Abstract Background: Obesity is a major breast cancer risk factor, yet its biological mechanisms remain poorly characterized in African populations. We hypothesized that distinct obesity-associated molecular signatures would differentiate obese from normal-weight Nigerian women and reveal subtype-specific patterns in U.S. women. Methods: Targeted gene expression profiling (NanoString, 785 genes) was performed on tumors from 46 Nigerian women (MEND), and publicly available gene expression data from Women’s Circle of Health Study (WCHS; n=367; African and European ancestry) were analyzed. Enrichment scores for obesity-related pathways (glycolysis, inflammation, Extracellular matrix (ECM) remodeling, adipokine signaling, insulin/IGF1 signaling, hypoxia, cholesterol biosynthesis) were computed using Gene Set Variation Analysis in R (v4.5.0) with KEGG and Reactome gene sets. Bipartite network clustering identified co-occurring mechanism clusters. Associations were tested for cluster membership with BMI using Firth logistic regression for MEND, and with subtype and ancestry using standard logistic regression for WCHS, adjusting for covariates (MEND: age, subtype, menopausal status; WCHS: age). Results: MEND participants averaged 48.7 (10.6) years; WCHS averaged 54.07 (11.99) years. In MEND, three clusters emerged (Q=0.14, p<0.05): Cluster 1 (hypoxia, cholesterol biosynthesis), Cluster 2 (ECM remodeling, adipokine, insulin/IGF1 signaling), and Cluster 3 (glycolysis, inflammation). Overweight/obese women had higher odds of Cluster 2 (aOR=5.4, 95% CI: 1.3-31.3), while normal-weight women were enriched for Cluster 1 (0.12, 0.02-0.54). In WCHS, six enrichment scores yielded three clusters (Q=0.10, p<0.05): Cluster 1 (inflammation, hypoxia), Cluster 2 (ECM remodeling, insulin/IGF1 signaling), and Cluster 3 (adipokine signaling, glycolysis). Cluster membership did not differ by ancestry, but subtype associations (Luminal A reference) were striking: Cluster 1 strongly associated with Luminal A (Luminal B: 0.33, 0.18-0.61; HER2: 0.15, 0.06-0.34; Triple Neg: 0.19, 0.11-0.34), Cluster 2 with Luminal B (3.47, 1.8-6.9) and HER2 (4.09, 1.9-8.99), and Cluster 3 with Triple Negative (3.15, 1.78-5.73). Conclusions: Obesity-linked mechanisms differ by BMI and subtype. ECM remodeling and growth factor signaling dominate obesity-related tumors, while hypoxia and lipid metabolism characterize normal-weight tumors. Subtype-specific clustering suggests heterogeneity beyond BMI. Findings highlight opportunities for precision prevention and treatment, including metabolic pathway targeting and potential use of GLP-1 receptor agonists in high-risk subtypes. Disclosure: Generative AI (Microsoft Copilot) was used to assist with language editing; authors reviewed and verified all content. Citation Format: Oyomoare Osazuwa-Peters, Jovita Kokwesiga Byemerwa, Omolola Salako, Adetola Daramola, Olusegun Isaac Alatise, Gabriel Ogun, Tomi Akinyemiju. BMI- and subtype-specific molecular clusters reveal distinct obesity mechanisms in breast cancer across Nigerian and U.S. cohorts [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 7866.

Cumulative lifetime endogenous estrogen exposure (CLEEE) is an established breast cancer (BC) risk factor, yet Nigeria faces increasing BC incidence and mortality despite reproductive patterns typically associated with lower estrogen exposure. We evaluated the association of endogenous estrogen exposure and BC risk in this population. We analyzed 609 Nigerian BC cases and 609 controls from the MEND case-control study to examine associations between CLEEE and BC risk by molecular subtype. CLEEE was defined as time from menarche to menopause (or enrollment), minus pregnancy duration; a breastfeeding-adjusted measure (CLEEE-b) subtracted breastfeeding duration. Most cases were grade 2 (67.2

