Radiation esophagitis

Topic Completed: 1 October 2012

Minor changes: 21 December 2020

Copyright: 2003-2021,, Inc.

PubMed Search: Radiation[TI] esophagitis[TI]

Elliot Weisenberg, M.D.
Page views in 2020: 1,156
Page views in 2021 to date: 1,057
Cite this page: Weisenberg E. Radiation esophagitis. website. Accessed October 22nd, 2021.
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

AFIP images

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

AFIP images

Normally oriented
epithelium is
thinner than

Radiated esophageal squamous cell carcinoma

Irradiated squamous carcinoma

Images hosted on other servers:

Neovascularization (highlighted with CD31)

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