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Category: Volume 07 Issue 09 September 2019
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Title: A Study of Histopathological Spectrum of Sellar, Suprasellar and Parasellar Lesions of CNS at Tertiary Care Centre

Authors: Om Prakash, Arpita Jindal, Natasha Agrawal, Ranjana Solanki, Jaidayal Kumar, Mukesh Kumar

 DOI: https://dx.doi.org/10.18535/jmscr/v7i9.17

Abstract

     

Background: The sellar and parasellar region is an anatomically complex area that represents a critical junction for important contiguous structures. A number of pathological processes occur in the sellar/para/ suprasellar region including: neoplastic, inflammatory, infectious, developmental and vascular abnormalities and the presentation of the various lesions can mimic the pituitary adenonmas clinically, endocrinologically and in the radiological presentation.

The overwhelming majority of sellar region masses are pituitary adenomas (85%), followed by craniopharyngiomas (3%), Rathke cleft cysts (2%), meningiomas (1%), and metastases (0.5%); all other lesions, such as hypophysitis, pituicytoma, spindle cell oncocytoma, and granular cell tumor of neurohypophysis, are rare lesions. The purpose here is to study the histopathological spectrum of sellar, suprasellar and parasellar lesion in biopsy specimen received in Department of Pathology of SMS Medical College and Hospital, Jaipur.

Objective: To find out proportion of various morphological types of sellar, suprasellar and parasellar lesions in intracranial lesions.

Material and Methods: A total of 671 samples of intracranial SOL biopsy specimens were received from IPD, out of which 100 samples of sellar / suprasellar biopsies were enrolled for present study. Histopathological analysis was done.

Results: Out of 100 cases Pituitary Adenoma was the commonest lesion followed by Craniopharyngioma. The number of male and female patients was approximately same, ratio was 1.27:1. Among females, most common age group was 41 to 50 years and in males it was 31 to 40 years.

Conclusion: Pituitary adenomas being the most frequent lesion encountered in the sellar/ parasellar/suprasellar area in our institute, followed by non-adenomatous lesions including meningiomas and the potentially malignant parasellar lesion Craniopharyngiomas.

Keywords: Sellar-Suprasellar lesions, Parasellar lesion, Pituitary tumor.

