Browsing by Author "Mremi, Alex"

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    Clinicopathological findings of retinoblastoma: A 10-Year experience from a tertiary hospital in Kampala, Uganda
    (Hindawi, 2019) Yahaya, James J; Rugwizangoga, Belson; Mremi, Alex; Munema, Asafu
    Retinoblastoma (RB) is one of the most common cancers occurring in young children in sub-Saharan Africa. The incidence rate reported in the literature is 9,000 new cases per year, which corresponds to 1 in 15,000 births. This study aimed at analyzing the clinicopathological findings in children with RB in Uganda. Purpose. The purpose of this study was to describe and analyze the clinicopathological findings in the patients with RB Design. This was a cross-sectional analytical study involving 234 eyeball surgical specimens from 214 patients with RB diagnosed between January 2006 and December 2015. Results. The mean age of the patients was 27.8 months (SD = 21.413, range: 1–132 months). More than half of the cases, 50.9%, presented with leukocoria. Invasion of choroid, sclera, anterior chamber, and optic nerve was found in 26.5% (n = 58), 51.2% (n = 88), 26.2% (n = 45), and 29.2% (n = 49), respectively. Twenty-six percent (n = 56) of the cases with intraocular tumour were at stage I and all patients with metastasis 4.7% (n = 11) had stage IV. The correlation between postlaminar optic nerve invasion and massive choroidal invasion was statistically significant (p=0.002). Also, there was a statistical significance difference between metastasis and post laminar invasion (p=0.004). The majority of children with RB in Uganda present clinically with leucokoria, and their parents or guardians seek medical intervention at a later stage. Moreover, there was a noticeably significant lag period for the patients to begin treatment after the diagnosis was done.
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    Metaplastic carcinoma of breast: a report of two cases
    (Oxford University Press, 2020) Yahaya, James; Mremi, Alex
    The pathogenesis of metaplastic breast carcinoma (MBC) is still debatable and it has been hypothesized that MBC develops as a result of transformation of epithelial cells into mesenchymal cells along with formation of a favorable tumor microenvironment. This favorable tumor microenvironment helps the transformed cells to undergo further mutations and clonal expansion. Case 1 was a 42-year old female with a 1-year history of a right breast fungating mass which was histologically confirmed to be matrix-producing type of MBC. Case 2 was a 47-year old female who presented with a recurrent left breast mass. Histologically, the tumor was confirmed to be carcinosarcomatous type of MBC. MBC is a rare, heterogeneous tumor with poor prognosis due to its aggressive behavior. It is more likely to mimic other benign breast conditions, therefore contributing to delay of diagnosis as it was for both of our patients herein presented.
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    Ovarian sex cord tumour with annular tubules in a 13-year-old female: a case report
    (Oxford University Press, 2020) Yahaya, James J.; Mshana, Daudi; Mremi, Alex
    Sex cord tumour with annular tubules (SCTAT) is uncommon and distinctive type of sex cord-stromal tumours of the ovary which develops from sex cord cells. Most of SCTATs are strongly associated with Peutz–Jeghers syndrome (PJS) and have low malignancy potential; however, 20% of non-PJS-associated SCTATs have been reported to have high malignancy potential. Herein, we present a 13-year-old female who presented with severe abdominal pain localized in the right lower side, associated with nausea. Based on histopathological and immunohistochemical findings, the diagnosis was confirmed to be SCTAT. SCTAT of the ovary is extremely rare in the paediatric population as compared to the general population. Its occurrence among paediatrics as it was the case in the patient described in this paper may pose diagnostic challenges due to lack of clinical suspicion and therefore resulting in delay of diagnosis.
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    The role of a minimum immunohistochemical antibody panel in confirming undifferentiated nasopharyngeal carcinoma: A cross-sectional study at the Muhimbili national hospital, Dar-es-Salaam, Tanzania.
    (Wolters Kluwer ‑ Medknow, 2019) Mremi, Alex; Yahaya, James; Abraham, Zephania; Mwakigonja, Amos
    Introduction: Nasopharyngeal carcinoma (NPC) is a malignant epithelial neoplasm arising in the nasopharyngeal mucosa that shows light microscopic and/or ultrastructural evidence of squamous differentiation. Immunohistochemistry (IHC) can be used to reliably distinguish undifferentiated NPC from other malignant tumors, and the technique may be a necessary tool toward the arrival of a definitive diagnosis, particularly when dealing with challenging cases. Materials and Methods: This was a cross‑sectional hospital‑based study which was conducted at Muhimbili National Hospital. The study involved 120 patients with NPC who were diagnosed on histopathological basis between 2009 and 2013. Results: The sensitivity and specificity of hematoxylin and eosin (H and E) stain in diagnosing NPC were 99% and 30.4%, respectively. The accuracy of H and E stain to diagnose NPC and lymphoma was 94.2% and 30.4%, respectively. CD45 antibody helped to confirm 16 cases which were diagnosed as NPC on H and E stain to be lymphoma. Further, AE1/AE3 antibody helped to confirm one case who was diagnosed as rhabdomyosarcoma on H and E stain to be NPC. Conclusions: The sensitivity and accuracy of H and E stains to diagnose NPC were very high whereas the specificity was very low. A significant proportion of previously diagnosed NPC cases by routine H and E stains were confirmed not to be so by a minimal IHC antibody panel of pan‑cytokeratin cocktail (AE1/AE3) and leukocyte common antigen (CD45). This highlights the paramount importance of a minimum IHC panel in assisting to obtain a definitive diagnosis in challenging cases of NPC.