A Practical Approach to the Differential Diagnosis of Intracranial Tumors: Gross, Histology, and Immunoprofile-based Algorithm

S, Raghothaman A. Challenges in the Histopathologic Diagnosis of Brain Tumors: An Institutional Experience in a Series of Cases

Background Central nervous system (CNS) tumors are relatively rare. However, brain tumors are one of the leading causes of cancer-related morbidity and mortality. Accurate histopathologic diagnosis and molecular diagnostics are critical for managing these patients. Histopathology plays a vital role in diagnosis, but clinical and radiological information is also crucial while evaluating brain tumors.

Materials and Methods A cross-sectional observational study was performed for a period of 1 year in the pathology department of a tertiary hospital. All the brain biopsies sent for histopathological analysis were analyzed, and among which five brain biopsy tissue posing the diagnostic dilemma in conventional histopathology were included in the study. Immunohistochemistry was performed wherever necessary.

Results During the study period, we encountered 32 cases of brain biopsy. Five cases posing diagnostic challenges in histopathological diagnosis were included in the study. Expert opinions of neuropathologists were taken in all of these cases. We reviewed the cases for the diagnostic difficulties. A review of all these cases has impacted further treatment.

Conclusion In this case series, we present five CNS tumors with a diagnostic dilemma in histopathological diagnosis where clinicoradiological correlation, immunohistochemistry, and expert opinion helped in the definitive diagnosis revealing the importance of a multidisciplinary approach for the better management of patients.