Geisinger K R, Scobey M W, Northway M G, Cassidy K T, Castell D O
Department of Pathology, Wake Forest University, Bowman Gray School of Medicine, Winston-Salem, North Carolina 27103.
Dig Dis Sci. 1990 Jul;35(7):833-9. doi: 10.1007/BF01536796.
Therapeutic pelvic irradiation is notorious for the production of clinically significant sequela after a long latency. One of the rarest of these complications is proctitis cystica profunda (PCP). To study the histologic changes of chronic radiation proctitis, we evaluated 35 female Wistar rats that had received a single exposure of 22.5 Gy of radiation to the rectum and were then followed for one year. We identified PCP and its precursor lesions in 18 rats. The fully developed lesion consisted of a focal expansion of the submucosa by dilated cystic spaces lined by a single layer of benign epithelial cells. Usually, PCP evolved as glands herniated between small defects in the muscularis mucosae. Mitotic figures were not recognized in the cells lining the herniating glands. In two rats, the radiation had apparently caused large ulcers, which had subsequently reepithelialized, resulting in prominent submucosal glandular tissue. Although the number of goblet cells in the displaced epithelium was reduced, the cells had rather mature appearances ultrastructurally. Glands displaced into the submucosa were encased by an intact basal lamina but lacked in muscularis.
盆腔治疗性放疗因在长时间潜伏期后产生具有临床意义的后遗症而声名狼藉。其中最罕见的并发症之一是深部囊性直肠炎（PCP）。为了研究慢性放射性直肠炎的组织学变化，我们评估了35只雌性Wistar大鼠，这些大鼠接受了单次22.5 Gy的直肠照射，然后随访一年。我们在18只大鼠中发现了PCP及其前驱病变。完全发展的病变表现为黏膜下层被单层良性上皮细胞衬里的扩张囊性间隙局灶性扩张。通常，PCP是由腺体在黏膜肌层小缺损之间疝出演变而来。在疝出腺体的衬里细胞中未发现有丝分裂象。在两只大鼠中，放疗显然导致了大溃疡，随后溃疡重新上皮化，导致黏膜下腺组织突出。尽管移位上皮中的杯状细胞数量减少，但这些细胞在超微结构上外观相当成熟。移位到黏膜下层的腺体被完整的基膜包裹，但缺乏肌层。
