Table of Contents
Definition / general | Clinical features | Gross description | Microscopic (histologic) description | Microscopic (histologic) imagesCite this page: Gulwani H. Radiation enterocolitis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/smallbowelradiationentero.html. Accessed April 17th, 2024.
Definition / general
- Observed acutely or years after radiation therapy for cervical carcinoma, Wilms tumor, lymphoma or other peritoneal tumors
Clinical features
- Acute: anorexia, cramps, diarrhea due to mucosal injury and malabsorption
- Chronic: may present as inflammatory colitis or indolent; also vascular injury, ischemic fibrosis, stricture
- Treatment: resection if severe
Gross description
- Thickened bowel wall
Microscopic (histologic) description
Acute:
Chronic:
- Varies from mild epithelial damage to massive necrosis and ulceration (BMC Surg 2004;4:10)
- Loss of columnar shape and nuclear polarity of enterocytes, nuclear pyknosis, bizarre nuclei, mucin depletion and decreased mitoses
- Also fibroblasts and endothelium with submucosal edema but low nuclear to cytoplasmic ratio, preservation of architecture
- No desmoplasia, no infiltrative pattern
Chronic:
- Atrophic and ulcerated mucosa, ectatic blood vessels, fibrosis of submucosa and muscular wall, vascular wall thickening, vascular stenosis
- Possible fistula formation, atherosclerosis-like changes of vasculature (subintimal lipid laden macrophages, calcification, thrombosis), hyalinization of lamina propria