An Update on the Histomorphological Pattern of Carcinoma of the Prostate Gland in Nigerian Men as seen in the University College Hospital, Ibadan.

OBJECTIVE: Within a multicentre prospective study of prostate cancer genetics, we analysed some parameters of cases seen in our centre over a 2-year period to see if there are any changes in histological grades and age compared to previous studies in this environment. METHODS: Histological grading and scoring had been done using the revised International Society of urologic pathology (ISUP) system and cases were classified into Grade groups. Gleason grades less than 3 were not assigned and Scores less than 6 not assigned. The Prostatic Specific Antigen (PSA) levels as well as the average tumour percentage in the biopsy specimens were determined. RESULTS: A hundred and forty-five (145) patients were seen. The majority of patients seen were in Grade group 5 (30.3%), followed by grade group 4 (26.2%) and then groups 1, 3 and 2 in that order. Patients' ages ranged from 47 years to 86 years, with peak age incidence in the 7th decade. PSA values ranged from 3.6 to 22,130ng/ml and tumour volumes ranged from 5% of biopsy tissue to 95%. The lowest PSA value was seen in a patient in grade group 1 but the highest PSA value was recorded in a patient in Grade group 3. The lowest and highest tumour volumes were seen in patients in grade group 4. The PSA and tumour volumes did not vary in linear fashion with Gleason grade. CONCLUSION: The results show that the majority of patients in Ibadan present with high grade prostatic carcinoma even using the new ISUP grading system but the proportion of highgrade tumours seems higher than in the previous study, likely because more diagnostic tissue has become available per case. Examining a minimum of 12 cores have definitely created an opportunity for proper grading. Peak incidence is in the 7th decade followed by the 8th decade. Very high PSA values recorded in our patients with prostatic carcinoma do not show linear relationship with prostatic carcinoma volume or grade.

BILATERAL GANGLIONIC HAEMORRHAGIC STROKE COMPLICATING SUSPECTED MENINGOCOCCAEMIA: A CASE REPORT.

Haemorrhagic stroke in pyogenic meningitis is a rare complication accounting for about 2% of all complications1,2. It often results from disseminated intravascular coagulation, which is a complication of bacterial meningitis and portends a poor prognosis. A superimposed intracranial haemorrhage, although extremely rare, is associated with high mortality rate. We report a child who had haemorrhagic stroke during the acute phase of bacterial meningitis. The diagnosis was made during post mortem examination. It was discovered that she had suffered haemorrhagic necrosis of both basal ganglion nuclei. Early imaging is advised in meningitis patient presenting with altered levels of consciousness to detect cerebrovascular complications.