Background: Neo adjuvant Radiotherapy and chemotherapy can cause significant changes in the gross and microscopic appearance of malignant tissues and normal surrounding tissues. Since radiotherapy is now offered to a large number of cancer patients, pathologists are more frequently presented with such changes. Both epithelial and stromal changes can be present. Epithelial changes in the form of atrophy, apoptosis, necrosis, dysplasia and neoplasia, while stromal changes the form of fibrosis, exudates, necrosis, pattern of invasion and vessel wall thickness. These changes may interfere with recognition of microscopic residual tumor if present. With increasing use of radiation therapy in cancer treatment and longer survival of patients, assessment of radiation-associated changes in tissues and tumours has become an important issue in modern pathology.
Materials and Methods: The present study was carried out on 50 patients. Type of samples includes cytological smears and histopathological specimens received in respective cytopathology and histopathology section of the pathology department after any chemotherapy or radiotherapy.
Objective
1.To study cyto-morphological changes after chemotherapy and/or radiotherapy.
2.To differentiate secondary malignancy from radiation damage.
Results: The present study was carried out on 50 patients including 13 patients with lymph node metastasis,12 cases with head & neck region, 2 scrap smear, 9 anterior chest wall swelling, 3 cases of liver, 5 cases of lung,1 plural fluid and 5 cases of breast. The effects have been divided mainly into two, as pathological changes in tumor cells and changes in the stroma.
Conclusion: It is concluded from the findings of present study that various nuclear abnormalities reveal a statistically significantly increases with increasing chemoradiation doses and time interval. Post neoadjuvant chemotherapy, specimens revealed nuclear enlargement, nuclear shrinkage, necrosis, vacuolation of nucleus, vacuolation of cytoplasm, dyscohesion, and shrinkage of tumor cells with nuclear changes of nonviability like karyorrhexis, karyolysis, and pyknosis. Stromal reactions manifested as fibrosis, elastosis, collagenization, hyalinization, microcalcification, and neovascularization. Areas of necrosis included both vascular and avascular pattern. The stroma also revealed fibrinoid necrosis and mucinous change. Hyalinization of the blood vessel wall was a common finding.
