Olaejirinde Olaniyi Olaofe

Background: Prostate carcinoma is the second most common cancer in men worldwide and a leading cause of cancer-related mortality, particularly in low- and middle-income countries. Prognostic assessment relies largely on International Society of Urological Pathology grading, which has recognized limitations. Molecular alterations, including phosphatase and tensin homolog (PTEN) loss and ETS-related gene (ERG) rearrangements, contribute to prostate carcinogenesis. This study aimed to evaluate immunohistochemical expression of PTEN and ERG across low-, intermediate-, and high-grade prostate carcinomas diagnosed at UNIOSUN Teaching Hospital, Osogbo, Nigeria.Materials and Methods: This retrospective observational study included 70 histologically confirmed prostate carcinoma cases diagnosed between January 2017 and December 2021. Formalin-fixed, paraffin-embedded tissue blocks were stained with monoclonal antibodies against PTEN and ERG. PTEN positivity was defined as >10% combined nuclear and cytoplasmic tumor staining, and ERG positivity was defined as strong nuclear staining in >20% of tumor cells. Associations between biomarker expression and tumor grade were assessed using the chi-square test (p<0.05).Results: Prostate carcinoma accounted for 13.3% (102 of 768) of all male solid tumors during the study period. The mean age of analyzed cases was 72.9±9.1 years (range, 47–91 years). PTEN loss was observed in 25.7% (18 of 70) of cases and was most frequent in high-grade tumors (51.6%, 16 of 31; p=0.001). ERG expression was not detected in any case, although internal and external controls stained appropriately.Conclusion: PTEN loss was significantly associated with high-grade prostate carcinoma, supporting its potential role as an adjunct prognostic biomarker. The absence of ERG expression may reflect populationspecific molecular patterns or archival tissue limitations and warrants further investigation.

Introduction: This study aimed to evaluate human leukocyte antigen B (HLA-B) expression in breast cancer tissues from two tertiary health institutions in southwestern Nigeria and explore its relationship with age at diagnosis. Methods: A cross-sectional study was conducted to investigate the immunohistochemical expression of HLA-B in the histologic tissues of breast cancer patients at the Obafemi Awolowo University Teaching Hospitals Complex, which was diagnosed between January 1, 2022, and December 31, 2022. The tissue samples were formalin fixed and paraffin embedded (FFPE) to preserve their morphology and antigenicity. We used an anti-HLA-B antibody (Clone PAS-35345) from Thermo Fisher Scientific as the primary antibody. Results: Thirty-eight cases of breast cancer were evaluated during the study period. Half of the breast cancer patients expressed little or no HLA-B protein. High and moderate expression was observed in only 7 (18.4%) and 10 (26.3%) of the patients, respectively. A comparison of the expression of HLA-B across the different age groups revealed no statistically significant differences between the age groups (p = 0.898). Conclusion: Our study revealed that over 40% of breast cancer patients exhibited moderate to high HLA-B expression, suggesting that a significant proportion of these cancers may be amenable to immunotherapy. There was no significant variation in the degree of expression of HLA-B across the various age groups at presentation. This could also mean that HLA-B expression is not particularly related to early-onset breast cancer.

Background: Desmoplastic fibroma is a very rare bone tumour that is commonly recognised by its striking resemblance to desmoid fibromatosis, commonly seen in soft tissues. Case Presentation: A 3-year-old girl presented to the Oral and Maxillofacial Department with swelling on the lower jaw for 4 months duration. Extra-oral examination revealed: Facial asymmetry due to the discrete swelling on the right mandible measuring 14 x 12cm in widest diameter below the right pre-auricular region to the right mental region. The Craniofacial CT scan showed an expansile jaw mass with destruction of the mandible. There was no evidence of bone formation. Histopathology diagnosis was desmoplastic fibroma of the bone. The tumour cells were weakly positive for MyoD1. Conclusion: Pathologists must know that cells of desmoplastic fibroma may sometimes be weakly positive for MyoD1, as in rhabdomyosarcoma.

