Radiation changes

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Radiation changes, also radiation effect, are seen occasionally by pathologists. They are usually a result of prior (radiation) treatments. The history is important in making this diagnosis

Gross

  • +/-Fibrotic appearing tissue.

Microscopic

Features:[1]

  • Cytoplasmic vacuolation - usually abundant.
  • Nucleus:
    • Enlarged nucleus - but normal NC ratio.
    • No nuclear membrane irregularies.
    • Chromatin: "smudgy".
    • +/-Multinucleation.
  • +/-Fibrosis (chronic change).
  • +/-Edema (acute change).

Important note:

  • Pleomorphism is often suggestive of malignancy. Paradoxically, in the context of radiation, less pleomorphic (clonal-appearing) cells may be malignant!

DDx:

See also

References

  1. Gupta, S.; Mukherjee, K.; Gupta, YN.; Kumar, M. (Aug 1987). "Sequential radiation changes in cytology of vaginal smears in carcinoma of cervix uteri during radiotherapy.". Int J Gynaecol Obstet 25 (4): 303-8. PMID 2887465.