Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-28T05:06:53.388Z Has data issue: false hasContentIssue false
  • English
  • Français

Contribution to the pathogenesis of radiation-induced injury to large arteries

Published online by Cambridge University Press:  29 June 2007

Nina Zidar ,
Dušan Ferluga ,
Asta Hvala ,
Mara Popovć  and
Erika Šoba
Nina Zidar*
Affiliation:
Institute of Pathology, Medical Faculty, Korytkova 2, 1105 Ljubljana, Slovenia.
Dušan Ferluga
Affiliation:
Institute of Pathology, Medical Faculty, Korytkova 2, 1105 Ljubljana, Slovenia.
Asta Hvala
Affiliation:
Institute of Pathology, Medical Faculty, Korytkova 2, 1105 Ljubljana, Slovenia.
Mara Popovć
Affiliation:
Institute of Pathology, Medical Faculty, Korytkova 2, 1105 Ljubljana, Slovenia.
Erika Šoba
Affiliation:
Institute of Oncology, Zaloška cesta 2, 1105 Ljubljana, Slovenia.
*
Address for correspondence: Nina Zidar, M.D., Institute of Pathology, Medical Faculty, Korytkova 2, 1105 Ljubljana, Slovenia. Fax: +386 61 301 816
Get access Rights & Permissions [Opens in a new window]

Abstract

We report a case of a 35-year-old man who died of a brain infarct 20 months after radiotherapy for carcinoma of the tonsil with metastases to the cervical lymph nodes. Histology revealed mild atherosclerosis, necrotizing vasculitis, and occlusive thrombosis of the internal carotid artery. Significant changes were observed in the vasa vasorum: swelling and detachment of the endothelium, subendothelial oedema, hyaline change, fibrinoid necrosis of the vessel walls with mononuclear cellular infiltration, accompanied by focal haemorrhages and chronic inflammation in the periadventitial soft tissue. We believe that these changes of the vasa vasorum and necrotizing vasculitis are causally related and that vasculitis represents focal ischaemic necroses with inflammatory reaction. Our findings support the hypothesis, based on experimental studies, that injury to the vasa vasorum is an important mechanism in the development of radiation-induced vasculopathy of large arteries. They also suggest an evolution of the injury to the vasa vasorum and periadventitial tissue from the early lesions described in our patient, to late stages resulting in dense periadventitial fibrosis as reported previously. We suggest that injury to the vasa vasorum and the consequent ischaemic lesions of the arterial wall are morphological features distinguishing radiation-induced arterial injury from spontaneous atherosclerosis.

Keywords

Radiation injury, pathogenesisArtery
Type
Pathology in Focus
Information
The Journal of Laryngology & Otology , Volume 111 , Issue 10 , October 1997 , pp. 988 - 990
Copyright
Copyright © JLO (1984) Limited 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Conomy, J. P., Kellermeyer, R. W. (1975) Delayed cerebrovascular consequences of therapeutic radiation. Cancer 36: 1702–1708.3.0.CO;2-V>CrossRefGoogle ScholarPubMed
Cormier, J. M., Brisset, D., Speir, Y., Galiardo, G., Marzelle, J., Laurian, C., Fichelle, J. M. (1993) Fifty-three atherosclerotic carotid stenoses in an irradiated environment. Journal des Maladies Vasculaires 18: 269–274.Google Scholar
Fajardo, L. F. (1993) Basic mechanisms and general morphology of radiation injury. Seminars in Roentgenology 28: 297–302.CrossRefGoogle ScholarPubMed
Fajardo, L. F., Berthrong, M. (1988) Vascular lesions following radiation. Pathology Annual 1: 297–330.Google Scholar
Fajardo, L. F., Lee, A. (1975) Rupture of major vessels after radiation. Cancer 36: 904–913.3.0.CO;2-U>CrossRefGoogle ScholarPubMed
Fonkalsrud, E. W., Sanchez, M., Zerubavel, R., Mahoney, A. (1977) Serial changes in arterial structure following radiation therapy. Surgery, Gynecology and Obstetrics 145: 395–400.Google ScholarPubMed
Glick, B. (1972) Bilateral carotid occlusive disease. Archives of Pathology 93: 352–355.Google ScholarPubMed
Himmel, P. D., Hassett, J. M. (1986) Radiation-induced chronic arterial injury. Seminars in Surgical Oncology 2: 225–247.CrossRefGoogle ScholarPubMed
Johnson, A. G., Lane, B., Harding Rains, A. J., O'Conell, D., Ramsay, N. W. (1969) Large artery damage after X radiation. British Journal of Radiology 42: 937–939.CrossRefGoogle ScholarPubMed
Levinson, S. A., Close, M. B., Ehrenfeld, W. K., Stoney, R. J. (1973) Carotid artery occlusive disease following external cervical irradiation. Archives of Surgery 107: 395–397.CrossRefGoogle ScholarPubMed
Loftus, C. M., Biller, J., Hart, M. N., Cornell, S. H., Hiratzka, L. F. (1987) Management of radiation-induced accelerated carotid atherosclerosis. Archives of Neurology 44: 711–714.CrossRefGoogle ScholarPubMed
McCready, R. A., Hyde, G. L., Bivins, B. A., Mattingly, S. S., Griffen, W. O. (1983) Radiation-induced arterial injuries. Surgery 93: 306–312.Google ScholarPubMed
Moritz, M. W., Higgins, R. F., Jacobs, J. R. (1990) Duplex imaging and incidence of carotid radiation injury after high- dose radiotherapy for tumors of the head and neck. Archives of Surgery 125: 1181–1183.CrossRefGoogle ScholarPubMed
Murros, K. E., Toole, J. F. (1989) The effect of radiation on carotid arteries. Archives of Neurology 46: 449–455.CrossRefGoogle ScholarPubMed
Silverberg, G. D., Britt, R. H., Goffinet, D. R. (1978) Radiation-induced carotid artery disease. Cancer 41: 130–137.3.0.CO;2-X>CrossRefGoogle ScholarPubMed
Smith, D. J. (1961) Effects of gamma radiation on isolated surviving arteries and their vasa vasorum. American Journal of Physiology 201: 901–904.CrossRefGoogle ScholarPubMed