Dermatitis cruris pustulosa et atrophicans (DCPA) is a chronic folliculitis prevalent in tropical regions, marked by intensely pruritic recurring follicular pustules with cutaneous oedema, subsequently followed by alopecia, and atrophy of the affected areas. It predominantly affects the shin, exhibits frequent relapses and often displays a limited response to therapy. Despite being described initially as the "Nigerian shin disease," it has been reported from various continents.1-3 Dermoscopy, an evolving diagnostic tool in the dark skin, has demonstrated high diagnostic utility in various forms of folliculitis; however, its application in DCPA remains unexplored, creating a gap in the literature.4 Given that several other forms of folliculitis prevalent in the tropics mimic DCPA, elucidating the distinctive dermoscopic features of DCPA is essential to enhance diagnostic accuracy and differentiate it from mimics.4 We report a case of DCPA in the dark skin highlighting its dermoscopic features. A 21-year-old female of African descent presented with a 6-year history of recurrent intensely pruritic right shin rashes. They started as papules and vesicles which became scaly, and occasionally, painful. She had atopic dermatitis and a notable habit of using petrolatum-based emollients for dry scaly skin. Examination revealed shiny right shin with sharply demarcated hyperpigmented areas harbouring multiple papules, vesicles, a few pustules. There was evident alopecia over these areas (Figure 1a). Dermoscopy demonstrated an accentuated honeycomb pigment pattern, absent skin furrows, perifollicular pustules with coarse hairs emerging from their centres, absent pin point white dots (eccrine duct openings), substantial hair follicle depletion, perifollicular red areas, and areas exhibiting erosions. (Figure 1b–d). Posttreatment showed clearance of pustules and erythema. (Figure 1e,f). Histopathology (40×) (Figure 2a,b) show mainly intense lymphocytic and few plasma cell infiltration around the hair follicles and other adnexial structures. The lymphoplamacytic infiltration extends from the supercial to deep dermis. There is associated perifollicular fibrosis. A diagnosis of DCPA was made. She was treated with Co-trimoxazole and advised to avoid occlusive skin care products. Two months later, the lesion had improved with symptom resolution. (Figure 1e,f) DCPA is uniquely localised to the shin, with rare occurrences on the forearms, trunk, and pubic area, exhibiting a preference for areas with terminal hairs.1-3 Recurrent symmetric follicular pustules at the initial phase eventually progress to alopecia and atrophy of the affected area. Although characteristic, diagnosis can be challenging due to its rarity and resemblance to folliculitis of other aetiologies. Dermoscopy, is potentially valuable for differentiating DCPA from other forms of folliculitis.4 Perifollicular pustules suggests folliculitis, while associated ingrown hair indicates pseudofolliculitis. The hang-glider sign and serpiginous tracts indicate scabietic folliculitis. Fungal folliculitis is marked by broken, zigzag, morse code, and corkscrew hairs. Central round pustules with peripheral sparse dotted vessels, though diagnostically less accurate, suggests bacterial folliculitis. Demodex tails (creamy or whitish gelatinous follicular plugs protruding from follicular openings) and round creamy or whitish plugs surrounded by an erythematous halo indicate demodex folliculitis.4 Peripheral, regularly distributed dotted vessels, in the absence of other findings, strongly indicate Malassezia folliculitis. Folliculitis decalvans typically presents with hair tufts.4 Specifically, the loss of hair follicular and eccrine openings and presence of hair casts as seen in our patient are more indicative of DCPA.3, 5 Exaggerated or discontinuous honey comb pigmentation and loss of normal skin furrows as was seen in our patient are nonspecific findings, and may be observed in other chronic inflammatory conditions in the dark skin.6 Despite its rarity, further research is required, involving a larger sample of DCPA cases, to investigate the robustness of these features in distinguishing DCPA from other forms of folliculitis. An improved understanding of these dermoscopic features will lead to early diagnosis and reduced need for biopsies. Nkechi Anne Enechukwu was involved in conceptualisation, methodology, writing—Original Draft Preparation, writing—Review and editing and visualisation. Gabriel Olabiyi Ogun was involved in Conceptualisation, writing—Original Draft Preparation, writing—Review and editing, supervision, investigation and Visualisation. The authors' received no funding(s), grants, royalties or licences. Neither have we received consulting fees nor honoraria for this research study. The authors' have no conflict of interest to declare. The patient in this manuscript gave a written informed consent for participation in the study and the use of her deidentified, anonymized, aggregated data and their case details (including photographs) for publication. Ethical Approval: not applicable.

