Difference between revisions of "Radiation colitis"
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*[http://gut.bmj.com/content/41/3/354/F2.large.jpg Radiation colitis - rat model (bmj.com)].<ref name=pmid9378391/> | *[http://gut.bmj.com/content/41/3/354/F2.large.jpg Radiation colitis - rat model (bmj.com)].<ref name=pmid9378391/> | ||
*[http://www.nature.com/nrgastro/journal/v5/n1/fig_tab/ncpgasthep1005_F5.html#figure-title Radiation colitis (nature.com)].<ref name=pmid18174905>{{Cite journal | last1 = Nielsen | first1 = OH. | last2 = Vainer | first2 = B. | last3 = Rask-Madsen | first3 = J. | title = Non-IBD and noninfectious colitis. | journal = Nat Clin Pract Gastroenterol Hepatol | volume = 5 | issue = 1 | pages = 28-39 | month = Jan | year = 2008 | doi = 10.1038/ncpgasthep1005 | PMID = 18174905 }}</ref> | *[http://www.nature.com/nrgastro/journal/v5/n1/fig_tab/ncpgasthep1005_F5.html#figure-title Radiation colitis (nature.com)].<ref name=pmid18174905>{{Cite journal | last1 = Nielsen | first1 = OH. | last2 = Vainer | first2 = B. | last3 = Rask-Madsen | first3 = J. | title = Non-IBD and noninfectious colitis. | journal = Nat Clin Pract Gastroenterol Hepatol | volume = 5 | issue = 1 | pages = 28-39 | month = Jan | year = 2008 | doi = 10.1038/ncpgasthep1005 | PMID = 18174905 }}</ref> | ||
==Sign out== | |||
<pre> | |||
RECTUM, BIOPSY: | |||
- RECTAL MUCOSA WITH ACTIVE INFLAMMATION, ULCERATION AND | |||
REGENERATIVE CHANGES. | |||
- LARGE ATYPICAL STROMAL CELLS COMPATIBLE WITH RADIATION CHANGES. | |||
- NO EVIDENCE OF MALIGNANCY. | |||
COMMENT: | |||
The immunostains done (pankeratin, p53, Ki-67) is in keeping | |||
with regeneration and radiation changes. | |||
</pre> | |||
==See also== | ==See also== | ||
Revision as of 17:47, 14 May 2014
Radiation colitis is inflammation of the colon due to radiation. It is usually iatrogenic. This article also covers radiation proctitis.
General
- Diagnosis should be supported by the clinical history.
General DDx for a colitis:
- Idiopathic, e.g. inflammatory bowel disease.
- Infection.
- Ischemia.
- Radiation.
Gross
- Superficial bowel wall injury - shallow ulceration.[1]
- Telangiectatic lesions.
Image:
Microscopic
Features - acute:[1]
- Mucosal changes:
- Necrosis of epithelium.
- "Ghost cells" = cells without nuclei.
- Hemorrhage.
- Necrosis of epithelium.
- Submucosa edema with neutrophilic infiltrate.
- +/-Fibrin thrombi.
Features - chronic:
- Nuclear atypia - esp. of the stromal cells.
- The epithelium is shed and regenerates... therefore usually does not have the changes.
- Fibrosis - esp. of the submucosa.
DDx:
- Ischemic colitis.
- Inflammatory bowel disease.
- Infectious colitis.
Images:
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RECTUM, BIOPSY: - RECTAL MUCOSA WITH ACTIVE INFLAMMATION, ULCERATION AND REGENERATIVE CHANGES. - LARGE ATYPICAL STROMAL CELLS COMPATIBLE WITH RADIATION CHANGES. - NO EVIDENCE OF MALIGNANCY. COMMENT: The immunostains done (pankeratin, p53, Ki-67) is in keeping with regeneration and radiation changes.
See also
References
- ↑ 1.0 1.1 1.2 Yano, Y.; Yao, H.; Aoyagi, K.; Kawakubo, K.; Nakamura, S.; Doi, K.; Ibayashi, S.; Fujishima, M. (Sep 1997). "Photochemically induced colonic ischaemic lesions: a new model of ischaemic colitis in rats.". Gut 41 (3): 354-7. PMID 9378391.
- ↑ 2.0 2.1 Nielsen, OH.; Vainer, B.; Rask-Madsen, J. (Jan 2008). "Non-IBD and noninfectious colitis.". Nat Clin Pract Gastroenterol Hepatol 5 (1): 28-39. doi:10.1038/ncpgasthep1005. PMID 18174905.