Immunohistochemical and Clinicopathological Characteristics of Invasive Breast Carcinoma in Nigeria.

Objectives: We aimed to study the immunohistochemical and clinicopathological characteristics of invasive breast carcinoma among Nigerian women. Methods: We conducted a retrospective assessment of female patients diagnosed with breast carcinoma at a tertiary hospital in Nigeria between 2012 and 2019. Archived pathology request forms and processed specimens (tissue blocks and slides) were used as source data in addition to the patients' demographic and other relevant data. Results: Reports pertaining to 113 patients were assessed. Their age range was 30 to 80 years (mean = 52.1±12.1 years). Breast carcinoma was most common in patients aged 40 to 49 years (32.7%), closely followed by those aged 50 to 59 years (30.1%). Invasive ductal carcinoma was the most common histopathological subtype (94.7%). Nottingham grade III and grade II breast carcinoma accounted for 41.6% and 40.7% of the cases, respectively. Mastectomy specimens formed 68.1% of the samples. The most common tumor size (75.9%) was > 5cm (mean = 6.8±3.2cm), consistent with the most common staging of T3 (46.0%). The most common lymph node involvement was N1 (56.6%). Immunohistochemical assessment of these tumors with estrogen receptor, progesterone receptor, and human epidermal growth factor receptor-2 (HER-2) biomarkers expressed positivity of 36.3%, 28.3%, and 41.6%, respectively. These tumors were immunohistochemically classified into luminal A (16.8%), luminal B (20.4%), HER-2 enriched (20.4%), and triple-negative (42.5%) subtypes. Conclusions: The most common immunohistochemical subtype of invasive breast carcinoma among this sample of Nigerian women was the triple-negative subtype, similar to the finding among African Americans.

Clinicopathological pattern of breast lesions in children and adolescents.

Background: Breast lesions are not common in children and adolescents. The aim of this study is to retrospectively survey the clinicopathological pattern of breast lesions in children and adolescents in our setting. Materials and method: This is a retrospective study of all breast specimens from children and adolescents that were histopathologically diagnosed in University of Uyo Teaching Hospital. Results: The youngest patients seen were 11 years old, with mean age of 17.1 ± 1.91. The commonest clinical diagnoses were fibroadenoma (n=134, 72.4%). Thirty-five-point seven percent of the patients presented within 6 months of noticing the lump. The mean size of the lumps was 6.2cm ± 3.9. Fibroadenoma was the most common benign diagnosis and the most common histopathologic diagnosis in this study. The mean age of patients with fibroadenoma was 17.15±1.83. Conclusion: The pattern of breast lesions in adolescents in Uyo is similar to that from other parts of Nigeria.

Clinicopathological and immunohistochemical characterization of gastrointestinal stromal tumour at four tertiary health centers in Nigeria using CD117, DOG1, and human epidermal growth factor receptor-2 biomarkers.

Aims: Gastrointestinal stromal tumors (GISTs) are neoplastic lesions that primarily affect the digestive tract and develop from interstitial cells of Cajal. These lesions require histopathological and immunohistochemical characterization due to their malignant potential and personalized treatment. In this investigation, the sex, age, lesional sites of origin, histopathological types, the prevalence of human epidermal growth factor receptors (HER-2) expression, prognostic indices (based on tumor size and mitotic figures), expression of CD117 and DOG1, and characteristics of patients with GIST were all characterized. Materials and Methods: This was a retrospective cross-sectional analysis of GIST cases seen at four tertiary health-care centers in Nigeria over a 10-year period (2008-2017) and investigated utilizing histopathological and immunohistochemical (CD117, DOG1, and HER-2) methods. Results: In this investigation, there were twenty GIST cases. Notably, the majority (40%) of the cases had tumors with sizes between 7.0 and 8.0 cm; the stomach was the most frequent site (70%) and the spindle cell type of GIST was the most prevalent (80%) histopathological type. In addition, the stomach was significantly associated with GIST as an origin site (with a P = 0.001), and 100% and 50% of these tumors were immunoreactive with CD117 and DOG1, respectively. Conclusions: In our study, GISTs most frequently develop in the stomach, and CD117 and DOG1 are essential for correctly diagnosing these tumors. However, HER-2 immunoreactivity is a predictive marker of survival for personalized care.

Résumé Objectifs: Les tumeurs stromales gastro-intestinales (GIST) sont des lésions néoplasiques qui affectent principalement le tube digestif et se développent à partir des cellules interstitielles de Cajal. Ces lésions nécessitent une caractérisation histopathologique et immunohistochimique en raison de leur potentiel malin et d'un traitement personnalisé. Dans cette enquête, le sexe, l'âge, les sites d'origine des lésions, les types histopathologiques, la prévalence de l'expression des récepteurs du facteur de croissance épidermique humain (HER-2), les indices pronostiques (basés sur la taille de la tumeur et les chiffres mitotiques), l'expression de CD117 et DOG1, et les caractéristiques des patients atteints de GIST ont toutes été caractérisées. Matériels et méthodes: Il s'agissait d'une analyse transversale rétrospective de cas de GIST observés dans quatre centres de soins de santé tertiaires au Nigeria sur une période de 10 ans (2008-2017) et étudiée à l'aide d'analyses histopathologiques et immunohistochimiques (CD117, DOG1 et HER). 2) méthodes. Résultats: Dans cette enquête, il y a eu vingt cas de GIST. Notamment, la majorité (40 %) des cas présentaient des tumeurs mesurant entre 7,0 et 8,0 cm ; l'estomac était le site le plus fréquent (70 %) et le type de GIST à cellules fusiformes était le type histopathologique le plus répandu (80 %). De plus, l'estomac était significativement associé au GIST comme site d'origine (avec un P = 0,001) et 100 % et 50 % de ces tumeurs étaient immunoréactives avec CD117 et DOG1, respectivement. Conclusions: Dans notre étude, les GIST se développent le plus souvent dans l'estomac, et CD117 et DOG1 sont essentiels pour diagnostiquer correctement ces tumeurs. Cependant, l'immunoréactivité HER-2 est un marqueur prédictif de survie pour une prise en charge personnalisée. Mots-clés: Biomarqueurs, tumeurs stromales gastro-intestinales, histopathologie, immunohistochimie.