BACKGROUND AND OBJECTIVE:The demonstration of HER2 in gastric adenocarcinoma (GA) tissues by immunohistochemistry assists in deciding whether targeted therapy would optimise the treatment of GA patients who are HER2 positive. However, this has not been extensively studied in our patients hence the need for this study.METHODS:Recipient tissue microarray blocks were constructed from donor archival formalin fixed paraffin embedded gastric tumour tissue from 80 patients seen over a period of 17 years in a retrospective descriptive study. Slides cut from these blocks were stained with antihuman HER2 antibody by immunohistochemistry and scored using the trastuzumab in gastric adenocarcinomas (ToGA) trial criteria. Data on age, gender, site of lesion and histological subtype of the gastric adenocarcinomas were also retrieved and reviewed.RESULTS:Eighty cases (52 males and 28 females; male to female ratio of 1.9:1), 55.65 ±13.50 years (modal age group 60-69 years), were studied. Most tumours (91.2%) involved the distal parts (pylorus, antrum and body) with a few (8.8%) involving the proximal part (cardia and fundus) of the stomach. HER2 was overexpressed in a total of 6 (7.5%) cases only. Two of seven (28.6%) proximal tumours showed HER2 positivity whereas only 4 of 73 (5.5%) of the distal tumours showed HER2 positivity.CONCLUSION:We had only a slightly lower HER2 overexpression rate than in studies from many other parts of the world. The observed overexpression was significantly higher in proximal than distally located tumours suggesting that distal tumours are less likely to respond to Trastuzumab than proximal tumours. The known association of distal gastric tumours with Helicobacter pylori infection probably provides for a possible difference in the molecular aetiopathogenesis of GAs by site of occurrence. The exact mechanisms for proximal gastric carcinogenesis remain to be more clearly elucidated. More studies, including clinical trials with larger sample sizes, are recommended to elucidate this differential expression of HER2 in gastric adenocarcinoma.

Introduction: Sub-Saharan Africa has a heavy burden of oral diseases and cancers. Also, there is a dearth of published records of oral pathology services in The Gambia. Therefore, this review aimed to determine the prevalence of biopsied oral and maxillofacial lesions in order to ascertain the uptake of oral histopathology services at the foremost tertiary institution in The Gambia. Materials and Methods: This was a retrospective study performed at the Pathology Department of Edward Francis Small Teaching Hospital. Reports of all oral and maxillofacial biopsies submitted for the period 2012 to 2021 were reviewed and data were extracted. Descriptive analysis was done using SPSS software, version 26. Results: Total number of biopsy reports was 158 representing 0.02% over the study period. The mean age of patients was 34.3 ± 19.7 years, the 3rd decade was the peak age of presentation and male-to-female ratio was 1:1.6. Majority (65/41.1%) of the cases were benign neoplastic lesions, and the mandible was the most (21/13.3%) common site of biopsy. Reactive lesions were the predominant (34/21.5%) group and squamous cell carcinoma had the highest (24/15.3%) number of lesions while odontogenic tumours constituted six cases only (3.8%). Conclusion: The findings of this study showed low uptake of oral histopathology services while biopsied oral and maxillofacial lesions were prevalent in female patients in the third decade of life. Also, the mandible was the most affected site whereas benign neoplastic diagnoses were most common. However, this study recorded a higher proportion of malignancies than some previous studies.

