Superficial malignant neoplasms in southwestern Ethiopia: a cytopathological approach.

The aim of this study was to describe the distributions of superficial malignant neoplasms diagnosed by fine-needle aspiration cytology (FNAC). A prospective cross-sectional study was conducted within the Jimma Teaching Hospital, Pathology Department, Jimma University during the years between September 1998 and August 2002. Cases fulfilling cytopathological evidences of superficial malignancies were included whereas deep-seated malignancies were excluded from the study. An air-dried smear stained with the Wright staining procedure was utilized for the FNAC diagnostic technique. A total of 3,200 cases were investigated during the study period where 267 (8.3%) cases were of primary superficial malignant neoplasms, with 98 cases in the peak age group of 40-59 yr (36.7%) and a median age of 38.0 yr (range, 0.2-88 yr). The most frequent superficial cytodiagnosis was breast carcinoma, 79 (29.6%) cases; followed by non-Hodgkin's lymphomas, 37 (13.9%) cases; and soft tissue sarcomas, 26 (9.7%) cases. The overall male-to-female ratio showed preponderance to female patients (1:1.3). Carcinomas were identified more frequently in those >40 yr of age whereas sarcomas were identified in those <40 yr of age (P > 0.05). The most common malignant neoplasm in women was breast carcinomas found in 74 (27.7%) cases, whereas in men non-Hodgkin's lymphomas were found in 29 (10.9%) cases. Large proportions of carcinomas (88 cases, 33.0%), lymphomas (33 cases, 12.4%), and sarcomas (20 cases, 7.5%) were detected on the trunk, head, and neck, as well as on the lower limb regions, respectively. This study uncovered different types of superficial malignant neoplasms that are prevalent in the southwestern part of Ethiopia. The most common types of cytodiagnoses such as breast carcinomas, etc. may suggest that attention be given to future high-caliber prospective studies in trying to identify some of the associated strong risk factors for the disease under study. This study may be helpful to local health planners in prioritizing some of the commonest malignancies. Some of the diagnostic challenges of lymphomas and thyroid follicular lesions were shown also. This investigation is the first in Ethiopia and therefore may act as baseline data for similar studies in the future.