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Difference between revisions of "Reactive changes"
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'''Reactive changes''' is a commonly used term in [[pathology]] 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]]. | ||
Significance of nuclear changes in inflammation: | Significance of nuclear changes in inflammation: | ||
*The line between a reactive process and a neoplastic process may be fuzzy. | *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: | Consequence: | ||
*In the context of inflammation, nuclear changes are typically present and the threshold for calling suspicious or malignancy is typically higher. | *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== | ||
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**Nuclear enlargement. | **Nuclear enlargement. | ||
**Nuclear hyperchromasia. | **Nuclear hyperchromasia. | ||
**Prominent nucleoli. | **Prominent [[nucleoli]]. | ||
*Inflammation - any type (e.g. [[neutrophil|neutrophilic]], [[plasma cells|plasmacytic]], lymphoplasmacytic). | *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]] | *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 | **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]] | ||