Diagnostic Utility of Fine Needle Aspiration Cytology in the Evaluation of Peripheral Lymphadenopathy.

BACKGROUND: Patients are often referred for fine needle aspiration cytology (FNAC) on account of peripheral lymphadenopathy. Relative to the rate of referrals, very few works have been done to establish the reliability of FNAC as a first-line investigation in the evaluation of peripheral lymphadenopathy in this environment. This study aims to determine the diagnostic utility of FNAC in evaluating common causes of peripheral lymphadenopathy in a teaching hospital in North western Nigeria. STUDY DESIGN: Eighty-six patients who had FNAC and histology or cell blocks preparation of the same lymph nodes were recruited over a 5-year period. Using histology and cell blocks as gold standards, the sensitivity, specificity, predictive values and test accuracy were deduced. RESULTS: The sensitivity, specificity, positive and negative predictive values were 71.4%, 91.5%, 87.5% and 81.1% respectively. The test accuracy of FNAC was 83.7%. CONCLUSION: FNAC is reliable for screening and diagnosing peripheral lymph node lesions. However, ancillary tests such as immunocytochemistry may be necessary for improved accuracy.

Nephrotic syndrome among children in Kano: a clinicopathological study.

OBJECTIVE: To evaluate the clinicopathological features of children with nephrotic syndrome seen in a pediatric nephrology unit in northern Nigeria. MATERIALS AND METHODS: All children less than 15 years of age who had nephrotic syndrome and who had been subjected to renal biopsy at Aminu Kano Teaching Hospital, Kano, were studied. Their histologic diagnoses were evaluated alongside clinical and other laboratory parameters. RESULTS: Twenty children, 17 males and three females, were studied. These represented 55% of all children with nephrotic syndrome seen in the pediatric nephrology unit during the study period, the rest of which have never had renal biopsies. Peak age was 7-8 years (range 2.5-13 years). Fourteen of the 20 children (70%) had previously been on steroid treatment. Of these, 11 (55%) were classified to be steroid resistant and three (15%) were frequent relapsers. Six (30%) children were newly diagnosed with nephrotic syndrome and had not commenced steroid treatment. Hypertension was found in seven (35%) children. Sixteen children (80%) had microscopic hematuria on presentation. The most common histopathological diagnosis was focal glomerulosclerosis in nine (45%) children (segmental = 8; global = 1). Minimal change disease was found in four children (20%), membranoproliferative glomerulonephritis in three children (15%), membranous nephropathy in three children (15%), and diffuse mesangial hypercellularity in one child (5%). Of the six children who had renal biopsy before commencement of steroid treatment, three (50%) were found to have glomerulosclerosis. CONCLUSION: Focal segmental glomerulosclerosis was the most common histological subtype diagnosed in Kano among children with nephrotic syndrome in this study.

Clinical and histological features of melanoma in adult Nigerians.

BACKGROUND: Melanoma known to be common among Caucasians is increasingly getting more common among blacks in the tropics. OBJECTIVE: To characterize the clinical and histological features of these tumours in adult Nigerians. METHODS: All cases of melanoma diagnosed between 2006 and 2010 in Aminu Kano Teaching Hospital, Kano, Nigeria were retrieved and their clinical and pathological features reviewed. RESULTS: Eighty five cases comprising 41 males and 44 females were diagnosed with mean age of 56 ± 14.6 years. Mean duration before presentation was 2.3 ± 0.8 years. Eighty five percent of cases were located in the foot, 8% with lymph node involvement and seventy eight of the 85 cases were of Breslow thickness > 4 mm. Fifty five cases were of Clark level V and 78% of Nodular variant. Prognostic features including ulceration, lymphocytic infiltration, significant mitotic activity, satellitosis and lymphovascular infiltration were present in 69%, 38%, 16%, 45% and 17% of cases respectively. Only three cases were amelanotic. CONCLUSION: Melanoma in the Nigerians is predominantly of the nodular variant and located in the foot, is characterized by late presentation and is generally associated with adverse prognostic features.

Audit of histopathology reports for breast cancer in Aminu Kano Teaching Hospital.

BACKGROUND: The usefulness of histopathology reports is a function of the quality of information contained therein. Thus there is need to establish minimum criteria to be met in reporting cases as a quality control mechanism. OBJECTIVE: To audit the quality of histopathology reports of mastectomy specimens received in the pathology laboratory of a Teaching Hospital. METHODS: Laboratory numbers of all cancer bearing mastectomy cases received in 10 years (1999-2008) were extracted from pathology reception registers and their accompanying original request cards were retrieved from archives. From these cards relevant information meeting six set audit criteria and average turn around times were determined and analysed. RESULTS: One hundred and sixty-five mastectomy cases were received but archival retrieval was possible for only 134 (81.2%) cases. The reports documented tumour size, macroscopic resection margin, histological tumour type, histological grading, lymphatic/vascular invasion characterized by invasion of tumour cells into lymphatic vessels, arteries or more importantly veins, and microscopic resection margin. These were documented in 50%, 62%, 92%, 40%, 12% and 64% of cases respectively. Average turn around time was 15.8 days. Only three (2.2%) of the reports met all the six criteria. CONCLUSION: This 10-year audit shows the lapses in our histopathology reports and the need for establishment of standard report formats as tools for quality assurance.

Audit of Histopathology Reports for Breast Cancer in Aminu Kano Teaching Hospital

BACKGROUND: The usefulness of histopathology reports is a function of the quality of information contained therein. Thus there is need to establish minimum criteria to be met in reporting cases as a quality control mechanism. OBJECTIVE: To audit the quality of histopathology reports of mastectomy specimens received in the pathology laboratory of a Teaching Hospital. METHODS: Laboratory numbers of all cancer bearing mastectomy cases received in 10 years (1999-2008) were extracted from pathology reception registers and their accompanying original request cards were retrieved from archives. From these cards relevant information meeting six set audit criteria and average turn around times were determined and analysed. RESULTS: One hundred and sixty-five mastectomy cases were received but archival retrieval was possible for only 134 (81.2) cases. The reports documented tumour size; macroscopic resection margin; histological tumour type; histological grading; lymphatic/vascular invasion characterized by invasion of tumour cells into lymphatic vessels; arteries or more importantly veins; and microscopic resection margin. These were documented in 50; 62; 92; 40; 12and 64of cases respectively. Average turn around time was 15.8 days. Only three (2.2) of the reports met all the six criteria. CONCLUSION: This 10-year audit shows the lapses in our histopathology reports and the need for establishment of standard report formats as tools for quality assurance

Pathology of peripheral lymph node biopsies in Kane, Northern Nigeria.

BACKGROUND: Lymphadenopathy is a common clinical problem here in Kano, Northern Nigeria but there has been no formal study. We therefore undertook this review to evaluate the pattern in our locality. METHOD: This is a seven-year (1998-2004) retrospective review of all histologically diagnosed lymph node biopsies received at Aminu Kano Teaching Hospital, Kano. RESULTS: Cervical, axillary and inguinal nodes were the most frequently biopsied accounting for 46%, 23% and 13%, while tuberculosis, lymphomas and metastases were the most commonly diagnosed lesions comprising 30%, 24% and 19% respectively. In general, benign lesions were more common constituting 57% of nodal biopsies. Lymphadenopathy was observed to be most prevalent in the first three decades. CONCLUSION: Our findings were broadly similar to most other Nigerian studies and slightly at variance with other African countries but significantly different from the Western World. The limitations of lymph node histopathology in the absence of modern molecular diagnostic techniques are highlighted.