Background:Progressive improvement in the accuracy of profiling of hormone receptors in breast cancer provides the basis for targeted endocrine therapy, a major pillar of multimodal breast cancer treatment. However, the disparity in findings from comparatively smaller sample-sized studies in West Africa has led to somewhat conflicting conclusions and recommendations.Objectives:This study investigates the immunohistochemical (IHC) profile of breast cancer specimens for estrogen receptor (ER), progesterone receptor (PR), human epidermal receptor-2 (HER2)/neu, and Ki-67 in a tertiary hospital in Ibadan, Nigeria over 12 years.Materials and Methods:We reviewed 998 IHC reports, documented clinicopathologic parameters, computed patterns of biomarkers, and stratified them based on the American Society of Clinical Oncology/College of American Pathologists recommendations. Descriptive analysis including frequency, mean, and median were generated from the data extracted.Results:Out of the 998 cases, 975 (97.7%) were females and 23 (2.3%) were males. The mean age was 48.84 ± 11.99 years. Open biopsies were the most common types of specimens (320, 41.6%): lumpectomy and incisional biopsy of ulcerated, fungating or unresectable tumours. In those cases, 246 (32.0%) were samples of breast-conserving or ablative surgical extirpation (mastectomy/wide local excision/quadrantectomy), and 203 (26.4%) were obtained by core needle biopsies. Invasive ductal carcinoma was the most common histopathological type (673, 94.5%). The majority of graded tumours were intermediate grade (444, 53.5%). Four hundred and sixty-nine (48.4%) were ER positive, 414 (42.8%) were PR positive, and 180 (19.4%) were HER2/neu positive. Three hundred and thirty-four (34.0%) were triple-negative. Eighty-nine cases had Ki-67 staining done, and of these 61 (68.5%) had positive nuclear staining.Conclusion:Steroid hormone receptors and HER-2/neu proportions in our cohort are likely to be more representative than the widely varied figures hitherto reported in the sub-region. We advocate routine IHC analysis of breast cancer samples as a guide to personalized endocrine therapy.

Background:This study aimed to characterise epithelial cell adhesion molecule (EpCAM) expression patterns in colorectal carcinomas (CRC) from Nigerian patients, its association with E-cadherin and tumour characteristics, to forecast patient selection for anti-EpCAM therapy among whom no data existed previously.Methods:Tissue microarray blocks of formalin-fixed and paraffin-embedded CRC tissues, with their non-cancer margins of resection, were sectioned and stained with EpCAM and E-cadherin primary antibodies. Scoring for antibody staining was done semiquantitatively by combining staining proportion and intensity. The outcome was correlated with patient age, gender and tumour histological parameters with p ≤ 0.05 regarded as statistically significant.Results:Sixty-three carcinoma tissues had staining status for the two markers and were included in this study. Of these, 36 (57.1%) showed positive EpCAM expression (immunoscore ≥3) out of which 83% (30/36 positive cases) were overexpressed (combined immunoscore ≥4) while 12 (19%) tissues were positive for E-cadherin. Non-tumour margins of resection tissues showed less EpCAM positivity in 24% (6/25) of histospots. The difference in staining between tumour and non-tumour margin tissues with EpCAM was significant (p < 0.001). Also, EpCAM overexpression was significantly associated with reduced E-cadherin (p < 0.035) expression in tumour cells. Tumour extent within the gut wall was equal (50% each) for early and late pT stages among EpCAM overexpressing tumours but two-thirds (8/12) of cases expressing E-cadherin had later pT stage paradoxically, while distant metastasis was negligible among tumours bearing both markers. Also, tumours overexpressing EpCAM had significant association with tumour-associated lymphocytes (p < 0.02 each).Conclusion:CRC in this study preferentially overexpress EpCAM over E-cadherin whose strong cell-cell contact inhibitory role is weakened even when expressed, resulting in further local tumour spread. This, and the observed immune response, supports targeted therapy among eligible patients.

Background:Clinical and histopathologic observations have indicated that psoriasis is not rare in our population as previously thought. The initial rarity also led to paucity of studies on the disorder including histopathologic features in our practice setting. To date, there is no report on the histopathologic features of psoriasis indigenous to our practice environment.Objective:To evaluate the frequency of occurrence of the various histopathologic features of psoriasis in patients from this environment and identify any peculiarities that exist in black African patients.Methods:A cross-sectional study of patients diagnosed clinically with psoriasis at the University College Hospital, Ibadan between January 2015 and October 2016. After baseline sociodemographic data, all patients had baseline clinical examination and were offered skin biopsy after obtaining informed consent. The biopsy specimen was examined for histopathologic features of psoriasis after routine processing and staining using a pretested proforma with the frequencies of each diagnostic feature reported in percentages.Results:Forty-four patients with plaque psoriasis were analyzed. The mean age of the patients studied was 39.84 ± 20.97 years with a male to female ratio of which was almost equal. The most consistent epidermal changes in decreasing other of frequency were acanthosis, hypogranulosis, hyperkeratosis followed by elongation of rete ridges while dermal features were dermal infiltration by inflammatory cells, and dilatation of superficial dermal vessels. Munro's microabscesses were found in less than half of the patients biopsied. Some of the patients were found to have atypical changes.Conclusion:Histopathological features of psoriasis in the study is similar to what has been previously established universally but typical features such as Munro's micro abscesses and Kogoj's spongiform pustules are less frequently seen than expected. Atypical changes such as dermal melanophages and periadnexal infiltration by inflammatory cells may also be seen.

