Histologic treatment effect
Reviewers: Elliot Weisenberg, M.D. (see Reviewers page)
Revised: 13 October 2012, last major update August 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.
● Also called post-chemotherapy / radiation therapy changes
● Occurs in 8% of patients with chemoradiation therapy for esophageal carcinoma, may be confused with dysplasia
● Also occurs after hepatic artery infusion chemotherapy (Am J Surg Pathol 1983;7:261, Mod Pathol 2001;14:389)
● After preoperative chemotherapy, may see reduction in tumor cellularity, increase in dense fibrosis, formation of large mucin pools with lymphocytes and macrophages
● In signet-ring carcinomas, see smaller intracytoplasmic mucin vacuoles
● Often see no effect (Arch Pathol Lab Med 1991;115:807)
● Flat appearance
● Patchy distribution, foveolar and gland involvement, surface maturation, open nuclear chromatin pattern with prominent nucleoli, retention of nuclear polarity, mitoses confined to pits
● May have bizarre nuclear atypia, endarteritis obliterans
● No atypical mitoses, no cytoplasmic eosinophilia, no vacuolization, no intestinal metaplasia, no irregular glandular microcystic change, no increased nuclear/cytoplasmic ratio
● p53-, MIB1+ only in deep foveolar epithelium
MIB1 and p53
End of Stomach > Dysplasia-like lesions > Histologic treatment effect
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