Histomorphometric Survey of Placentas of HIV-positive Mothers in Relation to their Clinical Stage in a Teaching Hospital in Uyo, South-South Nigeria.

Objectives: HIV infection in pregnancy affects the mother, her placenta, and fetus resulting in perinatal/maternal morbidity and mortality. Studies show that HIV-positive mothers have several placental morphological changes. This study aimed to describe the histomorphometric parameters/lesions of placentas of HIV-positive mothers in Uyo, Akwa Ibom State, Nigeria. Methods: A prospective cross-sectional hospital-based analytical study was conducted at the departments of Obstetrics and Gynecology, and Histopathology, University of Uyo Teaching Hospital, Nigeria from December 2015 to May 2016. We studied 144 pregnant mothers (48 HIV-positive as the test group vs. 96 HIV-negative as controls). Their placentas (fetal membrane, umbilical cord, and placental disk) were collected post-delivery and evaluated (grossly/microscopically) to determine the range of histomorphometric placental parameters/lesions. Relevant obstetric data were obtained from their case notes. Results: The test group delivered more through cesarean section than the control group (52.1% vs. 31.3%), with mean birth weights of 2.8±0.7 and 3.1±0.6 kg (p = 0.004). The mean placental weights were 57±190.1 and 664.6±167.4 g (p = 0.003), with mean placenta-birth weight ratio of 20.1±4.8 and 20.5±4.57% (p = 0.33). The test groups placental fetal membranes, umbilical cords, and disks mainly displayed acute chorioamnionitis (47.9%), acute umbilical phlebitis (14.6%), and villous vasculopathy (33.3%). The test group had a higher stage/grade of placental inflammation than the control group. In the test group, two stage 4 HIV disease state cases presented with the most severe form of placental inflammatory lesions. Conclusions: The commonest placental histomorphometric parameters/lesions were acute chorioamnionitis, acute umbilical phlebitis, and acute intervillositis. There was no significant association between HIV/AIDS disease stage with the most severe forms of placental inflammatory lesions.

A retrospective survey of death care practices and procedures in handling suspected and confirmed COVID-19 deceased bodies in the mortuary of a resource-poor tertiary healthcare facility in Uyo, South-South Nigeria.

Introduction: the death care of deceased bodies of confirmed COVID-19 cases is a critical component of holistic healthcare provision for COVID-19 cases particularly from the public health perspective of infection prevention/control. Regrettably, there is a dearth of research-based information on the management (death care) of COVID-19 deceased bodies. Thus, we aimed to determine the preservation/storage death care practices and procedures in accordance with infection prevention/control measures used for deceased bodies of suspected/confirmed COVID-19 cases deposited in our mortuary and explore their antemortem age/sex distribution. Methods: a retrospective hospital-based cross-sectional survey done at the mortuary unit of Department of Histopathology, University of Uyo Teaching Hospital (UUTH), Uyo, Akwa Ibom State (covering January 2020 to September 2021). Our study participants were all deceased bodies of suspected/confirmed COVID-19 cases deposited in/cared for at UUTH mortuary within this period. Results: we found 28 suspected/confirmed COVID-19 deceased bodies, of which 51.86% were within the 6th and 7t hdecade of life and 71.43% were males (M/F = 2.5/1). They constituted 5.93% of the deceased bodies deposited in UUTH mortuary within this period. All (100%) were embalmed, and 75% were embalmed by immersion. The peak periods of their deposition were within the first halves of the two years affected by the COVID-19 pandemic. Conclusion: we provided death care (mainly through embalmment) for deceased bodies of suspected/confirmed COVID-19 cases in our resource poor setting using locally derived innovative means while still adhering to infection prevention/control measures to protect our death care workers in the mortuary.

Multicentric Plasma-Cell Type Castleman Disease Masquerading As Hodgkin Lymphoma: A Case Report.

Castleman disease (CD), or angiofollicular hyperplasia, or giant lymph node hyperplasia, is a heterogeneous benign lymphoproliferative disorder of unknown etiology. It has three distinct histologic subtypes (hyaline vascular, plasma cell, and mixed hyaline vascular plasma cell types) as well as unicentric Castleman disease (UCD) and multicentric Castleman disease (MCD) variants. In the unicentric form, the disease is confined to one anatomical lymph node and usually with no systemic symptoms. However, in the multicentric form (further subdivided into idiopathic MCD, human herpes virus-8-associated MCD, and POEMS-associated MCD), lymphadenopathy is more generalized with more aggressive systemic symptoms mimicking a malignant lymphoma. Therefore, this case report aims to underscore the importance of immunohistochemical evaluation as an indispensable ancillary technique to routine histopathological examination of a lymph node biopsy specimen, as a gold standard for definitive diagnosis of proliferative lymph node lesions.