Research Articles (Anatomical Pathology)http://hdl.handle.net/2263/25922024-03-28T14:46:35Z2024-03-28T14:46:35ZRenal papillary necrosis (RPN) in an African population : disease patterns, relevant pathways, and managementGaudji, Guy RogerBida, M.Conradie, MariusDamane, Botle PreciousBester, Meganhttp://hdl.handle.net/2263/951912024-03-13T22:50:18Z2023-01-01T00:00:00ZRenal papillary necrosis (RPN) in an African population : disease patterns, relevant pathways, and management
Gaudji, Guy Roger; Bida, M.; Conradie, Marius; Damane, Botle Precious; Bester, Megan
Renal papillary necrosis (RPN) is characterized by coagulative necrosis of the renal
medullary pyramids and papillae. Multiple conditions and toxins are associated with RPN. Several
RPN risk factors, or POSTCARDS, have been identified, with most patients presenting with RPN
having at least two contributing risk factors. Currently, there is no specific test to diagnose and
confirm RPN; however, several imaging tools can be used to diagnose the condition. RPN is currently
underdiagnosed in African populations, often with fatal outcomes. In African clinical settings, there
is a lack of consensus on how to define and describe RPN in terms of kidney anatomy, pathology,
endourology, epidemiology, the identification of African-specific risk factors, the contribution of
oxidative stress, and lastly an algorithm for managing the condition. Several risk factors are unique to
African populations including population-specific genetic factors, iatrogenic factors, viral infections,
antimicrobial therapy, schistosomiasis, substance abuse, and hypertension (GIVASSH). Oxidative
stress is central to both GIVASSH and POSTCARDS-associated risk factors. In this review, we present
information specific to African populations that can be used to establish an updated consensual
definition and practical grading system for radiologists, urologists, nephrologists, nuclear physicians,
and pathologists in African clinical settings.
2023-01-01T00:00:00ZProfile of human papillomavirus genotypes in breast and oesophageal cancer patients in Pretoria, South AfricaMaroga, N.Mokoena, TaoleMusekiwa, AlfredBida, MeshackKgomo, Mpho K.Lebelo, R.http://hdl.handle.net/2263/942012024-01-31T22:48:05Z2023-07-01T00:00:00ZProfile of human papillomavirus genotypes in breast and oesophageal cancer patients in Pretoria, South Africa
Maroga, N.; Mokoena, Taole; Musekiwa, Alfred; Bida, Meshack; Kgomo, Mpho K.; Lebelo, R.
BACKGROUND : The association between human papillomavirus (HPV) and cervical cancer is well established, and cervical cancer can be prevented through HPV vaccination. Little has been reported on the association between HPV and breast carcinoma (BC) or oesophageal squamous cell carcinoma (OSCC) in Africa. It is possible that use of appropriate HPV vaccines against genotypes responsible for these cancers may also prevent their development. OBJECTIVES : To investigate HPV genotype prevalence in BC and OSCC patients in Pretoria, South Africa (SA). METHODS : A retrospective cross-sectional study of BC and OSCC patients managed at Steve Biko Academic Hospital from 2015 to 2019 was undertaken. Patient medical records were analysed, and DNA was extracted from their archived pathology material and amplified by polymerase chain reaction before hybridisation for HPV genotypes. RESULTS : There were 101 patients with BC and 50 with OSCC. The prevalence of HPV infection in BC patients was 77.2%, with 35.6% highrisk (HR) genotypes, and that in OSCC patients 90.0%, with 56.0% HR genotypes. The most prevalent HPV genotypes (>20% each) were HPV 16, 70 and 51 for BC and HPV 51, 70, 16 and 82 for OSCC, with 31.7% and 60.0% of patients, respectively, having co-infection with ≥2 genotypes. CONCLUSION : The high prevalence of infection with multiple HPV genotypes in BC and OSCC patients, with HPV 16, 51, 70, 35 and 82 the most common genotypes in these cancers, warrants expansion of the current SA bivalent HPV 16/18 vaccine for girls to include boys, and inclusion of HPV 51, 70, 35 and 82, in order to prevent BC and OSCC as well as cervical cancer.
