Abstract

Background: Primary CNS tumors show wide clinical, histomorphological, and immunohistochemical variation. Distinguishing these lesions from each other and from reactive process can be challenging due to overlapping cell morphology. So, the diagnosis and categorization of primary CNS tumors, is essential for planning the management and to determine the prognosis. Objectives: To evaluate the clinico-radiological features in diagnosing CNS tumors; to study the occurrence of CNS tumors in relation to age, sex, and anatomical sites, and the histopathological features of various CNS tumors and to evaluate the role of immunohistochemistry in diagnosing as well as classifying various CNS tumors according to CNS5. Materials and Methods: This study included a total of 242 case’ biopsy of primary CNS tumors received in the Department of Pathology over 5 years from 2020 to 2024. All specimens were examined grossly, processed routinely, stained with H&E, and evaluated using a panel of IHC markers (IDH1, ATRX, p53, Ki-67, GFAP, Synaptophysin, EMA, PR, etc.). Results: Out of 242, the most common age group was 15-39 years with male: female ratio of 1.3:1 with most common site- cerebrum. Majority of the cases were non-malignant (61%), while 39% cases were malignant. The most frequent tumors were gliomas, followed by meningiomas, schwannoma, pituitary adenomas, and medulloblastomas. IHC significantly assisted in differentiating astrocytic tumors, subtyping meningiomas, and confirming embryonal tumors. Ki‑67 index correlated with the tumor grade. Conclusion: A combined clinico-pathological and IHC approach markedly improves diagnostic accuracy of primary CNS tumors.

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