IPLab:Lab 12:Radiation Changes - Revision history

Peter Anderson: /* Autopsy Findings */

2020-07-09T21:12:53Z

Autopsy Findings

← Older revision		Revision as of 16:12, 9 July 2020
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	The surgical specimen consisted of a 13-cm segment of ileum having a luminal circumference of 5 cm. There was a full-thickness tear measuring 2.5 cm in the center of the specimen. On opening the bowel, the mucosa was ulcerated and showed a perforation.		The surgical specimen consisted of a 13-cm segment of ileum having a luminal circumference of 5 cm. There was a full-thickness tear measuring 2.5 cm in the center of the specimen. On opening the bowel, the mucosa was ulcerated and showed a perforation.

	~~== Autopsy Findings ==~~
	The surgical specimen consisted of a 13-cm segment of ileum having a luminal circumference of 5 cm. There was a full-thickness tear measuring 2.5 cm in the center of the specimen. On opening the bowel, the mucosa was ulcerated and showed a perforation.

	== Images ==		== Images ==

Peter Anderson: /* Clinical Summary */

2020-07-09T21:12:45Z

Clinical Summary

← Older revision		Revision as of 16:12, 9 July 2020
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	== Clinical Summary ==		== Clinical Summary ==
	This 46-year-old white female was ~~found to have prolapse of the uterus two years earlier for which a vaginal hysterectomy had been performed. Study of the specimen demonstrated~~ invasive squamous cell carcinoma of the cervix~~. Subsequently, she underwent a radical parametrectomy, removal of both tubes~~ and ~~ovaries, and partial resection of the bladder~~. ~~Six months~~ later~~, a recurrence of the tumor was treated by 6000 rads to the whole pelvis. Subsequently,~~ the patient developed ~~intermittent~~ small bowel obstruction which ~~resulted in the~~ resection of a segment of ileum. She did well following surgery.		This 46-year-old white female was diagnosed with invasive squamous cell carcinoma of the cervix and subsequently received radiation therapy. Three years later the patient developed several episodes of small bowel obstruction which necessitated resection of a segment of ileum. She did well following surgery.

			The surgical specimen consisted of a 13-cm segment of ileum having a luminal circumference of 5 cm. There was a full-thickness tear measuring 2.5 cm in the center of the specimen. On opening the bowel, the mucosa was ulcerated and showed a perforation.

	== Autopsy Findings ==		== Autopsy Findings ==

Seung Park at 16:37, 3 January 2014

2014-01-03T16:37:36Z

← Older revision		Revision as of 11:37, 3 January 2014
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	File:IPLab12RadiationChanges8.jpg\|This high-power photomicrograph of the wall of the ileum shows more examples of pleomorphic cells caused by radiation injury (arrows).		File:IPLab12RadiationChanges8.jpg\|This high-power photomicrograph of the wall of the ileum shows more examples of pleomorphic cells caused by radiation injury (arrows).
	</gallery>		</gallery>

			== Virtual Microscopy ==
			<peir-vm>IPLab12RadiationChanges</peir-vm>

	== Study Questions ==		== Study Questions ==

Seung Park: /* Images */

2013-08-30T01:48:17Z

Images

← Older revision		Revision as of 20:48, 29 August 2013
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	=== Images ===		=== Images ===
	* [~~http://peir.path.uab.edu~~/library/index.php?/tags/56-radiation PEIR Digital Library: Radiation Images]		* [{{SERVER}}/library/index.php?/tags/56-radiation PEIR Digital Library: Radiation Images]
	* [http://library.med.utah.edu/WebPath/GIHTML/GIIDX.html#5 WebPath: Small Intestine Images]		* [http://library.med.utah.edu/WebPath/GIHTML/GIIDX.html#5 WebPath: Small Intestine Images]

Seung Park: /* Related IPLab Cases */

2013-08-26T15:12:13Z

Related IPLab Cases

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	* [http://peir.path.uab.edu/library/index.php?/tags/56-radiation PEIR Digital Library: Radiation Images]		* [http://peir.path.uab.edu/library/index.php?/tags/56-radiation PEIR Digital Library: Radiation Images]
	* [http://library.med.utah.edu/WebPath/GIHTML/GIIDX.html#5 WebPath: Small Intestine Images]		* [http://library.med.utah.edu/WebPath/GIHTML/GIIDX.html#5 WebPath: Small Intestine Images]

	~~== Related IPLab Cases ==~~


	{{IPLab 12}}		{{IPLab 12}}

	[[Category: IPLab:Lab 12]]		[[Category: IPLab:Lab 12]]

Seung Park: /* Reference */

2013-08-26T15:12:04Z

Reference

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	== Additional Resources ==		== Additional Resources ==
	=== Reference ===		=== Reference ===
			* [http://emedicine.medscape.com/article/180084-overview eMedicine Medical Library: Intestinal Radiation Injury]
			* [http://emedicine.medscape.com/article/265956-overview eMedicine Medical Library: Radiation Therapy in Gynecology]
			* [http://www.merckmanuals.com/professional/injuries_poisoning/radiation_exposure_and_contamination/radiation_exposure_and_contamination.html Merck Manual: Radiation Exposure and Contamination]

	=== Journal Articles ===		=== Journal Articles ===

Seung Park: /* Journal Articles */

2013-08-26T15:10:57Z

Journal Articles

← Older revision		Revision as of 10:10, 26 August 2013
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	=== Journal Articles ===		=== Journal Articles ===
			* Reis ED, Vine AJ, Heimann T. [http://www.ncbi.nlm.nih.gov/pubmed/12780647 Radiation damage to the rectum and anus: pathophysiology, clinical features and surgical implications]. ''Colorectal Dis'' 2002 Jan;4(1):2-12.

