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

Abstract

Sujata Naik1, Nibedita Sahoo2, Bishwaranjan Mohanty3, Anasuya Lenka4, Ajit Surya Mohapatra,5 Prateek Das6, Prabhudutta Dash7

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.

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