Background: Different reasons for autopsies include medico-legal causes, medical education and deducing the cause of death. An additional benefit is auditing with regards to patient care in the diagnosis and treatment of diseases. The main objective of this study was to determine the concordance between ante-mortem clinical diagnoses and post-mortem causes of death. Materials and Methods: From January 2009 to December 2015, Autopsy records at the Department of Pathology, University College Hospital, Ibadan were reviewed. Discrepancies between the clinical diagnoses and postmortem findings were categorised using Goldman criteria into major and minor classes. Goldman's criteria can be sub-categorised into five classes: Class I, Class II, Class III, Class IV and Class V. Classification of the cause of death categories was by the International Classification of Diseases, Version 10. The study was carried out with respect to the world medical association's Declaration of Helsinki (2013). Data analysis was carried out with the use of the Statistical Package for the Social Sciences (SPSS version 22). Results: Five hundred and thirty-three cases were involved with a male-female ratio of 1.6. The most common postmortem causes of death were traumatic Injuries (20.6%), Circulatory system-related deaths (19.7%), infections (16.9%) and malignant neoplasms (9.4%). Only 298 (55.9%) of the cases showed a concordance between the post-mortem causes of death and the clinical diagnosis. Conclusion: The post-mortem autopsy is useful in the audit of current medical practice in our environment.

Breast cancer is now the commonest cancer in most sub-Saharan African countries. Few studies of the epidemiology and genomics of breast cancer and its molecular subtypes in these countries have been done. The African Female Breast Cancer Epidemiology (AFBRECANE) study, a part of the Human Heredity and Health in Africa (H3Africa) initiative, is designed to study the genomics and epidemiology of breast cancer and its molecular subtypes in Nigerian women. We link recruitment of breast cancer cases at study sites with population-based cancer registries activities to enable ascertainment of the incidence of breast cancer and its molecular subtypes. We use centralized laboratory processing to characterize the histopathological and molecular diagnosis of breast cancer and its subtypes using multiple technologies. By combining genome-wide association study (GWAS) data from this study with that generated from 12,000 women participating in our prospective cohort study of cervical cancer, we conduct GWAS of breast cancer in an entirely indigenous African population. We test associations between dietary intakes and breast cancer and focus on vitamin D which we measure using dietary intakes, serum vitamin D, and Mendelian randomization. This paper describes the AFBRECANE project, its design, objectives and anticipated contributions to knowledge and understanding of breast cancer.

There is conflicting evidence on the role of lipid biomarkers in breast cancer (BC), and no study to our knowledge has examined this association among African women. We estimated odds ratios (ORs) and 95% confidence intervals (95% CI) for the association of lipid biomarkers—total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides—with odds of BC overall and by subtype (Luminal A, Luminal B, HER2-enriched and triple-negative or TNBC) for 296 newly diagnosed BC cases and 116 healthy controls in Nigeria. Each unit standard deviation (SD) increase in triglycerides was associated with 39% increased odds of BC in fully adjusted models (aOR: 1.39; 95% CI: 1.03, 1.86). Among post-menopausal women, higher total cholesterol (aOR: 1.65; 95% CI: 1.06, 2.57), LDL cholesterol (aOR: 1.59; 95% CI: 1.04, 2.41), and triglycerides (aOR: 1.91; 95% CI: 1.21, 3.01) were associated with increased odds of BC. Additionally, each unit SD increase in LDL was associated with 64% increased odds of Luminal B BC (aOR 1.64; 95% CI: 1.06, 2.55). Clinically low HDL was associated with 2.7 times increased odds of TNBC (aOR 2.67; 95% CI: 1.10, 6.49). Among post-menopausal women, higher LDL cholesterol and triglycerides were significantly associated with increased odds of Luminal B BC and HER2 BC, respectively. In conclusion, low HDL and high LDL are associated with increased odds of TN and Luminal B BC, respectively, among African women. Future prospective studies can definitively characterize this association and inform clinical approaches targeting HDL as a BC prevention strategy.

