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Background: Central nervous system (CNS) lesions show considerable geographic and racial variations with respect to the incidence and their pattern of distribution. The histological spectrum of CNS lesions is broad and it varies among extremes of age groups. The study is aimed to determine the diversity of CNS lesions as well as to highlight the incidence and the histological spectrum of CNS lesions in a tertiary health center in India. Materials and Methods: A total of 238 CNS lesions were retrospectively analyzed in the Department of Pathology from October 2014 to November 2017. The specimens were processed by routine histotechniques, and immunohistochemistry (IHC) was performed whenever required. The diagnosis was confirmed by applying the existing World Health Organization classification. Results: Two hundred and thirty-eight cases of CNS lesions were analyzed, of which 33 (13.86%) cases were nonneoplastic, with the majority being cystic lesions 12 (36.36%). The neoplastic lesions comprised 205 (86.13%) cases, which included 200 (97.56%) primary and 5 (2.43%) metastatic lesions. Among the primary lesions, gliomas 57 (27.80%) were the most common followed by meningiomas 43 (20.97%) and schwannomas 37 (18.04%). Conclusion: The present study highlights the histological diversity of CNS lesions in both adult and pediatric age groups. Although with the advent of modern imaging techniques, a provisional diagnosis could be given to these diseases, histological examination with further utilization of IHC remains the gold standard in diagnosis and grading of all CNS lesions. This has further helped in management as well as the prognosis of these diseases.
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