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Category: Volume 08 Issue 06 June 2020
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Title: Study of Clinico-pathological Spectrum of Lesions of Spinal Cord and its Coverings: at Tertiary Care Centre

Authors: Kotia Suman, Gandhi Sapna, Gandhi Ashok, Binawara Kamal Kishore, Shekhawat Pratibha

 DOI: https://dx.doi.org/10.18535/jmscr/v8i6.12

Abstract

 

Introduction: The diversity of anatomic structures in the spinal region challenges both the clinician and a pathologist with distinct and interesting group of spinal lesions having wide spectrum of clinical and histological presentations. The first step of the diagnostic alogorithm includes the analysis of clinical and radiological features because it narrows down the differential diagnosis to a significant extent. The next step includes the histopathology.

Aim: To analyse the histopathological morphology of spinal cord lesions with clinical and radiological features.

Materials and Methods: The study was carried out in Department of Pathology, S.M.S. Medical College, Jaipur (Rajasthan) from June 2018 to November 2019. Our study comprised of a total 85 surgical resection specimens of lesions of spinal cord and its coverings. All cases were analyzed by examining hematoxylin and eosin stained slides with use of special stains and immunohistochemistry, as needed.

Results: Most of the cases were in the age group 31 – 40 years. The female to male ratio 1.12:1. Backache was the most frequent symptom followed by weakness of lower limbs. Thoracic segment was most commonly involved, followed by lumbar and cervical. Most common site was intradural extramedullary followed by extradural and intradural intramedullary. 60% neoplastic, 21.18% inflammatory and 18.83% non-neoplastic lesions. Commonest was Nerve sheath tumours (24.70%) followed by meningioma (12.94%),ependymoma (9.41%), astrocytoma (5.88%).16.47% of tuberculosis. 2 cases each of hemangioblastoma, lymphoma, and metastatic carcinoma respectively. 

Conclusion: The combination of clinical, radiological and histopathological features forms the basis of the multi-disciplinary diagnostic approach towards the spinal cord and its covering lesions.

Keywords: Spinal cord lesions, Extradural, Intradural, Intramedullary, Histopathology.

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Corresponding Author

Gandhi Sapna

Associate Professor, Department of Pathology, SMS Medical, College, Jaipur, Rajasthan