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.
Downloads
References
Global Burden of Disease Cancer Collaboration. Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived with Disability, and Disability-Adjusted Life-years for 32 Cancer Groups, 1990 to 2015: A Systematic Analysis for the Global Burden of Disease Study. JAMA Oncol. 2017;3(4):524–548. doi:10.1001/jamaoncol.2016.5688.
Wrensch M, Minn Y, Chew T, Bondy M, Berger MS. Epidemiology of primary brain tumours: current concepts and review of the literature. Neuro-oncology. 2002;4(4):278-299. doi:10.1093/neuonc/4.4.278.
Davis FG, McCarthy BJ. Current epidemiological trends and surveillance issues in brain tumours. Expert Rev Anticancer Ther 2001;1(3):395-401. doi:10.1586/14737140.1.3.395.
Ghanghoria S, Mehar R, Kulkarni CV, Mittal M, Yadav A, Patidar H. Retrospective histological analysis of CNS tumours –A 5-year study. Int J Med Sci Public Health. 2014;10(3):1205-1207. doi: 10.5455/ijmsph.2014.080720141.
Mollah N, Baki A, Afzal N, Hossen A. Clinical and pathological characteristics of brain tumor. Bangabandhu Sheikh Mujib Medical University J. 2010;3(2):68-71. doi:https://doi.org/10.3329/bsmmuj.v3i2.7054.
Rathod V, Bhole A, Chauhan M, Ramteke H, Wani B. Study of clinico-radiological and clinico-pathological correlation of intracranial space occupying lesion at rural center. Int J Neurosurg. 2009;7(1).
Komori T. The 2016 WHO Classification of Tumours of the Central Nervous System: The Major Points of Revision. Neurol Med Chir (Tokyo). 2017;57(7):301-311. doi:10.2176/nmc.ra.2017-0010
Yeole BB. Trends in the Brain cancer incidence in India. Asian Pac J Cancer Prev 2008;9(2):267-270.
Madabhushi V, Venkata RI, Garikaparthi S, Kakarala SV, Duttaluru SS. Role of immunohistochemistry in diagnosis of brain tumours: A single institutional experience. J NTR Univ Health Sci 2015; 4:103-111. doi: 10.4103/2277-8632.154262.
Butt ME, Khan SA, Chaudrhy NA and Qureshi GR. Intracranial Space occupying lesions – A morphological analysis. Biomedica. 2005;21:31-35.
Kothari F, Shah A. Prospective study of intra cranial tumour. SEAJCRR. 2014;3(5):918-932.
Kalyani D, Rajyalakshmi S, Sravan Kumar O. Clinicopathological study of posterior fossa intracranial lesions. J Med Allied Sci. 2014;4(2):62-68.
Sajjad M, Shah H, Khan ZASU. Histopathological pattern of intracranial tumors in a tertiary care hospital of Peshawar, Pakistan. J SZMC. 2015;7(1):909-912.
Aryal G. Histopathological pattern of central nervous system tumor: A three-year retrospective study. J Pathol Nepal 2011;1:22-25.
Katsura S, Suzui J, Wada T. A statistical study of brain tumours in the neurosurgical clinics in japan. J Neurosurg. 1959;16(5):570-580. doi:10.3171/jns.1959.16.5.0570
Verma RN, Subramanyam CSV, Banerjee AK. Intracranial neoplasms- pathological review of 283 cases. Indian J Pathol Microbiol. 1983;26(4):289-297.
Monga K, Gupta VK, Gupta S, Marwah K. Clinicopathological study and epidemiological spectrum of brain tumours in Rajasthan. Indian J Basic App Med Res. 2015;5(1):728-734.
Hema NA, Ravindra RS, Karnappa AS. Morphological Patterns of Intracranial Lesions in a Tertiary Care Hospital in North Karnataka: A Clinicopathological and Immunohistochemical Study. J Clin Diagn Res. 2016;10(8): EC01-EC05. doi: 10.7860/JCDR/2016/19101.8237
Anand A, Sonawane B, Titare P, Rathod P. Computed tomography evaluation of Intracranial space occupying lesions in adults. Int J Sci Study. 2014;2(9):47-52.
Chawla N, Kataria SP, Malik S, Sharma N, Kumar S. Histopathological spectrum of cns tumours in a tertiary care referral centre–A one-year study. Int J Basic App Med Sci. 2014;4(2):141-145.
Masoodi T, Gupta RK, Singh JP, Khajuria A. Pattern of central nervous system neoplasms: a study of 106 cases. JK-Practitioner. 2012;17(4):42-46.
Surawicz TS, Davis F, Freels S, Laws ER, Menck HR. Brain tumor survival: Results from the National Cancer Data Base. J Neuro-Oncology. 1998;40(2):151-160. doi:10.1023/a:1006091608586.
Lee CH, Jung KW, Yoo H, Park S, Lee SH. Epidemiology of primary brain and central nervous system tumors in Korea. J Korean Neurosurg Soc. 2010; 48(2):145-152. doi:10.3340/jkns.2010.48.2.145.
Jamjoom AB. Patterns of intracranial space occupying lesions: the experience at King Khalid Hospital. Ann Saudi Med. 1989;9(1):166-178. doi: https://doi.org/10.5144/0256-4947.1989.3.
Ayaz B, lodhi FR, Hassan M. Central nervous system tumours: a hospital based analysis. Pak Armed Forces Med J. 2011;61(1):61-64.