Histopathological Spectrum of Central Nervous System Lesions in a Tertiary Care Hospital in Eastern India

Abstract

BACKGROUND Tumours of central nervous system (CNS) are reported to be less than 2 % of all malignancies. In India, CNS tumours constitute about 1.9 % of all tumours. The CNS space occupying lesions cause grave life-threatening outcomes irrespective of their nature as they grow in a confined space and are present close to vital structures. Hence, it is of great importance to establish the accurate diagnosis for proper and timely neurosurgical intervention. METHODS This was a retrospective study carried out in a tertiary care teaching hospital which caters as a referral unit for neurosurgical cases in Eastern India, for a duration of one and half year (January 2018 - July 2020) among 185 cases of CNS lesions collected from archives of Department of Pathology. The tumours were reclassified and graded according to the most recent World health organisation (WHO) classification of CNS tumours (2016). RESULTS Neoplastic lesions (168 cases, 91.35 %) were commoner than non-neoplastic entities and amongst the neoplastic lesions, meningioma was the commonest entity followed by diffuse astrocytic and oligodendroglial tumours while least incidence was noted for neuronal and mixed neuronal glial tumours. Out of all the tumours for which World Health Organization (WHO) grading was done, highest was WHO grade I (80 cases, 54.8 %) and least was grade III tumours (10 cases, 6.8 %). Male predominance was seen overall except in meningioma. Some rare and interesting cases like solitary fibrous tumour / hemangiopericytoma (anaplastic type), primary CNS diffuse large B cell lymphoma (DLBCL), CNS plasmacytoma which we came across are also highlighted. CONCLUSIONS The present study helps to provide information regarding the disease burden in our area. This study attempts to categorise various CNS neoplasms as per recent WHO classification (2016) which has not only diagnostic implication but also has significant prognosis and predictive value. KEYWORDS Central Nervous System, Immunohistochemistry, Eastern India, Meningioma, Solitary Fibrous Tumour / Hemangiopericytoma, Diffuse Large B Cell Lymphoma

Piecing Together a Puzzle of Exceptional Lesions: A Retrospective Study of a Potpourri of 160 Space-Occupying Lesions of the Central Nervous System

“…Out of the 160 CNS lesions, neoplastic outnumbered the non-neoplastic lesions. Other studies in India conducted by Khonglah et al and Naik et al showed 86.13% versus 13.87% and 91% versus 9% distribution of lesions of neoplastic versus non-neoplastic pathology, respectively [ 2 , 5 , 6 ].…”

“…In our study, astrocytoma was the most common tumor followed by meningioma, a finding in concordance with those of Khonglah et al, Agarwal et al, and Aryal [ 2 , 5 , 9 ]. However, various studies across India have reported meningioma to be the commonest tumor followed by astrocytoma [ 6 , 7 ]. Other frequently diagnosed tumors in our study were pituitary adenoma, schwannoma, and oligodendroglioma.…”