Dysplasia-like lesions
Histologic treatment effect

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

Revised: 19 December 2016, last major update August 2012

Copyright: (c) 2003-2016,, Inc.

PubMed Search: atypia following hepatic arterial infusion chemotherapy
Cite this page: Histologic treatment effect. website. Accessed April 23rd, 2017.
Definition / General
  • 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)
Gross Description
  • Flat appearance
Micro 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
Micro Images

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