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RETROSPECTIVE STUDY OF LESIONS OF CENTRAL NERVOUS SYSTEM IN A TERTIARY CARE HOSPITAL
Abstract
The aim of our study was to establish the relative frequency of biopsy proven tumors of central nervous system (CNS). One hundred and twenty (120) CNS Biopsy specimens were studied in a two year period. Out of 120 CNS tumors, 103 were primary, 17 were metastatic. Among 17 metastatic tumors, the most common histological type is adenocarcinoma. The most frequent type of CNS tumour was astrocytoma followed by meningioma.
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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.
Background: Central nervous system (CNS) tumor are considered as most notorious in all types of cancers. Incidence of CNS tumors in developing countries is lower as compared to developed countries, but increased rate has been observed in both. The aim of the study was to highlight the incidence and histological spectrum of CNS tumors in our region. To diagnose and classify brain tumours according to WHO 2007 classification. Material and Methods: This retrospective histopathological analysis of brain tumors was carried out in department of Pathology from January 2014 to December 2015. During this period, a total of 38 neurosurgical specimens were received in department. The specimens were processed by routine histotechniques and immunohistochemistry was performed whenever required. The diagnosed brain tumor studied and classified according to WHO classifications. Results: Among 38 cases, tumours of meningeal tissue (40%) were commonest followed by neuroepithelial tissue (34%). Cranial and spinal nerve sheath tumour (18%) and rarely metastatic tumours (5.3%) were encountered. Tumours were seen in all age groups but mean age group affected was 41-50 years accounting for 14 (36.8%) cases. Male to female ratio of 0.81:1.22 was noted with female preponderance. Conclusion: The present study helps to provide information regarding the burden of disease in our area. Despite the use of modern imaging technique that helps in provisional diagnosis of disease, histological examination is gold standard in diagnosis of varied types. Further utility of immunohistochemistry aids in confirmation and prognosis of disease.
Background: There is no documented data regarding the histopathological spectrum of the central nervous system (CNS) tumors in Nepal. The aim of this study was to establish the relative frequency of biopsy proven tumors of the CNS from a single university hospital in Nepal. Materials and Methods: In the period between1998-2000, we retrospectively analyzed data on 57 patients (28 male and 29 female) diagnosed with CNS tumors according to the World Health Organization’s diagnostic criteria. Patient data were retrieved from the archives of the department of Pathology, Nepal Medical College. Results: A total of 57 CNS tumors were diagnosed during a three year period. Of these, 49 (86%) were primary, and 8 (14%) were metastatic. The most frequent type of CNS tumors was astrocytoma (22 cases, 38.6%), followed by meningioma (8 cases, 14%) and metastatic tumor (8 cases, 14%). Among the 8 metastatic tumors, the most common histologic type was adenocarcinoma (7 cases, 87.5%). Conclusion: The most frequent type of CNS tumors in this study was astrocytoma, followed by meningioma and metastatic tumor. The ratio of male to female for all CNS tumors was 0.9:1. Female outnumbered male in meningioma (1:0.3). Keywords: Astrocytoma; Meningioma; Tumor; Nepal; Central nervous system DOI: 10.3126/jpn.v1i1.4445 Journal of Pathology of Nepal (2011) Vol.1, 22-25
WHO Classification of Tumours of the Central Nervous System from the 2007 is distinguished from the previous 2000 classification by a few conceptual modifications, changes in the terminology and seven newly codified tumour entities. The text shows a short comparison of both classifications emphasising the most important changes from the surgical neuropathology point of view. The newly codified entities are: angiocentric glioma, pilomyxoid astrocytoma, papillary glioneuronal tumor, rosette-forming glioneuronal tumor of the 4th ventricle, papillary tumour of the pineal region, spindle cell oncocytoma and pituicytoma. Mostly, they are rare tumours already known from the literature. Based on new knowledge from the molecular pathology the paragraphs about tumour genetics were markedly changed. The complexity and diversity of tumours of the nervous system is enormous, and, not surprisingly, some problematic questions of classification and grading remain unresolved.
This special issue contains 18 articles describing population-based analyses of incidence and survival for cancer among children and adolescents in Europe over the period 1978-1997. The analyses were derived from the large database of the ACCIS project (Automated Childhood Cancer Information System), which was built through collaboration of 62 population-based cancer registries in 19 European countries. Data on 88,465 cancers in children and 15,369 in adolescents (age 15-19 yrs) were included in the various analyses, making this the largest database on cancer in these age-groups in the world. National data were grouped into five European regions to allow comparisons of incidence and survival, for all cancers and by tumour type, including analysis of trends in both over time. This overview paper focuses on the comparability of the data from multiple registries and describes the potential confounding factors. Age-standardised annual incidence rates of many, but not all, cancers in children and adolescents are clearly rising. There are geographical differences in survival for the majority of tumour types. Survival rates increased for nearly all types of cancer in children and adolescents. The implications of these findings for aetiological factors and treatment delivery for cancer in children and adolescents are discussed.
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