References

  1. Ruscalleda J. Imaging of parasellar lesions. European Radiology 2000;15:549–59
  2. Smith JK. Parasellar Tumors: Suprasellar and Cavernous Sinuses. Top Magnetic Resonance Imaging. 2005;16:307-15
  3. Rennert J, Doerfler A. Imaging of sellar and parasellar lesions. Clinical Neurology and Neurosurgery. 2007;109(2):111-24
  4. Freda PU, Post KD. Differential diagnosis of sellar masses. Endocrionlology & Metabolism Clinics of North America. 1999;28(1):81-117
  5. Bonneville JF, Kucharczyk W. (2008): Diseases of the sella and parsellar region. Disease of the Brain, Head and Neck, Spine. 2008;1:123-9
  6. Saeger W, L¨udecke DK, Buchfelder M, Fahlbusch R, Quabbe HJ, Petersenn S. Pathohistological classification of pituitary tumors: 10 years of experience with the German Pituitary Tumor Registry. Eur J Endocrinol. 2007;156(2):203–16
  7. Lloyd RV, Kovacs K, Young Jr WF, Farrel WE, Asa SL, Truillas J, Kontogeorgos G, Sano T, Scheithauer BW, Horvath E, DeLellis RA, & Heitz PU. (2004b). Pituitary tumors. In: WHO classification of tumors of the endocrine organs: pathology and genetics of endocrine organs, Eds. DeLellis R, Lloyd RV, Heitz PV, Eng C, pp. 10–13,International Agency for Research and Cancer (IARC), Lyon.
  8. Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Burger PC, Jouvet A, Scheithauer BW, & Kleihues P. The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathologica 2007;114:97–109
  9. Famini P, Maya MM, & Melmed S. (2011). Pituitary Magnetic Resonance Imaging for Sellar and Parasellar Masses: Ten-Year Experience in 2598 Patients. Journal of Clinical Endocrinology & Metabolism 2011;96:1633–41
  10. Glezer A, Belchior Paraiba D, Bronstein MD. Rare Sellar Lesions. Endocrinology and Metabolism Clinics of North America 2008;37:195-211
  11. Dogar T, Imran AA, Hasan M, Jaffar R, Bajwa R, Qureshi ID, "Space occupying lesions of central nervous system: A radiological and Histopathological Correlation" Biomedica 2015;31:15-20.
  12. Banna M, Baker HL, Houser OW. Pituitary and parapituitary tumours on computed tomography. BJR. 1980;53:1123-43
  13. Goyani BR, Ukani BV, Naik P, Bhagat H, Vadel MK, Sheth R, "A Study on role of MRI in intracranial space occupying lesions" Natl J Med Res 2015;5:18-21.
  14. Kaki RR, Anuradha B, Rani BS, Rao KS, Kusumalatha P, Sathyasuneetha, "Imaging of intracranial space occupying lesions- A prospective study in a tertiary care centre- GGH, Kakinada" A.P. J Evid Based Med Healthc 2017;4:617-23
  15. Jindal N, Verma SR, Gupta PK, Mital M, "Imaging of Intracranial Space Occupying Lesion: A prospective Study in a tertiary care centre in North India" IOSR Journal of Dental and Medical Sciences 2016:15:34-41.
  16. Tesfay M, Hawaz Y, Assefa G, Abebe M, R'adiological features and postoperative histopathologic diagnosis of intracranial masses at Tikur Anbessa specialized hospital and MCM Hospital" East and Central AfrJ Surg 2013;18:95-106.
  17. Sunila, Kumarguru. B.N., T S Vasan, Manjunath. G.V. Space occupying lesions of central nervous system: A radiological-histopathological correlation study. Indian Journal of Pathology and Oncology. 2018;5(2):202-7
  18. 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. The Internet Journal of Neurosurgery. 2010;7:1
  19. Butt ME, Khan SA, Chaudrhy NA, Qureshi GR. Intra-cranial space occupying [2]lesions A morphological analysis. Biomedical. 2005;21:31-5
  20. Lee BCP, Deck MDF. Sellar and juxtasellar lesion detection with MR. Radiology. 1985;157:143-7
  21. Johnson DE, Woodruff WW, Allen IS, Cera PJ, Funkbouser GR, Coleman LL. MR imaging of sellar and juxtasellar regions. Radiographics. 1991:11:727-58.
  22. Batra V, Gupta PK, Gehlot R, Awasthi P. Radiopathological correlation of sellar and suprasellar masses: our experience. Int J Res Med Sci 2016;4:3924-8
  23. I.Ogbole, O.A.Adeyinka, C.A.Okolo, A.O.Ogun,O.M.Atalabi. Low field MR imaging of sellar and parasellar lesions: Experience in a developing country hospital European Journal of Radiology 2012;81(2):139-46
  24. Nibhoria S, Tiwana KK, Phutela R, Bajaj A, Chhabra S, Bansal S. Histopathological spectrum of central nervous system tumours: a single centre study of 100 cases. Int J Sci Stud. 2015;3:130-4
  25. Jat KC, Vyas SP, Bihari NA, Mehra K. Central nervous system tumours: A histopathological study. Int J Res Med Sci. 2016;4:1539-45
  26. Donovan J, Nesbit GM. Distinction of masses involving the sella and suprasellar space: specificity of imaging features.AJR 1996;167:597-603
  27. Zamora C and Castillo M\. Sellar and Parasellar imaging Neurosurgery 2017;80:17–38
  28. Reddy R, Praveen K, Singh R. Histopathological spec-trum of meningioma and its variants. Asian Pac. J. Health Sci. 2016;3(1):151-5.
  29. Gadgil N, Margam S, Chaudhari C, Kumavat P. The histopathological spectrum of meningeal neoplasms. IJPO. 2016;3(3):432-6
  30. Couldwell WT, Weiss MH: Nonadenomatous lesions of the pituitary,in Krisht A, Tindall, GT (eds): Pituitary Disorders. Baltimore, MD: Lipincott Williams & Wilkins,1999
  31. Valassi E, Biller BMK, Klibanski A, Swearingen B. Clinical features of nonpituitary sellar lesions in a large surgical series. Clinical Endocrinology. 2010;73(6):798-807
  32. Jahangiri A, Jian B, Miller L, El-Sayed IH, Aghi MK. Skull base chordomas: clinical features, prognostic factors, and therapeutics. Neurosurg Clin N Am. 2013;24(1):79-88

Corresponding Author

Om Prakash

Department of Pathology, Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan