[Clinicopathologic features of delayed radiation-induced brain injury after radiotherapy for brain tumor].
OBJECTIVE
To study the clinicopathologic features of delayed radiation-induced brain injury after radiotherapy for brain tumor.


METHODS
The clinical, histopathologic and immunohistochemical features of 9 cases with delayed radiation-induced injury were evaluated.


RESULTS
The disease occurred from 6 months to 12 years after radiotherapy and often presented with headache and muscle weakness. Magnetic resonance imaging showed peripheral enhancing lesions with slight mass effect and surrounding edema. Microscopically, the major changes included coagulative necrosis, fibrinoid necrosis of vessels, vascular hyalinization with luminal stenosis and peripheral reactive gliosis. Immunostaining for hypoxia-inducible factors 1α was positive in reactive astrocytes.


CONCLUSIONS
Delayed radiation-induced brain injury is a relatively common complication of radiation therapy. The lesion was frequently misdiagnosed as brain tumor. Correct diagnosis relies on clinical, radiologic and pathologic correlation.
Department of Pathology, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China.
Xing-fu
XF
Wang
Sheng
S
Zhang
Yu-hong
YH
Ye
Yu-peng
YP
Chen
Xue-yong
XY
Liu
D000368:Aged; D001932:Brain Neoplasms / Q000532:radiotherapy*; D005260:Female; D005910:Glioma / Q000532:radiotherapy*; D006801:Humans; D051795:Hypoxia-Inducible Factor 1, alpha Subunit / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011832:Radiation Injuries / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D011878:Radiotherapy / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed
C497442:HIF1A protein, human; D051795:Hypoxia-Inducible Factor 1, alpha Subunit