Other nonneoplastic lesions
Histologic treatment effect

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

Revised: 9 November 2018, last major update August 2012

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

PubMed Search: Atypia following hepatic arterial infusion chemotherapy
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Cite this page: Weisenberg, E. Histologic treatment effect. website. Accessed January 23rd, 2019.
Definition / general
  • Also called postchemotherapy / 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)
Gross description
  • Flat appearance
Microscopic (histologic) description
  • 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