Author: Elliot Weisenberg, M.D. (see Authors page)

Revised: 12 January 2018, last major update October 2012

Copyright: (c) 2003-2018,, Inc.

PubMed Search: Radiation[TI] esophagitis[TI]

Cite this page: Weisenberg, E. Radiation esophagitis. website. Accessed March 23rd, 2018.
Definition / general
  • Complication of treatment for cancer of lung, mediastinum or esophagus with doses of 30 gray or higher
  • Radiation esophagitis is primary dose limiting acute toxicity for radiation therapy of thoracic neoplasms (Semin Radiat Oncol 2004;14:280)
  • Use of cytotoxic chemotherapy has an additive effect (World J Gastroenterol 2005;11:2626)
  • Acute damage: mucosal necrosis, submucosal edema
  • Chronic injury: due to fractionated doses of 60 gray or more; submucosal fibrosis, capillary telangiectasia, thick walled arterial vessels, mucus glandular atrophy, atypical fibroblasts; grossly are ulcers, strictures or fistulas
Gross images

Images hosted on PathOut server:

Esophageal squamous cell carcinoma:

Radiation has destroyed tumor

Deep ulcer with necrotic base

Microscopic (histologic) description
  • Variably sized cells in all layers, often increased cytoplasm but usually normal nuclear to cytoplasmic ratio
  • Nuclei enlarged with bizarre shapes, may be hyperchromatic or smudged
  • May have large eosinophilic nucleoli; usually no mitotic figures
Microscopic (histologic) images

Images hosted on PathOut server:

Normally oriented
epithelium is
thinner than

Radiated esophageal squamous cell carcinoma

Irradiated squamous carcinoma

Images hosted on other servers:

Neovascularization (highlighted with CD31)