CONTRIBUTIONS OF
IBADAN TO THE
DEVELOPMENT OF
PATHOLOGY IN THE
TROPICS
Prof. EEU Akang
FMCPath, FWACP
INAUGURAL
LECTURE
27...
“I returned, and saw under the
sun, that the race is not to the
swift, nor the battle to the
strong, neither yet bread to
...
PATHOLOGY?
Pathology is the clinical
diagnostic science that
underpins patient care
(Royal College of
Pathologists, 2006)
PATHOLOGY?

Histopathology, Chemical
Pathology, Haematology
and Medical Microbiology
Histopathology- includes
cytopatholog...
DEATH AND
DYINGPERSPECTIVES OF
DISEASE
Prof. AA Abioye
PhD, FMCPath,
FWACP
INAUGURAL LECTURE
THE LADY AND THE
LOOKING GLASSBREAST CANCER IN
NIGERIAN WOMEN
Prof. PU Aghadiuno
MD, FRCPath,
FMCPath, FWACP
INAUGURAL LEC...
HEADS OF PATHOLOGY
WD SILVERA
 BGT ELMES
 GM EDINGTON
 AO WILLIAMS
 BO OSUNKOYA
 AA ABIOYE
 TA JUNAID
 PU AGHADIUNO...
CONTRIBUTIONS OF
IBADAN TO THE
DEVELOPMENT OF
PATHOLOGY IN THE
TROPICS
Prof. EEU Akang

FMCPath, FWACP
INAUGURAL
LECTURE
DEFINITIONS
NEOPLASM- new growth
 TUMOUR- swelling
An
abnormal
mass
produced
by
autonomous, uncontrolled, purposeless
pro...
DEFINITIONS
TERATOMA( τερατοσ
(Gr.)monster)
Tumour that originate s from germ
cells displaying derivatives of three
germ l...
TERATOMA-

MACROSCOPIC
APPEARANCE
HISTORY OF TERATOMA
Ancient Babylon
(2000 BC)

Records on cuneiform
tablets

Scultetus (1659)

Earliest medical record of
...
TERATOMA-

MICROSOCOPIC
APPEARANCE
S IT E A N D S EX D IS T R IB UT IO N O F T ER A T O M A S
A ka ng e t a l, 1994
O the r

6
1
4
0
8
8
0

C he s t
T e s ti...
A G E A N D S EX D IS T R IB UT IO N O F T ER A T O M A S
A ka ng e t a l, 1994
2

70- 79

0

60- 69

0

50- 59

1

40- 49...
CHILDHOOD TERATOMA
IN IBADAN-

Akang EE et al: Hum Pathol 1992

Bimodal peak age incidence
 Female: male ratio = 5:1
 Sa...
RETINOBLASTOMA IN IBADANAjaiyeoba et al: Afr J Med Med Sci 1993








Malignant embryonal childhood
intraocular neop...
CHILDHOOD MORTALITY IN
IBADANAkang EE et al:
Nig J Paediatr 1992; 19:30-36

Bronchopneumonia, meningitis,
gastroenteritis
...
PAEDIATRIC
PATHOLOGY


Congenital malformations
(Pediatr Pathol 1993; 13:659-70)



Childhood cancer (Pediatr
Pathol Lab...
BURKITT’S LYMPHOMA


Declining incidence

in Ibadan
Okpala et al 1991;
Akang 1996;
Ojesina et al 2002;
NEUROPATHOLOGY




Malomo et al 1990- Report
of a case of cerebral
coenurosis- Trop Geogr
Med
Ibadan-Indianapolis
NEUROPATHOLOGY






Osuntokun et al 1994- Low incidence
of plaques and tangles in elderly
Africans- Lancet
Park et al ...
IBADAN PATHOLOGISTSContributions










Practising pathologists at every level
in the country and in the Diaspor...
M E D L IN E T OT A L A N D P A T HOL OG Y C IT A T ION S

900000
800000
70 0 0 0 0
600000
50 0 0 0 0
400000
300000
200000...
MEDLINE PATHOLOGY CITATIONS
3500
3000
2500
2000
1500
1000
500
0
M ED LIN E T O T A L A N D P A T H O LO G Y C IT A T IO N S
3000
2500
2000
1500
1000
500
0

