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Related Experiment Videos

Chemotherapy-induced histologic changes in Wilms' tumors.

L A Guarda, A G Ayala, N Jaffe

    Pediatric Pathology
    |January 1, 1984
    PubMed
    Summary

    Preoperative chemotherapy effectively alters Wilms tumor histology, primarily affecting stromal and vascular components. Differentiated elements remain largely unaffected by this treatment approach.

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    Area of Science:

    • Pediatric Oncology
    • Nephrology
    • Pathology

    Background:

    • Wilms tumor is a common pediatric kidney cancer.
    • Preoperative chemotherapy is a standard treatment modality for Wilms tumor.
    • Understanding chemotherapy's pathological effects is crucial for treatment optimization.

    Purpose of the Study:

    • To pathologically evaluate the effects of preoperative chemotherapy on Wilms tumor histology.
    • To compare chemotherapy-treated tumors with a control group of untreated Wilms tumors.
    • To determine the susceptibility of different Wilms tumor elements to chemotherapy.

    Main Methods:

    • Pathological examination of 21 nephrectomy specimens from patients treated with vincristine and actinomycin D chemotherapy.
    • Review of 20 control specimens from untreated Wilms tumor patients.
    • Histological analysis focusing on stromal, blastematous, differentiated, and vascular components.

    Main Results:

    • Diffuse histological changes observed in chemotherapy-treated tumors, primarily affecting the undifferentiated stroma (edema, fibrovascular background, histiocytes).
    • Blastematous nodules showed reduction in size and necrosis in 5 cases.
    • Vascular changes (fibrinoid necrosis, thrombosis, inflammation) were prominent in 15 treated tumors.
    • Differentiated elements (glomeruloid, tubular, rhabdomyoblastic) were largely unaffected.
    • Minimal and focal histological changes noted in the control group.

    Conclusions:

    • Preoperative chemotherapy significantly alters Wilms tumor histology, particularly in stromal and vascular tissues.
    • The study defines the differential susceptibility of Wilms tumor components to chemotherapy.
    • Chemotherapy-induced changes are more pronounced and diffuse compared to minimal changes in untreated tumors.

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