Difference between revisions of "Reactive changes"

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'''Reactive changes''' is a commonly used term that implies:
'''Reactive changes''' is a commonly used term in [[pathology]] that implies:
# Inflammation.
# Inflammation.
# Nuclear changes compatible with inflammation.
# Nuclear changes compatible with inflammation.
# The absence of both neoplasia ''and'' the suspicion of neoplasia, i.e. it implies benignancy.
'''Reactive inflammatory changes''' and '''inflammatory changes''' can be considered synonyms.


==General==
==General==
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*Inflammatory processes.
*Inflammatory processes.
*Repair.
*Repair.
*Neoplastic processes.   
*Neoplastic processes, i.e. pre-cancerous conditions (e.g. dysplasia) and [[cancer]].   


The line between a reactive process and a neoplastic process may be fuzzy. In the context of inflammation, nuclear changes are typically present and the threshold for calling suspicious or malignancy is typically higher.  
Significance of nuclear changes in inflammation:
*The line between a reactive process and a neoplastic process may be fuzzy, i.e. it may be very difficult to be certain whether something is benign or [[malignant]].
 
Consequence:
*In the context of inflammation, nuclear changes are typically present and the threshold for calling ''suspicious for malignancy'' or ''[[malignancy]]'' is typically higher.


==Microscopic==
==Microscopic==
Features - generic:
Features - generic:
*Nuclear changes:
*Nuclear changes - typically:
**Nuclear enlargement.
**Nuclear enlargement.
**Nuclear hyperchromasia.
**Nuclear hyperchromasia.
**Prominent nucleoli.
**Prominent [[nucleoli]].
*Inflammation - acute and/or chronic.
*Inflammation - any type (e.g. [[neutrophil|neutrophilic]], [[plasma cells|plasmacytic]], lymphoplasmacytic).
*+/-Proliferation (e.g. mitotic figures) or changes suggestive of proliferation (e.g. hyperplasia).
 
Notes:
*Cytoplasmic changes may be present.


DDx:
DDx:
*[[Waffle diagnosis]] (e.g. [[indefinite for dysplasia]]) - nuclear changes of unknown significance.
*Normal.
**Terminology dependent on the anatomical site.  
*[[Waffle diagnosis]] - nuclear changes of unknown significance.
**Terminology dependent on the anatomical site, e.g. [[indefinite for dysplasia]], [[ASCUS]], [[ASAP]].  
*[[Nuclear atypia]].
*[[Nuclear atypia]].
**This is often qualified as it may represent neoplastic process or a benign process dependent on the context.
**This is often qualified as it may represent a neoplastic process or a benign process.
**Common qualifiers:
**Common qualifiers:
***Worrisome lesions: "cannot exclude dysplasia", "suspicious for malignancy".
***Worrisome lesions: "... cannot exclude dysplasia", "... cannot exclude malignancy", "... suspicious for malignancy".  
***Suspected to be benign: "favour benign".
***Suspected to be benign: "... favour benign".
*[[Malignancy]].
*[[Malignancy]].


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*[[NC ratio]].
*[[NC ratio]].
*[[Reactive squamous epithelium of the uterine cervix]].
*[[Reactive squamous epithelium of the uterine cervix]].
*[[Reactive astrocytes]].


[[Category:Stuff]]
[[Category:Stuff]]
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