T OT AL
P A T HO LO G Y
George Millar Edington
Co-author of Pathology in the
Tropics
 Started professional career in
Ghana (1950-1960)
 In Ibada...
Akin Olufemi Williams
One of most prolific African
Pathologists
 First Nigerian Head of Pathology
 Established Pathology...
Babatunde O. Osunkoya


Burkitt’s lymphoma

Ayinla A. Abioye



Amoebiasis
First inaugural lecture

Ed ‘B Attah



Tr...
T. Abisogun Junaid


Gynaecological pathology

Patrick U. Aghadiuno




Breast cancer
Second inaugural lecture

Jaiyeol...
FUTURE DIRECTIONS


Gastrointestinal and liver
pathology



Breast and cervical cancer



Soft tissue and skin tumours
...
“ It is not so much

as what Nigeria
can do for you
as what you can
do for Nigeria ”
ACKNOWLEDGMENTS









My parents
My siblings
My teachers
My students
My friends and brethren in Christ
Patholog...
FINIS
“Therefore let us also, seeing we
are surrounded by so great a
cloud of witnesses, lay aside
every weight and the si...
Inaugural lecture
Inaugural lecture
Inaugural lecture
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Inaugural lecture

  1. 1. CONTRIBUTIONS OF IBADAN TO THE DEVELOPMENT OF PATHOLOGY IN THE TROPICS Prof. EEU Akang FMCPath, FWACP INAUGURAL LECTURE 27 July 2007
  2. 2. “I returned, and saw under the sun, that the race is not to the swift, nor the battle to the strong, neither yet bread to the wise, nor yet riches to men of understanding, nor yet favour to men of skill; but time and chance happeneth to them all.” Eccl. 9:11, KJV
  3. 3. PATHOLOGY? Pathology is the clinical diagnostic science that underpins patient care (Royal College of Pathologists, 2006)
  4. 4. PATHOLOGY? Histopathology, Chemical Pathology, Haematology and Medical Microbiology Histopathology- includes cytopathology, forensic pathology, oral pathology, neuropathology and
  5. 5. DEATH AND DYINGPERSPECTIVES OF DISEASE Prof. AA Abioye PhD, FMCPath, FWACP INAUGURAL LECTURE
  6. 6. THE LADY AND THE LOOKING GLASSBREAST CANCER IN NIGERIAN WOMEN Prof. PU Aghadiuno MD, FRCPath, FMCPath, FWACP INAUGURAL LECTURE
  7. 7. HEADS OF PATHOLOGY WD SILVERA  BGT ELMES  GM EDINGTON  AO WILLIAMS  BO OSUNKOYA  AA ABIOYE  TA JUNAID  PU AGHADIUNO  JO THOMAS  JO OGUNBIYI 
  8. 8. CONTRIBUTIONS OF IBADAN TO THE DEVELOPMENT OF PATHOLOGY IN THE TROPICS Prof. EEU Akang FMCPath, FWACP INAUGURAL LECTURE
  9. 9. DEFINITIONS NEOPLASM- new growth  TUMOUR- swelling An abnormal mass produced by autonomous, uncontrolled, purposeless proliferation of cells derived from a single cell in which mutations have occurred. May be benign (harmless) or malignant (CANCER) 
  10. 10. DEFINITIONS TERATOMA( τερατοσ (Gr.)monster) Tumour that originate s from germ cells displaying derivatives of three germ layers (endoderm, ectoderm and mesoderm) 
  11. 11. TERATOMA- MACROSCOPIC APPEARANCE
  12. 12. HISTORY OF TERATOMA Ancient Babylon (2000 BC) Records on cuneiform tablets Scultetus (1659) Earliest medical record of teratoma Calbet (1893) Escape of primordial cells from growth control Meckel (1880) Foetus in foetu (theory of suppressed second twin) Bosaeus (1926) Parthenogenesis
  13. 13. TERATOMA- MICROSOCOPIC APPEARANCE
  14. 14. S IT E A N D S EX D IS T R IB UT IO N O F T ER A T O M A S A ka ng e t a l, 1994 O the r 6 1 4 0 8 8 0 C he s t T e s ti s Ne c k Sa c r um 4 Ovar y 15 FE MA LE MA LE 22 342 0 0 50 100 150 200 250 Numbe r of c a s e s 300 350 400
  15. 15. A G E A N D S EX D IS T R IB UT IO N O F T ER A T O M A S A ka ng e t a l, 1994 2 70- 79 0 60- 69 0 50- 59 1 40- 49 8 11 31 3 30- 39 FE MA LE 1 20- 29 5 33 1 0- 9 44 12 0 MA LE 69 3 10- 19 77 20 40 60 Numbe r of c a s e s 80 100
