Breast-axillary complex in HIV/AIDS patients.

BACKGROUND: HIV/AIDS have not only increased the health care burden especially in developing countries, it equally complicates the presentation of many diseases. Some well known disease entities now occur in fulminant complexities not previously described or known as such. The objective of this article is to report an unusual presentation of HIV/AIDS patients to the surgeon with Axillary and ipsilateral breast swelling. METHOD: This is a report of three cases seen and managed by the authors. RESULTS: Three adult female patients presented with progressively increasing axillary and ipsilateral breast swellings. They also had associated fevers and weight loss. Their main concern had been development of breast cancer. One of the patients was a known retroviral positive on Highly Active Anti-Retroviral Therapy (HAART). Examination revealed axillary abscess and ipsilateral breast oedema in two cases. The patient on HAART had a hard breast-axillary mass complex. Biopsy (FNAB) revealed inflammatory cells and no malignancy in all three cases. HIV screening was positive in all cases. One of the patients had excision of breast-axillary mass complex, and the histology showed features of chronic inflammation, with no malignant cells. The other two had incision and drainage of their axillary abscess. CONCLUSION: This shows the ubiquitous presentation of HIV/AIDS in our environment and surgeons should be aware of the breast axillary complex in HIV/AIDS. Medical practitioners should be careful to obtain accurate diagnosis before embarking on treatment especially mutilating surgical procedures.

Hormonal profile of men investigated for infertility at the University of Maiduguri in northern Nigeria.

INTRODUCTION: This study aims to determine the prevalence and pattern of endocrinological abnormalities in patients investigated for male infertility in our environment. METHODS: An observational, retrospective study was conducted on men investigated for infertility at the University of Maiduguri Teaching Hospital over a two-year period, from April 2004 to March 2006. Hormonal assessments were done on those with abnormalities of their sperm count. RESULTS: A total of 1,201 men were evaluated for infertility during the study period, out of which 96 underwent hormonal assessment because of abnormalities of their sperm counts. 88 had abnormal hormonal assays, giving a prevalence of endocrine abnormality of 7.3 percent. The mean age of the patients was 35.7 years. 68 (70.8 percent) patients had primary infertility and 72 (75 percent) had azoospermia. 64 (66.7 percent) patients had elevated follicle-stimulating hormone levels, while 48 (50 percent) had decreased testosterone levels. 12 (12.5 percent) patients had elevation of serum prolactin. 40 (41.7 percent) patients had hormonal profile in keeping with hypergonadotropic hypogonadism, while the endocrinological diagnosis in four (4.2 percent) patients was hypogonadotropic hypogonadism. Patients with primary infertility were found to be more likely to have partial androgen resistance (odds-ratio 2.241, 95 percent confidence interval 0.458-10.955). CONCLUSION: Endocrinopathy, which can be successfully treated, is not an uncommon cause of male infertility in our environment. Therefore, hormonal assessments should be performed in the evaluation of male infertility as appropriate.

Correlation between histopathologic and fine needle aspiration cytology diagnosis of palpable breast lesions: a five-year review.

Fine needle aspiration cytology (FNAC) of the breast has been used as an initial investigative procedure of palpable breast lesions. The purpose of this study is to evaluate our experience with Fine Needle Aspiration Cytology (FNAC) and to correlate between histopathologic and FNAC diagnoses of palpable breast lesions. A 5-year retrospective study was performed using records of all patients who had had both FNAC and histopathologic results of breast lumps. This is a retrospective study of 220 diagnosed cases of breast lesion at the University of Maiduguri Teaching Hospital (UMTH), Nigeria between the periods of January 2001 and December 2005. The results of the FNAC were interpreted as inflammatory, benign, suspicious or malignant. A total of 220 patients had both cytopathologic and histopathologic diagnoses and therefore fulfilled the criteria for this study. There were 11 (5%) cases of inflammatory, 140 (63.6%) cases of benign and 69 (31.4%) cases of malignancy. There were two cases that were suspicious of malignancy and for the purpose of this study were considered as malignant. There were five (5) cases of cytologically interpreted errors which were three cases of false negative and two cases of false positive. The diagnostic accuracy was 97.7%, sensitivity was 95.7%: and specificity was 98.7%. The false negative and false positive rates were 2.9% and 1.9% respectively. FNAC of breast lesions is sensitive, specific, and highly accurate as the initial investigation of palpable breast lesions in our tertiary hospital. We therefore implore clinicians to embrace this procedure in the management of patients.