2023-07-01T00:00:00ZSuperficial spreading cervical squamous cell carcinoma in situ with extensive endomyometrial infiltration masquerading as a primary endometrial cancerOlivier, H.J.Snyman, Leon CorneliusOliva, E.Slavik, Tomashttp://hdl.handle.net/2263/933262023-11-16T22:49:39Z2022-12-01T00:00:00ZSuperficial spreading cervical squamous cell carcinoma in situ with extensive endomyometrial infiltration masquerading as a primary endometrial cancer
Olivier, H.J.; Snyman, Leon Cornelius; Oliva, E.; Slavik, Tomas
The presence of squamous cell carcinoma (SCC) on endometrial histology raises the possibility of a primary endometrial carcinoma, as well as secondary endometrial involvement by SCC from another site, especially the cervix. This distinction relies on numerous cardinal clinical and pathologic findings and may occasionally be problematic. We document an unusual tumour in a postmenopausal woman who presented with clinical and radiologic features of a primary endometrial cancer, confirmed on endometrial histology as a keratinising SCC. Subsequent pathologic evaluation of the hysterectomy specimen, however, demonstrated an exclusively in situ cervical SCC, with extensive endometrial intramucosal spread and widespread infiltration of the myometrium, macroscopically mimicking a primary endometrial neoplasm. We review the pathologic distinction between primary endometrial SCC and secondary corpus involvement of cervical SCC, as well as the broader differential diagnosis when SCC is identified on endometrial histology.
2022-12-01T00:00:00ZNew horizons in the diagnosis of tuberculosis of the spine : the role of whole genome sequencingNgcelwane, M.V. (Mthunzi)Omar, Shaheed V.Said, H.M. (Halima Mohammed)Bida, Nndweleni Meshackhttp://hdl.handle.net/2263/932132023-11-09T22:49:14Z2023-06-01T00:00:00ZNew horizons in the diagnosis of tuberculosis of the spine : the role of whole genome sequencing
Ngcelwane, M.V. (Mthunzi); Omar, Shaheed V.; Said, H.M. (Halima Mohammed); Bida, Nndweleni Meshack
STUDY DESIGN : Prospective study.
PURPOSE : To evaluate the utility of whole genome sequencing (WGS) in drug resistance testing, lineage of the organisms, and organism-related factors responsible for bacilli settling in the spine.
OVERVIEW OF LITERATURE : The workstream for the diagnosis of tuberculosis (TB) involves isolation and culture of the organism and drug resistance testing using phenotypic methods. Xpert MTB/RIF Ultra is a genetic-based method that detects for Mycobacterium tuberculosis DNA in the rpoB gene. Meanwhile, WGS is a newer genetic-based method that assesses the whole genome of the bacterium. Very few studies have reported the use of WGS for extrapulmonary TB. Herein, we used WGS to diagnose spinal TB.
METHODS : Tissues from 61 patients undergoing surgery for spinal TB underwent histologic examination, Xpert MTB/RIF Ultra, and culture and sensitivity testing. DNA from the cultured bacteria was sent for WGS. The test bacterial genome was compared to a reference strain of pulmonary TB.
RESULTS : Acid-fast bacilli were observed in 9/58 specimens. Meanwhile, histology confirmed TB in all the patients. Bacilli were cultured in 28 patients (48.3%), and the average time to culture was 18.7 days. Xpert MTB/RIF Ultra was positive in 47 patients (85%). WGS was performed in 23 specimens. Overall, 45% of the strains belonged to lineage 2 (East Asian). There was one case of multidrug-resistant TB and two cases of non-tuberculous mycobacteria on WGS. We could not confirm any genomic difference between pulmonary and spinal TB strains.
CONCLUSIONS : Xpert MTB/RIF Ultra of tissues or pus is the investigation of choice when diagnosing spinal TB. Meanwhile, WGS can diagnose multidrug-resistant TB and non-tuberculous mycobacteria more accurately. No mutations were identified in spinal and pulmonary TB bacteria.
2023-06-01T00:00:00Z