Background: Sub-Saharan Africa has the highest childhood mortality worldwide. In this study, we reviewed post-mortem records retrospectively noting both the causes of death and autopsy trend in childhood documented at our hospital. Aim: This study was done to ascertain the mortality patterns in childhood as seen in post mortem examinations. Materials and Methods: Autopsy records of deceased who were 16 years or less performed from 2008 to 2017 in our hospital were accessed and reviewed. Written consents were duly obtained before all post-mortem examinations. The causes of death were defined using the International Classification of Diseases-11. Results: There were 89 cases representing 8.2% of 1092 autopsies performed within the review period. Most of the childhood mortalities were in the 1st year of life. The majority of cases in the 1st year of life were cases of early neonatal death (40%), followed by deaths from 29 days to 1 year (34.3%) and late neonatal death constituting 25.7% of cases. Infections resulted in deaths in 34.8% of cases, followed by malignancies at 12.4%, developmental anomalies at 10.1%, accidents at 6.7%, sickle cell disorder at 4.5%, and nephrotic syndrome at 4.5%. Pneumonia represented 48.4% of all infectious death, followed by bacteria sepsis of newborn at a distant 9.7%. Malignancies are the main cause of mortality in children above 10 years of age. It constitutes 36% of the cases in that age group. Mortalities from developmental anomalies were relatively more common in infants (17.1% of deaths). Conclusion: This study has shown varying causes of death in different age demographics among children in the population studied. Infection control and adequate treatment in addition to early diagnosis of malignancies are advocated.

Background: Surgical resection margins (RM), axillary nodal involvement and lymph node ratio (LNR) determine loco-regional control (LRC) in breast cancer management. Late presentation precludes breast conservation therefore surgical option is usually mastectomy and adjuvant chemoradiation minimize loco-regional recurrence (LRR). Objective: We investigated the prognostic role of lymph nodes positive for malignancy (pN), LNR and RM on LRR of breast cancer in a tertiary hospital in Ibadan, Nigeria. Methods: Longitudinal cohort study of 225 females with breast carcinoma managed and followed up for 5-years with end point of LRR or not. Chi-square test and logistic regression analysis were used to evaluate the interaction of resection margin and proportion of metastatic lymph nodes with LRR. The receiver-operator curve was plotted to determine the proportion of metastatic lymph nodes which predicted LRR. Results: Ninety-nine percent had modified radical mastectomy and 163 (72.4%) had negative resection margins. A mean of 11 axillary lymph nodes were harvested at surgery. The age, positive resection margin and number of harvested nodes with malignant cells are associated with LRR. The overall 5-year LRR rate was 16%. Conclusion: LRR is dependent on lymph node involvement as well as and tumor aggressiveness.

548 Background: Modern management of breast cancer requires proper subtyping of the breast tumor to guide appropriate treatment and prognostication. However, there are barriers to availability of this resource in low- and middle-income countries (LMIC) which contributes to global inequalities in breast cancer management and outcomes. The non-availability is due to high cost, and lack of personnel and infrastructure required for immunohistochemistry (IHC), the current gold standard for subtyping. IHC results are affected by pre-analytic and analytic handling and are subjective. Alternative methods that are more objective, cost less and require less infrastructure and skilled personnel will improve access and reduce disparities. Methods: In the AFBRECANE Project, we compared the results of ER and PR subtyping of 1,000 breast cancer tumors from patients recruited from 5 clinical sites in Nigeria using IHC and Cepheid GeneXpert RNA STRAT4 biomarker assay at ACCME Lab in Nigeria and University of Maryland. Results: For ER, the sensitivities, specificities, and agreement between IHC and STRAT4 ranged from 50.0%, 71.4% and 59.4% to 77.1%, 80.0% and 78.5% while for PR, they ranged from 58.1%, 66.7% and 62.5% to 84.6%, 84.2% and 84.4%. Conclusions: The wide range of sensitivities, specificities, and agreement between IHC and STRAT4 in this study confirms the challenges of molecular subtyping of breast cancer in LMICs like Nigeria. Sustainable objective methods are sorely needed to improve diagnosis, treatment and prognostication, and reduce global disparities.

