Clinico Pathological Study of Parenchymal Lesions of Spinal Cord

Abstract

Background: Spinal parenchymal lesions are rare with a wide spectrum of clinical and histological presentation.The aims and objectives was to study the incidence and histopathological features of parenchymal lesions of spinal cord in relation to age,sex,clinical features, radiological findings and topographical distribution. Methods: We studied spinal lesions over a period of ten years in a tertiary care hospital. Our study comprised a total number of 241 surgical resection specimens of lesion of spinal cord out of which 73 cases of spinal cord parenchymal lesions were found. Primary vertebral tumors and paraspinal soft tissue lesions were excluded. Descriptive cross-sectional study of cases including detailed clinical data of age, sex, duration of disease, type of lesion, and radiological findings of the patients was obtained. All cases were analyzed by examining Hematoxylin and Eosin stained slides with use of special stains and immunohistochemistry, as needed. Results: Male predominance was seen in spinal cord parenchymal lesions and 3rd and 4th decade age group was most commonly affected. These lesions were more common in thoracic region followed by cervical region .Neoplastic lesion of spinal cord parenchyma are more frequently encountered than nonneoplastic lesions. Astrocytomas (24.63 %) were commonest neoplastic spinal cord lesions with preponderance of low grade astrocytoma. Ependymomas and PNET accounted for 20.53 % and 4.10 % respectively Conclusion: The histopathological diagnosis of spinal parenchymal lesions can be extremely challenging, the difficulty exaggerated by small size of the specimen. In such situation a multidisciplinary approach including neurosurgeons, neuroradiologist and neuropathologist is highly recommended.