Cystic hygroma (lymphangioma) is a benign congenital malformation of the lymphatic system that occurs in infants and children younger than two years of age. It is rarely seen in adults. Occurrence in adults is uncommon, and only few cases of adult lymphangioma have been reported in the literature. Here we present a rare case of cystic hygroma in a 52 year old patient who presented with a swelling in the neck. Computed tomography revealed presence of cystic masses in the lesion. After total excision of the mass, histopathological diagnosis of cystic lymphangioma was made. After an uneventful postoperative period patient was discharged. No recurrence has occurred since then. This case report discusses the differential diagnoses and up-to-date management of cystic hygroma in adults. The objectives of this report are to discuss about the clinical presentation, diagnosis, pathologic findings and management of this malformation.
Rhabdoid meningioma is a rare subtype of meningiomas accounting for 1-3% of all intracranial meningiomas and classified as WHO Grade III tumor. It has an aggressive course and needs to be treated by both surgery and radiotherapy. Here we present a rare case of rhabdoid meningioma in a 24 year old lady with complaints of focal seizures, paresis and diplopia. CT & MRI showed a mass attached to dura in left posterosuperior frontoparietal region with peripheral edema. Histopathology showed large tumor cells arranged in sheets, whorls and papillary pattern. The patient was treated by surgery followed by radiation. This is reported to aware the surgical pathologists to keep this subtype as a differential diagnosis while interpreting any meningioma as it has an aggressive course.
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
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