  16. 16. CHILDHOOD TERATOMA IN IBADAN- Akang EE et al: Hum Pathol 1992 Bimodal peak age incidence  Female: male ratio = 5:1  Sacrococcyx and ovary are 2 most common sites  81% mature; 15% immature; 4% malignant 
  17. 17. RETINOBLASTOMA IN IBADANAjaiyeoba et al: Afr J Med Med Sci 1993     Malignant embryonal childhood intraocular neoplasms displaying retinal differentiation More common in developing countries Worse outcome in younger patients Dismal outcome in Nigerian children
  18. 18. CHILDHOOD MORTALITY IN IBADANAkang EE et al: Nig J Paediatr 1992; 19:30-36 Bronchopneumonia, meningitis, gastroenteritis  Tuberculosis, measles, malaria  Most deaths preventable  High perinatal death toll (pregnancy and early childhood problems) 
  19. 19. PAEDIATRIC PATHOLOGY  Congenital malformations (Pediatr Pathol 1993; 13:659-70)  Childhood cancer (Pediatr Pathol Lab Med 1996; 16:791800)
  20. 20. BURKITT’S LYMPHOMA  Declining incidence in Ibadan Okpala et al 1991; Akang 1996; Ojesina et al 2002;
  21. 21. NEUROPATHOLOGY   Malomo et al 1990- Report of a case of cerebral coenurosis- Trop Geogr Med Ibadan-Indianapolis
  22. 22. NEUROPATHOLOGY    Osuntokun et al 1994- Low incidence of plaques and tangles in elderly Africans- Lancet Park et al 1997- Report of a case of subacute sclerosing panencephalitisAm J Ophthalmol Ogunniyi et al 2002- Lewy body disease case report- Int Psychogeriatr
  23. 23. IBADAN PATHOLOGISTSContributions        Practising pathologists at every level in the country and in the Diaspora A former State governor Acting Vice Chancellors Provosts Deans Vice Deans Professors of Pathology, both at home and abroad.
  24. 24. M E D L IN E T OT A L A N D P A T HOL OG Y C IT A T ION S 900000 800000 70 0 0 0 0 600000 50 0 0 0 0 400000 300000 200000 10 0 0 0 0 0 T OT A L P A T HOL OG Y
  25. 25. MEDLINE PATHOLOGY CITATIONS 3500 3000 2500 2000 1500 1000 500 0
  26. 26. M ED LIN E T O T A L A N D P A T H O LO G Y C IT A T IO N S 3000 2500 2000 1500 1000 500 0 T OT AL P A T HO LO G Y
  27. 27. George Millar Edington Co-author of Pathology in the Tropics  Started professional career in Ghana (1950-1960)  In Ibadan (1960-1976)  Zaria  Maiduguri (Acting ViceChancellor) 
  28. 28. Akin Olufemi Williams One of most prolific African Pathologists  First Nigerian Head of Pathology  Established Pathology in Calabar  Ambassador to OAU  Laboratory of Molecular Virology at NIH 
  29. 29. Babatunde O. Osunkoya  Burkitt’s lymphoma Ayinla A. Abioye   Amoebiasis First inaugural lecture Ed ‘B Attah   Tropical pathology, cardiac pathology Zaria, Calabar
  30. 30. T. Abisogun Junaid  Gynaecological pathology Patrick U. Aghadiuno   Breast cancer Second inaugural lecture Jaiyeola O. Thomas-Ogunniyi  Renal pathology, cytology and lymphoma J. Olufemi Ogunbiyi  Liver pathology, hypertension and prostate cancer
  31. 31. FUTURE DIRECTIONS  Gastrointestinal and liver pathology  Breast and cervical cancer  Soft tissue and skin tumours  Forensic pathology  Renal pathology
  32. 32. “ It is not so much as what Nigeria can do for you as what you can do for Nigeria ”
  33. 33. ACKNOWLEDGMENTS         My parents My siblings My teachers My students My friends and brethren in Christ Pathology Department co-workers My collaborators My wife and children
  34. 34. FINIS “Therefore let us also, seeing we are surrounded by so great a cloud of witnesses, lay aside every weight and the sin which so easily entangles us, and let us run with patience the race that is set before us” Hebrews 12:1, KJV

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