	=== Images ===		=== Images ===

Seung Park: /* Images */

2013-08-26T15:10:15Z

Images

← Older revision		Revision as of 10:10, 26 August 2013
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	=== Images ===		=== Images ===
			* [http://peir.path.uab.edu/library/index.php?/tags/56-radiation PEIR Digital Library: Radiation Images]
			* [http://library.med.utah.edu/WebPath/GIHTML/GIIDX.html#5 WebPath: Small Intestine Images]

	== Related IPLab Cases ==		== Related IPLab Cases ==

Seung Park at 04:27, 23 August 2013

2013-08-23T04:27:00Z

← Older revision		Revision as of 23:27, 22 August 2013
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	* <spoiler text="Why are the small intestine and colon so susceptible to radiation injury?">The gastrointestinal tract is very radiosensitive and is frequently affected in all forms of deep radiation. The intestinal epithelium (crypt cells) are particularly radiosensitive due to their high turnover rate. These cell often show nuclear and cellular pleomorphism, mitotic abnormalities, and cell necrosis. Later, ulcerations may appear, along with vascular and connective tissue changes. The late effects of intestinal injury comprise mucosal and submucosal atrophy and fibrosis, occasionally producing intestinal strictures.</spoiler>		* <spoiler text="Why are the small intestine and colon so susceptible to radiation injury?">The gastrointestinal tract is very radiosensitive and is frequently affected in all forms of deep radiation. The intestinal epithelium (crypt cells) are particularly radiosensitive due to their high turnover rate. These cell often show nuclear and cellular pleomorphism, mitotic abnormalities, and cell necrosis. Later, ulcerations may appear, along with vascular and connective tissue changes. The late effects of intestinal injury comprise mucosal and submucosal atrophy and fibrosis, occasionally producing intestinal strictures.</spoiler>
	* <spoiler text="Are patients who have been treated with radiation more susceptible to formation of new cancers?">Yes, due to the above-mentioned alterations in nuclear and mitotic activity.</spoiler>		* <spoiler text="Are patients who have been treated with radiation more susceptible to formation of new cancers?">Yes, due to the above-mentioned alterations in nuclear and mitotic activity.</spoiler>

			== Additional Resources ==
			=== Reference ===


			=== Journal Articles ===


			=== Images ===


			== Related IPLab Cases ==


	{{IPLab 12}}		{{IPLab 12}}

	[[Category: IPLab:Lab 12]]		[[Category: IPLab:Lab 12]]

Seung Park at 16:27, 21 August 2013

2013-08-21T16:27:24Z

← Older revision		Revision as of 11:27, 21 August 2013
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	File:IPLab12RadiationChanges8.jpg\|This high-power photomicrograph of the wall of the ileum shows more examples of pleomorphic cells caused by radiation injury (arrows).		File:IPLab12RadiationChanges8.jpg\|This high-power photomicrograph of the wall of the ileum shows more examples of pleomorphic cells caused by radiation injury (arrows).
	</gallery>		</gallery>

			== Study Questions ==
			* <spoiler text="Why was there an obstruction at this site?">Radiation damage caused fibrosis of the bowel wall and atrophy of the mucosa. This probably led to an area of poor peristalsis and a physiologic obstruction. The fibrosis in the wall can also lead to a physical obstruction (stricture).

			Due to the atrophy of the mucosa, the fibrosis, and the poor blood flow to this area (chronic vascular occlusive lesions), this area of bowel would be more susceptible to rupture, as happened in this case.</spoiler>
			* <spoiler text="Why are the small intestine and colon so susceptible to radiation injury?">The gastrointestinal tract is very radiosensitive and is frequently affected in all forms of deep radiation. The intestinal epithelium (crypt cells) are particularly radiosensitive due to their high turnover rate. These cell often show nuclear and cellular pleomorphism, mitotic abnormalities, and cell necrosis. Later, ulcerations may appear, along with vascular and connective tissue changes. The late effects of intestinal injury comprise mucosal and submucosal atrophy and fibrosis, occasionally producing intestinal strictures.</spoiler>
			* <spoiler text="Are patients who have been treated with radiation more susceptible to formation of new cancers?">Yes, due to the above-mentioned alterations in nuclear and mitotic activity.</spoiler>

	{{IPLab 12}}		{{IPLab 12}}

	[[Category: IPLab:Lab 12]]		[[Category: IPLab:Lab 12]]