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Breast malignant, males, children

Miscellaneous

Treatment effect - radiation therapy


Reviewer: Monika Roychowdhury, M.D. (see Reviewers page)
Revised: 18 November 2012, last major update August 2012
Copyright: (c) 2001-2012, PathologyOutlines.com, Inc.

See also atypical or benign vascular proliferations post-radiation of breast

Case reports
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● 57 year old woman with radiation induced morphea (J Med Case Rep 2008;2:136)

Micro description
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● Giant tumor cells with bizarre nuclear changes (J Clin Pathol 1990;43:152), naked nuclei and abnormal mitotic figures
● Extensive tumor necrosis demarcated by thick fibrous walls
● Changes in non-neoplastic breast include atypia, lobular sclerosis and atrophy (may distort lobular architecture and obscure myoepithelial cells, Hum Pathol 1984;15:545), intimal thickening in small muscular arteries (Radiother Oncol 2009;92:477) and fat necrosis, but usually no mitotic activity or loss of polarity
● Changes do not regress over time (Am J Surg Pathol 2004;28:47)

Micro images
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Fibrotic stroma, DCIS and atrophic glands   Atypical stromal cells, lymphocytic infiltrate
                       and increased collagen bundles

                
Large stromal fibroblasts may          Thickened basement membranes
also occur In NON-irradiated tissue

                
Atypical stromal fibroblasts            LCIS unchanged by radiation compared
                       to atrophic normal glands

                
Atypia in normal duct              Atypia within normal lobule

                
Fat necrosis post-iridium implant         Vessel shows reduplicated elastic lamina
                        and intimal thickening (elastin stain)


Collagenization of intralobular stroma and glandular atrophy (AFIP)

Radiation induced epithelial atypia   #2   #3

Virtual slides
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Post-therapy

Differential diagnosis
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Pleomorphic lobular carcinoma

End of Breast malignant, males, children > Miscellaneous > Treatment effect - radiation therapy


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