P53 is a tumor suppressor gene. p53 expression in epithelial ovarian tumors (EOTs) is correlated with their biological behavior and predicts patient overall survival. However, there is a dearth of knowledge regarding p53 expression in these tumors among women from southwest Nigeria. Our study aimed to determine the patterns of p53 expression in various types of epithelial ovarian tumours. We conducted a retrospective study of epithelial ovarian tumours. We retrieved formalin-fixed, paraffin-embedded (FFPE) tissue blocks of previously diagnosed epithelial tumors from the departmental archive. We performed immunohistochemical analysis using p53 antibodies. We scored the expression and staining intensity of p53 as follows: negative (0), focal/weakly positive (1 +), and diffuse/strongly positive (2 +) on the basis of the recommended Cytomation scoring system. The spectrum of p53 expression in the 51 histologically diagnosed cases revealed that 29 cases had no expression, consisting of 21 benign EOTs, two borderline EOTs, and six malignant EOTs. Nine cases exhibited wild-type expression, including six serous carcinomas, two mucinous carcinomas, and one signet ring cell carcinoma. p53 overexpression was observed in 13 patients overall, with 12 having serous carcinomas and one having endometrioid carcinoma. Among the 21 serous carcinoma patients, 28.6% (6 patients) presented with wild-type p53 expression, 57.1% (12 patients) presented with p53 overexpression, and 14.3% (three patients) presented negative p53 expression. There was a significant association between p53 expression and the histological grade of serous carcinoma. Most epithelial ovarian carcinomas in our hospital are high grade, with many serous carcinomas showing either p53 overexpression or loss of expression. This may contribute to the poor patient survival rate.

Tumours that metastasize to the ovary can occur in conjunction with other ovarian lesions, including benign sex cord stroma tumours like fibroma or fibrothecoma. This case report presents a unique instance of metastatic signet ring carcinoma involving the ovary in a background of fibroma in a Black African woman. A 46-year-old gravida 3, para 0 (2 alive), patient was referred from the general outpatient clinic to the gynecology clinic due to progressive abdominal swelling over the past eight months. Abdominal examination revealed marked distension with massive ascites. Physical examination of the chest demonstrated dullness to percussion over both lung bases, with increased dullness noted on the right. Auscultation revealed decreased air entry in the right middle and lower lung zones, with normal to increased air entry in the remaining lung fields. Abdominopelvic ultrasound revealed a large irregularly marginated homogeneous solid mass in the right adnexa measuring 16.4 × 11.7 × 12.7 cm. An abdominal CT scan revealed bilateral pleural effusion, which was more pronounced on the right, ascites, and evidence of pulmonary and hepatic metastasis. Serum chemistry revealed abnormal levels of several analytes, including elevated CA 125 at 1,108.8 (normal range 0–35) U/L and CA 19–9 at 63.8 (normal range 0–35) U/L. She subsequently underwent staging laparotomy with total abdominal hysterectomy and bilateral salpingo-oophorectomy, without any postoperative complications. The histologic sections of the right and left ovaries revealed a moderately cellular lesion composed of intersecting bundles of spindle cells in a fascicular and storiform pattern. Additionally, pockets of small round to oval-shaped cells with intracytoplasmic clear vacuoles pushing the nucleus to the periphery (signet ring cells) were identified in a few foci. These cells were initially thought to be ovarian stroma or theca cells. Microscopic examination revealed signet ring cells with cytoplasmic positivity for periodic acid-Schiff (PAS) staining. The histopathological diagnosis was metastatic signet ring cell carcinoma involving the ovary, with an underlying ovarian fibroma. Ovarian metastatic signet ring carcinoma in a background of fibroma can pose a significant diagnostic challenge, as signet ring cells can mimic the ovarian stroma or theca cells, especially if they are only observed in a few foci of the sections.

Background: Sebaceous carcinoma is a very rare malignant skin adnexal tumor that is occasionally aggressive. We have not seen a case of sebaceous carcinoma in our center in the last 10 years. It is extremely rare in Black Africans. Case presentation: We described the case of a 55-year-old man African man who presented to our ophthalmologist with complaints of growth on the right upper eyelid for 8 months. He had surgery and chemotherapy for rectal carcinoma 6 years prior to presentation and received his last dose of chemotherapy 5 years before seeing our ophthalmologist. There was a history of spontaneous unprovoked bleeding from the lesion. He subsequently underwent surgical excision under general anesthesia. Histology of the mass showed an effaced architecture due to proliferating malignant epithelial cells disposed as trabecules, solid nests, and tongues. The microscopic features of widespread multivacuolated cytoplasm of the neoplastic cells led us to conclude that the tumor was a sebaceous carcinoma. The patient is alive and well. Conclusion: Sebaceous carcinoma is a rare malignant skin adnexal tumor in Black Africans. It can present as an eyelid mass with spontaneous bleeding. It can follow cancer chemotherapy either because of its association with other tumors in Muir–Torre syndrome or because of mutagenic effects of chemotherapeutic agents.