Background: Lymphomas are a heterogeneous group of tumors of lymphoid tissue in which there is a malignant proliferation of cells of the lymphatic system. They are the most frequent nonepithelial malignancy in the head and neck region. Objectives: The aim of this study was to evaluate the histological pattern of the disease in the head and neck region and trends in presentation seen in our centerMaterials and Methods: This was a retrospective study of cases of head and neck lymphoma (HNL) seen in the Pathology Department of the University College Hospital Ibadan, Nigeria over a period of 37 years (1981–2017). Information extracted from the records included the sociodemographics of the patients, tumor location, and histological type among others. Data were analyzed and results were presented as frequencies and percentages. Results: There were a total of 373 cases of histologically and/or cytologically diagnosed HNL seen during the study period (an average of 10 cases per year). The mean age of patients was 33.5 ± 21.9 years with male:female ratio of 1.6:1. Most HNL were non-Hodgkin’s lymphomas (NHL), accounting for 91% of cases. Nodal disease was seen in 39% of cases. The bone (prominently, the jaws) predominated (25%) in extranodal lesions. Burkitt’s lymphoma was the most common specific subtype of NHL, occurring in 25.5% of cases. Conclusion: There has been an apparent upward trend in the prevalence of HNL over the past four decades, although other parameters such as age and sex predilection appear unaffected. Factors responsible for this trend need to be interrogated and ascertained.

AIM:To describe the pattern of paediatric Rhabdomyosarcomas (RMS) and Non-Rhabdomyosarcomas (NRMS) with emphasis on the indices that affect survival outcomes.METHODS:We reviewed all patients with histologically confirmed RMS and NRMS in the Departments of Pathology and Paediatrics, University College Hospital (UCH), Ibadan, Nigeria; in children aged 0-14 years. The study period was January 1991 to December 2016. Information obtained included age, gender, morphology and site of the tumours. The tumour grade and pathologic/clinical staging of all patients were also obtained and verified by the clinical records. Tumour grading was carried out using the Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCC) Sarcoma group grading system and staging was done using TNM. Follow up, survival information and final outcome were retrieved.RESULTS:The 104 patients included in the study had almost equal male-to-female ratio, age ranged between 5 months and 14 years (median 8.2 years). Rhabdomyosarcoma had mean age of 5.6 (±3.8) years while that of NRMS was 9.2(±4.1) years. Overall, the modal age group was 5-9 years. Rhabdomyosarcoma was the commonest histological type (76%), undifferentiated sarcomas (6.7%), fibrosarcoma (3.8%) and 2.9% each for synovial sarcoma and dermatofibrosarcoma protuberans. The common primary sites were the head and neck (including the orbit) 49 (47.1%), and the abdominopelvic 26 (25%) regions. Majority (89%) had histologic grade 3 at presentation. Seventy per cent and 64% of patients with RMS and NRMS, respectively, had high stage tumour at presentation. Median survival for all patients with Rhabdomyosarcoma was 45 weeks with a 1-year survival of 43% and 2-year survival of 25%. Non-RMS (Dermatofibrosarcoma protuberans and Solitary fibrous tumours) had survival of over 4 year's duration.CONCLUSION:Majority of our patients presented at a late stage with histologic high grade which confers poor prognosis and reduced chances for good overall survival outcome.

Background: The routine use of abdominal ultrasonography and computed tomography scan has increased the detection of asymptomatic renal cysts. Laparoscopy is usually suitable for treating large symptomatic renal cysts. Objective: To report a case of laparoscopic treatment of a man with large left renal cyst mimicking chest infection. Case presentation: A 75-year-old man, known hypertensive who had empirical treatment for chest infection without resolution of symptoms of cough and chest pain. He was on treatment for storage and voiding lower urinary tract symptoms with 10mg alfuzocin. Abdominal ultrasound and computed tomography scan confirmed a large left renal cortical cyst that measured 380mls. He subsequently had transperitoneal laparoscopic deroofing and excision of the renal cyst with operation finding of 300mls of straw coloured fluid excluding spillage. The immediate postoperative period was uneventful, and he was discharged home in a stable condition on the second day. The aspirate yielded no growth while the cytology report of cystic fluid was acute-on-chronic inflammation. Histology was reported as chronic pyelonephritis with cystic degeneration. Conclusion: Large renal cyst should be considered as differential diagnosis of unresolved chest infection and is safely treated by laparoscopic deroofing and excision.