratories in Lagos State were reviewed. The clinical data such as the age, sex, and clinical summary were extracted from demographic information in patients' case file. Results: Twenty cases representing 2.8% of all gastrointestinal tumours were recorded. The mean age was 65.4 years (SD-12.3) with M:F ratio of 1:1. Squamous cell carcinoma predominated; 18 cases (90%); the remaining two cases (one of which showed evidence of Barrett's oesophagus) were adenocarcinoma (10%). All presented at advanced stage with dysphagia and weight loss with or without vomiting, regurgitation, and/or haematamesis. Two third had mid oesophageal fungating masses, the remaining were located in the lower third. Two cases had surgery, the rest were not fit for any intervention. Conclusion: Oesophageal cancer is not common in Lagos, Nigeria, majority are squamous cell carcinoma. Late presentation gives it a dismal outlook. Although the overall survival is poor, efforts at improving quality of life by palliative measures should be encouraged.