A Five-Year Histopathological Review of CNS Tumours in a Tertiary Centre With Emphasis on Diagnostic Aspects of Uncommon Tumours

Abstract

BACKGROUND Tumours of central nervous system (CNS) are of varied histogenesis and show divergent lines of differentiation and morphological features. These tumours show specific predilection for age and sex groups, more commonly than of tumours of other systems. Though tumours of glial tissue are more common, other tumours of neural, ependymal and meningeal origin are not uncommon. Metastatic disease is the common encounter in elderly. Tumour diagnosis is not always straight forward as many non-neoplastic lesions and reactive proliferations mimic tumours. Immunohistochemistry may help in problematic cases and thus can be used as an adjuvant tool in the diagnosis of such cases in addition to the routine histopathological staining methods. An accurate histological diagnosis is of extreme importance in these sites as exact diagnosis helps in proper management and favourable clinical outcome. MATERIAL & METHODS This study is on a retrospective and prospective basis in our institution from January 2011 to January, 2016. Our institute is a tertiary care center attached to a medical college catering to the needs of a rural based population. During this period, a total of 717 central nervous system tumour specimens were received and diagnosed based on examination of Haematoxylin and Eosin stained sections of formalin fixed and paraffin embedded specimens. Immunohistochemical markers (IHC) were applied in selective cases for an accurate diagnosis and a number of rare cases were diagnosed based on morphology and IHC marker studies. RESULTS Age and sex incidence and anatomic distribution of various tumours were studied. In adults, meningiomas occurred most frequently in the present study followed by nerve sheath tumours, astrocytomas, metastatic deposits, glioblastomas and pituitary adenomas. Embryonal tumours occurred frequently in children. Other rare tumours identified are amyloidogenic pituitary adenoma, central neurocytoma, glioneuronal tumour with neuropil-like islands, ganglioglioma, large cell medulloblastoma, rhabdoid and secretory meningioma, immature teratoma and gliosarcoma. Grading of the tumours was done according to the revised World Health Organization criteria. CONCLUSION In this study, we discuss the process of establishing accurately the diagnosis of central nervous system tumours including spinal tumours, with emphasis on rare tumours encountered and how IHC helped in the diagnosis.

Histomorphological Spectrum of Central Nervous System Tumours- A Three-Year Retrospective Descriptive Study in a Tertiary Care Centre

“…The majority of CNS neoplasms are astrocytic tumours similar to other studies conducted by Jalai et al 7 and Javaria et al 8 but different from study conducted by Pidakala et al 9 The most malignant and frequent being glioblastoma multiforme, as also evidenced by our study. 10,11 In previous studies, incidence rates were higher for men.…”

Analysis of histopathological spectrum of intracranial central nervous system tumours in a tertiary care hospital

“…7,14 However, other studies by Mondal, Vimal et al, Hema et al, Kanthikar et al, Khonglah et al, Mehta et al, Pidakala et al showed higher percentage of schwannomas ranging from 6.1 to 18.05%. 5,6,9,11,13,16,23 In our study meningiomas showed slight female preponderance similar to that of studies by Vimal, Jaiswal et al, Khonglah et al, Mohammad et al and Mehta et al while Hamdani et al showed male dominance. 5,7,9,13,14,16 Meningothelial meningioma was the commonest type in this study as previously noted by Vimal et al 13 Glioblastoma were commonest astrocytoma with 57.58% of total astrocytoma.…”

“…5,13 Frontal and the fronto-parietal lobe (16 cases each) were the commonest location for the tumours in our study. 5,9,[12][13][14]23 Sumathi et al and Lakshmi et al found parietal lobe being common followed by frontal lobe. 21,8 Out of total cases, supratentorial tumours were common (75.25%).…”

Prevalence of primary CNS tumors in a diagnostic setup in Nairobi, Kenya

“…Other studies have shown similar data with occasional study showing astrocytomas to be more common. 1,2,8,19 Research has shown multiple genetic and environmental risk factors for meningiomas. Genetically, it is known to be associated with neurofibromatosis type II and multiple endocrine neoplasia type I.…”

“…CNS tumors diagnosis is often difficult as general pathologist lack experience and non-neoplastic processes mimic tumors and primary needs to be differentiated from secondaries. [1][2][3][4] The most prevalent primary CNS tumors in adults are astrocytic tumors followed by meningiomas. Numerous classifications have been put forth to classify tumors since 1979, which was based on light microscopy.…”