Aberrant right coronary artery in an elderly Nigerian with recent dyspnoea detected on coronary CT angiogram

An anomalous origin of the right coronary artery has been documented in up to 0.92% of the general population, which is more common than an anomalous origin of the left coronary artery. We present a case of an elderly hypertensive man who developed mild dyspnoea on exertion for 3 months with associated retro-sternal pain as well as occasional palpitation which all tend to subside at rest. An electrocardiogram showed evidence of left atrial enlargement. A coronary computed tomographic angiogram was acquired with a 160-slice scanner which revealed the right coronary artery to originate from the left aortic sinus with a retro-aortic pattern of anatomical course. Vascular wall calcifications were noted with multilevel luminal narrowing on the left anterior descending however distal opacification was adequate. Our case further depicts the reason for keeping in mind anatomical variations while evaluating cardiac pathologies even among Black Africans.

Clinical and histological features of melanoma in adult Nigerians

BACKGROUND

Melanoma known to be common among Caucasians is increasingly getting more common among blacks in the tropics.

OBJECTIVE

To characterize the clinical and histological features of these tumours in adult Nigerians.

METHODS

All cases of melanoma diagnosed between 2006 and 2010 in Aminu Kano Teaching Hospital, Kano, Nigeria were retrieved and their clinical and pathological features reviewed.

RESULTS

Eighty five cases comprising 41 males and 44 females were diagnosed with mean age of 56 ± 14.6 years. Mean duration before presentation was 2.3 ± 0.8 years. Eighty five percent of cases were located in the foot, 8% with lymph node involvement and seventy eight of the 85 cases were of Breslow thickness > 4 mm. Fifty five cases were of Clark level V and 78% of Nodular variant. Prognostic features including ulceration, lymphocytic infiltration, significant mitotic activity, satellitosis and lymphovascular infiltration were present in 69%, 38%, 16%, 45% and 17% of cases respectively. Only three cases were amelanotic.

CONCLUSION

Melanoma in the Nigerians is predominantly of the nodular variant and located in the foot, is characterized by late presentation and is generally associated with adverse prognostic features.

Pathology of peripheral lymph node biopsies in Kane, Northern Nigeria

BACKGROUND

Lymphadenopathy is a common clinical problem here in Kano, Northern Nigeria but there has been no formal study. We therefore undertook this review to evaluate the pattern in our locality.

METHOD

This is a seven-year (1998-2004) retrospective review of all histologically diagnosed lymph node biopsies received at Aminu Kano Teaching Hospital, Kano.

RESULTS

Cervical, axillary and inguinal nodes were the most frequently biopsied accounting for 46%, 23% and 13%, while tuberculosis, lymphomas and metastases were the most commonly diagnosed lesions comprising 30%, 24% and 19% respectively. In general, benign lesions were more common constituting 57% of nodal biopsies. Lymphadenopathy was observed to be most prevalent in the first three decades.

CONCLUSION

Our findings were broadly similar to most other Nigerian studies and slightly at variance with other African countries but significantly different from the Western World. The limitations of lymph node histopathology in the absence of modern molecular diagnostic techniques are highlighted.

A review of medico-legal deaths in Kano

Medicolegal death (MLD) is a relatively uncommon subject of study in Nigeria. This prospective review of 200 cases in Kano found the commonest cause to be road traffic accidents (48.5%) followed by homicides (34%) and natural deaths (5%). Gang violence among local youths with blunt and sharp weapons accounted for most of the homicides. MLDs most frequently (60.5%) occurred in the 3rd to 5th decades of life and males were predominant (M:F = 3.5:1). Our findings differed significantly from MLDs in the developed world where natural deaths were overwhelmingly preponderant. The prevalence of MLDs in Kano can be substantially reduced if the recommendations of this study are implemented.