Histopathological spectrum of central nervous system lesions

Abstract

Introduction: Central nervous system (CNS) neoplasms, in India, constitute 1.9% of all cancers and in U.S. adults-2% of all cancers. Many of the non-neoplastic CNS lesions can clinically & radiologically simulate brain tumours. In such cases, histopathological examination (HPE) can be helpful in differentiating between neoplastic and non-neoplastic etiologies. Materials and Methods: This retrospective descriptive study of histopathological analysis of brain tumours was carried out in TMMC&RC, Department of Pathology from January 2015 to December 2018. The biopsies were processed by routine histological techniques and H&E stained sections were analyzed. Special stains and IHC were performed wherever appropriate. The diagnosed brain tumours were classified according to WHO 2016 classification system. Results: A total of 96 CNS biopsies were studied. The neoplasms constituted 62 (64.6%) cases, which included 60 (96.8%) primary, 1 (1.6%) metastatic and 1 miscellaneous lesion (1.6%). The 3 most common primary tumours were Astrocytic tumours, Schwannomas and Meningiomas. About 34(35.4%) cases were non neoplastic out of which the 2 most common lesions were: Cystic Lesions and non-specific inflammation. Patients' age ranged from 5 days to 80 years. The ratio of number of male and female patients was 1:1.67. IHC for Glial Fibrillary Acidic Protein (GFAP) was positive in astrocytomas and mixed neuronal-glial tumours. Conclusion: The present study provides information regarding the spectrum and frequency of various CNS lesions in our area and concludes that histological examination of biopsies is gold standard for accurate diagnosis of various lesions of CNS when coupled with radiological and clinical data.

Histomorphological spectrum of intracranial space occupying lesions: Experience at tertiary care centre

“…1,9,11,14,15 250 cases (96%) were of primary tumour and 11 cases (4%) were of metastatic deposits. These findings were in agreement with studies by Hema et 2,6,11,12,14,16,17,20,22 Out of 261 neoplastic ICSOLs, majority belonged to gliomas (48%) followed by meningiomas (20%) and schwannomas (9%). (Table 4 2,9,11,14,15,17,20,23 In case of meningiomas our findings were in agreement with studies by Khonglah et 11,12,[14][15][16]18,23 Studies by Pachori et al (42.8%) and Kaki RR et al (32%) reported higher percentage of meningiomas.…”

“…These findings were in agreement with studies by Hema et 2,6,11,12,14,16,17,20,22 Out of 261 neoplastic ICSOLs, majority belonged to gliomas (48%) followed by meningiomas (20%) and schwannomas (9%). (Table 4 2,9,11,14,15,17,20,23 In case of meningiomas our findings were in agreement with studies by Khonglah et 11,12,[14][15][16]18,23 Studies by Pachori et al (42.8%) and Kaki RR et al (32%) reported higher percentage of meningiomas. 10,17 Studies by Hema et al (14%), Butt et al (12%), Adnan et al (8.6%), Kaki RR et al (6%), Datta et al (6.5%), Lakshmi et al (5.5%) and Kothari et al (6%) showed similar distribution of schwannomas as in present study.…”

“…2,14,15,17,18,20,23 A higher percentage of schwannomas was noted in studies by Khonglah et al (18.04%), Shihora et al (21.57%) and Joshi et al (22.6%). 11,12,16 Amongst gliomas, in our study the most common type was glioblastoma (41.1%) followed by astrocytomas (18%). Our findings were concordant with studies by Masoodi et al, Pachori et al, Khonglah et al, Adnan et al, Thambi et al and Kakshapati et al 8,10,11,15,21,24 68.6% of glioblastomas belonged to age group 31-60 years.…”

“…Jamjoom et al, Hema et al, Shihora et al, and Joshi et al reported 6.6%, 6.5%, 3.07% and 8.3% of abscesses respectively, out of all ICSOLs. 1,2,12,16 1.54%, 3.1%, 2.27% of epidermoid cysts out of all ICSOLs were observed in studies by Shihora et al, Joshi et al and Sunila et al respectively. 12,16,27 In present study, 55 cases (18.33%) belonged to paediatric age group.…”

“…The present study is an attempt to assess the histomorphological spectrum of ICSOLs at a tertiary The male to female ratio was 1. 2,8,11,13,[16][17][18] Out of total 300 cases, 220 cases (73%) were located supratentorially and 80 cases (27%) infratentorially. These findings were seen to correspond with studies by Jamjoom et al, Masoodi et al, Pachori et al and Kaki RR et al 1,8,10,17 In supratentorial compartment, majority (19.7%) of cases showed multiple lobe involvement followed by 48 cases (16%) involving frontal lobe.…”