Background: The aim of our study is to describe the gross morphology of ovarian specimens and to see if some entities can be distinguished based on their gross morphology. Methods: We did a cross-sectional study of all ovarian specimen received by the department of morbid anatomy and forensic medicine of Obafemi Awolowo university teaching hospitals complex (OAUTHC), Ile-Ife, Nigeria from January 1, 2018, to December 31, 2022 (Five-year period). OAUTHC is situated in the southwestern part of Nigeria. Results: We examined 225 right ovarian specimens. Non- neoplastic lesions were the most common lesions of the right ovary accounting for 52 cases followed by malignant tumour accounting for 25 cases. We examined 233 specimens of the left ovary of which 133 were normal. Eighteen (72%) of malignant tumors of the left ovary had cystic cut surfaces. The spectrum of lesions of both ovaries has different average widest diameters with significant overlap in their distribution. Metastatic carcinoma is seen to involve both ovaries and found to mainly have a solid cut surface. We found that the average widest diameter of a normal left ovary is 3.6 cm while that of a normal right ovary is 4.9 cm. Conclusions: The ovarian lesions have different widest diameters and are usually larger than that of a normal ovary. Benign ovarian tumours are generally larger than their malignant counterparts but cannot be distinguished based on size alone. Metastatic carcinoma involved both ovaries and had a predominantly solid-cut surface. The normal left ovaries were smaller than the normal right ovaries.

SARS-CoV-2 infection is a major pandemic that has involved all continents in the world. It has caused almost seven million deaths since its onset. SARS-CoV-2 commonly enters cells by binding to angiotensin-converting enzyme 2 (ACE2) molecules on the surface of cells in the human body. SARS-CoV-2 infection, although mild in many patients, has the potential to cause dysfunction of many organ systems in the body. The body response to the internalisation of the virus in the epithelial cells of the lungs can lead to alveolar epithelial inflammation, commonly referred to as the exudative phase of acute respiratory distress syndrome (ARDS). Cardiac symptoms shown by patients infected with SARS-CoV-2 include chest tightness/pain and palpitations. These features can be because of newly developed or worsening ischaemic heart disease and arrythmias, respectively. SARS-CoV-2 infection is known to cause a clinical condition known as COVID-19-associated nephropathy (COVAN), a disease quite similar to HIV-associated nephropathy (HIVAN). Like HIVAN, COVAN is relatively more common in people of African descent and is associated with the APOL1 variant gene. Researchers have not identified unique morphological changes that could be used to identify the infection in tissues. Hence, the use of RT-PCR for diagnosis is still very important.

Background: Our aim is to describe the clinicopathology features of spindle cell tumors of the female genital tract seen in our hospital and to compare the findings with what is seen in other parts of the world. Methods: We conducted a cross-sectional study of all spindle cell tumors diagnosed in the department of Morbid Anatomy and Forensic medicine of Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria from January 1, 2017, to December 31, 2022. Results: Leiomyoma was the most common spindle cell tumour seen. Only 570 cases met the inclusion criteria. Only one nodule was removed in 130 cases (22%) while greater than one nodule was excised in 432 cases (75.8%). The mean age of patients was 40.77 years while the age range was 19-79 years. About three-quarters of leiomyomas are removed in the age-group 31-50. There was no correlation between the number of nodules removed and the age of the patient. The next second most common spindle cell tumor seen was malignant mixed mullerian tumour. Eleven cases were seen in the study period, The average age was 57.7 years. The age range of cases was 27-72 years. Conclusions: Our study supports the general observation that leiomyomas commonly cause symptoms in the reproductive age group and that most patients with leiomyoma frequently have more than one nodule. Our study further reinforces the widely established knowledge that MMMT is found in older post-menopausal women and can occasionally be seen in younger pre-menopausal women.

Aim: To describe the clinical and pathological features of the various fungal and parasitic diseases seen at our hospital over a five-year period. Study Design: This is a retrospective study of records of fungal and parasitic diseases. Place and Duration of Study: The study was done at the Department of Morbid Anatomy and Forensic Medicine of Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife from January 2018 to December 2022. Methods: The tissue sections of each case went through routine processing in the histopathology laboratory. The slides of the sections were viewed using a simple binocular microscope. The slides were scanned using APERIO CS2 digital slide scanner. Results: Eight cases of fungal infections and eleven cases of parasitic infections were noted during the study period. Aspergillosis accounted for five of the fungal infections, while mucormycosis accounted for two nasal infections. Schistosomiasis accounted for six cases of parasitic infections. Conclusion: Aspergillosis was the most diagnosed fungal infection while Schistosomiasis was the commonest parasitic infection. Digital stain separation could be an added tool in identification of fungal and parasitic stages in histological tissue sections.