Prevalence and severity of atherosclerosis in extra cranial carotid arteries in Nigeria: an autopsy study.

BACKGROUND: There has been a paucity of autopsy studies on atherosclerotic lesions in Nigerians, the last one conducted at our centre being more than four decades ago. There has also been considerable epidemiological transition. The objective of the study was to determine the frequency, severity, pattern and distribution of atherosclerotic lesions in extra cranial carotid arteries (ECCA) in Nigerians at autopsy. METHODS: ECCA of 30 consecutive Nigerian patients undergoing autopsy at a University teaching hospital were examined using the American Heart Association (AHA) histological grading and classification of atherosclerosis. RESULTS: Atherosclerotic lesions of ECCA were present in 73.3% of the subjects with the right and the left carotid bifurcations (28.3%) being the most frequently affected sites. Using the AHA classification of atherosclerosis, a total of 176(73.3%) lesions were found in the 240 histological sections of blood vessels examined. Of these, 22.5% were types I, 22.5% were types II, 15.4% were type V, and 7.5% were type III. The VII to type IX lesions were rare. When these atherosclerotic lesions were grouped into mild, moderate and severe, 52.5% were mild lesions (types I-III); 18.3% were moderate lesions (types IV and V); and 2.5% were severe lesions (types VI to IX). The severe lesions were most frequently observed in the left carotid bifurcation (50%) and they first appeared in the age group 45-49 years. Age, hypertension and diabetes mellitus were strong risk factors for atherosclerosis. CONCLUSIONS: Compared with four decades ago there has been an apparent increase in severity and extent of ECCA atherosclerosis especially after the age of 45 years in autopsies from our centre. This change in the amount of atherosclerosis over time is possibly due to the epidemiologic transition. This may worsen the rise in stoke incidence within this community and as such, great effort should be made to follow-up and manage CVD risk factors within the community.

A fifteen-year review of lymphomas in a Nigerian tertiary healthcare centre.

In Africa, epidemiological data on the effect of the HIV epidemic on the occurrence of lymphomas are scanty. The 1990s witnessed the alarming rates of HIV/AIDS in Nigeria. The prevalence of HIV/AIDS in Nigeria increased from 1.8% in 1991 to 4.4% in 2005. The aim of this study was to determine whether there have been any changes in the frequency and pattern of lymphomas in view of the HIV/AIDS epidemic in the country. This is a retrospective study of all lymphoma cases diagnosed during 1991-2005. The prevalence of lymphomas declined from 1.4% to 0.7% of surgical biopsies during 1991-2005. There was a decline in the proportion of high-grade non-Hodgkin lymphoma and Burkitt's lymphoma from 79.1% and 45.8% respectively to 21.1% and 13.6% respectively. There is a suggestion that the HIV/AIDS epidemic in the country may not have influenced the pattern of occurrence of both major histomorphological types of lymphoma in Ibadan.

Clinico-pathological profile of head and neck malignancies at University College Hospital, Ibadan, Nigeria.

INTRODUCTION: This retrospective study analysed head and neck malignancies seen over a 19-year period at the University College Hospital, Ibadan. METHODOLOGY: One thousand, one hundred and ninety two patients with head and neck malignancies were analysed according to age, gender, topography and histology. RESULTS: There was an annual hospital frequency of 62 cases per year. The overall mean age for these malignancies was 43.9 (SD ± 19.3) years. The lesions from the respiratory tract were the most frequent (43.2%) of all cases. The palate was the most frequent intra-oral site (13.8%). Epithelial malignancies constituted 73.4% of all cases with a male: female ratio of 2:1, a mean age of 48.1 (SD ± 17.5) years and were mostly located in the larynx (19.7%). Lymphomas constituted 17.5% of all head and neck cancers with a male: female ratio of 1.6:1, a mean age of 35.1 (SD ± 20.6) years and nodal involvement (39.7%) was most common. Sarcomas constituted 8.9% of all malignancies with a male: female ratio of 1.5:1, mean age of 27.1 (SD ± 16.7) years and the maxillofacial bones (42.5%) were most commonly involved. Neuroendocrine malignancies accounted for 0.2% of head and neck malignancies with a male: female ratio of 1:1, a mean age of 28.5 (SD ± 6.4) years and both cases involved the nose. CONCLUSION: This study has further confirmed that carcinomas remain the most frequent cancers of the head and neck region in south-western Nigeria.

Head and neck cancer--a clinicopathological study in a tertiary care center.

Head and neck cancers display diverse patterns of biological behavior and considerable variation in geographical distribution. This study presents an analysis of head and neck cancer in a Nigerian tertiary healthcare center. It comprises cases diagnosed at the University College Hospital, Ibadan, Nigeria, 1991-2005. Out of 1,750 head and neck tumors, 972 (55.5%) were malignant and 778 (44.5%) were benign. Cancers displayed male predominance, with a gender ratio of 1.8:1. The mean age of cancer patients was 43.8 +/- 19.6 years. Carcinomas constituted 71.7% of head and neck cancers, with 2.4% occurring in children and overall mean age of 48.2 years. Squamous cell carcinoma comprised 66.7% of carcinomas and 47.8% of all head and neck cancers. Hematopoietic malignancies constituted 20.4% of head and neck cancers, and comprised mainly lymphomas, which accounted for 19.3% of all head and neck cancers. The mean age of patients with hematopoietic malignancies was 34.9 years. The most common childhood malignancy was Burkitt's lymphoma, which comprised 28.2% of pediatric head and neck cancers. Connective tissue tumors constituted 7.9% of all cancers, the most common being rhabdomyosarcoma, accounting for 44.2% of sarcomas. The mean age of patients with sarcomas was 26.5 years. There is a need for uniformity in the definition of head and neck cancer so as to permit comparison of international studies. In addition, prospective population-based studies are required to determine the national incidence and to identify risk factors for head and neck cancer in the Nigerian population.

A study of the utility of silver nucleolar organizer regions in categorization and prognosis of salivary gland tumors.

BACKGROUND: this study aimed at assessing the utility of silver nucleolar organizer region (AgNOR) staining in categorization and prognostication of salivary gland tumors. METHODS: Twenty-seven malignant salivary gland tumors, 16 benign neoplasms, and 6 chronic sialadenitis lesions were stained using the technique described by Ploton et al. (1986). RESULTS: The mean AgNOR counts for inflammatory lesions (1.67 +/- 0.19) and benign neoplasms (1.67 +/- 0.11), were less than for malignant neoplasms (3.59 +/- 0.55), P < .05. There was no significant difference between the mean AgNOR counts of different specific histological types and grades of malignant neoplasms. In addition, no correlation was found between mean AgNOR counts and the clinical course of malignant or benign salivary gland neoplasms. CONCLUSION: Our results suggest that AgNOR staining is useful for distinguishing benign from malignant lesions, but is neither helpful for discriminating between histological types and grades of malignant neoplasms, nor prognostication of malignant salivary gland neoplasms.

Dementia with Lewy bodies in a Nigerian: a case report.

Dementia with Lewy bodies (DLB) is the second most common neuropathologically diagnosed cause of degenerating dementia after Alzheimer's disease. We report the first autopsy-confirmed case in sub-Saharan Africa in a Nigerian patient. The case presented highlights the varied clinical presentation of DLB, and is intended to raise awareness about another possible cause of dementia in Nigerian subjects.