90Y-TheraSpheres: The New Look of Yttrium-90

Christina A. Arnold, Maryam Kherad Pezhouh, Dora Lam-Himlin, Meredith E. Pittman, Christopher Vandenbussche, Lysandra Voltaggio

Research output: Contribution to journalArticle

Abstract

Selective internal radiation therapy with 90Y-TheraSphere or 90Y-SIRSphere is used in the treatment of unresectable hepatic malignancies. To the best of our knowledge, this is the first 90Y-TheraSpheres series. BTG International Canada Inc. provided nonradiated microspheres from the Nordion manufacturer. The histologic processed microspheres were colorless, refractile, polarizable, 20 to 30 μm in diameter, and an occasional internal bulls'-eye seen with the condenser out and an internal cross seen with polarized light. Identical microspheres were identified in 15 hepatectomy specimens from four centers between February 2016 and March 2018. The patients were usually male (male=10, female=5) with a mean age of 59 years. All patients had a prior diagnosis of hepatocellular carcinoma (HCC) and documented 90Y-TheraSphere (mean duration from last deployment=32 wk). All surgical pathology specimens in these 15 patients were reviewed, but the microspheres were only identified in the hepatectomy specimens. During manuscript preparation, one case of 90Y-TheraSpheres gastritis was prospectively identified from a separate patient with a history of HCC and 90Y-TheraSpheres. In conclusion, recognition of 90Y-TheraSpheres is important so that one may consider the possibility of a nearby malignancy and or establish the cause of the background inflammatory or radiation-related injury. These structures can be easy to miss because the subtle morphology is distinct from previously reported 90Y-SIRSphere. Clues to the diagnosis include a history of HCC and background radiation change. We report the characteristic morphology as microspheres that overlap in size with 90Y-SIRSphere, but can be differentiated based on 90Y-TheraSpheres' colorless appearance with occasional internal bulls'-eyes with the condenser out and an internal cross with polarized light.

Original languageEnglish (US)
JournalAmerican Journal of Surgical Pathology
DOIs
StatePublished - Jan 1 2019

Fingerprint

Yttrium
Microspheres
Hepatocellular Carcinoma
Hepatectomy
Background Radiation
Light
Surgical Pathology
Radiation Injuries
Manuscripts
Gastritis
Canada
Neoplasms
Radiotherapy
Liver

Keywords

  • Y-SIRSphere
  • Y-TheraSphere
  • hepatocellular carcinoma
  • microspheres
  • selective internal radiation therapy (SIRT)
  • transarterial chemoembolization (TACE)
  • transarterial radioembolization

ASJC Scopus subject areas

  • Anatomy
  • Surgery
  • Pathology and Forensic Medicine

Cite this

Arnold, Christina A. ; Kherad Pezhouh, Maryam ; Lam-Himlin, Dora ; Pittman, Meredith E. ; Vandenbussche, Christopher ; Voltaggio, Lysandra. / 90Y-TheraSpheres : The New Look of Yttrium-90. In: American Journal of Surgical Pathology. 2019.
@article{19b8349660dc47f3849302ece100d981,
title = "90Y-TheraSpheres: The New Look of Yttrium-90",
abstract = "Selective internal radiation therapy with 90Y-TheraSphere or 90Y-SIRSphere is used in the treatment of unresectable hepatic malignancies. To the best of our knowledge, this is the first 90Y-TheraSpheres series. BTG International Canada Inc. provided nonradiated microspheres from the Nordion manufacturer. The histologic processed microspheres were colorless, refractile, polarizable, 20 to 30 μm in diameter, and an occasional internal bulls'-eye seen with the condenser out and an internal cross seen with polarized light. Identical microspheres were identified in 15 hepatectomy specimens from four centers between February 2016 and March 2018. The patients were usually male (male=10, female=5) with a mean age of 59 years. All patients had a prior diagnosis of hepatocellular carcinoma (HCC) and documented 90Y-TheraSphere (mean duration from last deployment=32 wk). All surgical pathology specimens in these 15 patients were reviewed, but the microspheres were only identified in the hepatectomy specimens. During manuscript preparation, one case of 90Y-TheraSpheres gastritis was prospectively identified from a separate patient with a history of HCC and 90Y-TheraSpheres. In conclusion, recognition of 90Y-TheraSpheres is important so that one may consider the possibility of a nearby malignancy and or establish the cause of the background inflammatory or radiation-related injury. These structures can be easy to miss because the subtle morphology is distinct from previously reported 90Y-SIRSphere. Clues to the diagnosis include a history of HCC and background radiation change. We report the characteristic morphology as microspheres that overlap in size with 90Y-SIRSphere, but can be differentiated based on 90Y-TheraSpheres' colorless appearance with occasional internal bulls'-eyes with the condenser out and an internal cross with polarized light.",
keywords = "Y-SIRSphere, Y-TheraSphere, hepatocellular carcinoma, microspheres, selective internal radiation therapy (SIRT), transarterial chemoembolization (TACE), transarterial radioembolization",
author = "Arnold, {Christina A.} and {Kherad Pezhouh}, Maryam and Dora Lam-Himlin and Pittman, {Meredith E.} and Christopher Vandenbussche and Lysandra Voltaggio",
year = "2019",
month = "1",
day = "1",
doi = "10.1097/PAS.0000000000001223",
language = "English (US)",
journal = "American Journal of Surgical Pathology",
issn = "0147-5185",
publisher = "Lippincott Williams and Wilkins",

}

90Y-TheraSpheres : The New Look of Yttrium-90. / Arnold, Christina A.; Kherad Pezhouh, Maryam; Lam-Himlin, Dora; Pittman, Meredith E.; Vandenbussche, Christopher; Voltaggio, Lysandra.

In: American Journal of Surgical Pathology, 01.01.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - 90Y-TheraSpheres

T2 - The New Look of Yttrium-90

AU - Arnold, Christina A.

AU - Kherad Pezhouh, Maryam

AU - Lam-Himlin, Dora

AU - Pittman, Meredith E.

AU - Vandenbussche, Christopher

AU - Voltaggio, Lysandra

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Selective internal radiation therapy with 90Y-TheraSphere or 90Y-SIRSphere is used in the treatment of unresectable hepatic malignancies. To the best of our knowledge, this is the first 90Y-TheraSpheres series. BTG International Canada Inc. provided nonradiated microspheres from the Nordion manufacturer. The histologic processed microspheres were colorless, refractile, polarizable, 20 to 30 μm in diameter, and an occasional internal bulls'-eye seen with the condenser out and an internal cross seen with polarized light. Identical microspheres were identified in 15 hepatectomy specimens from four centers between February 2016 and March 2018. The patients were usually male (male=10, female=5) with a mean age of 59 years. All patients had a prior diagnosis of hepatocellular carcinoma (HCC) and documented 90Y-TheraSphere (mean duration from last deployment=32 wk). All surgical pathology specimens in these 15 patients were reviewed, but the microspheres were only identified in the hepatectomy specimens. During manuscript preparation, one case of 90Y-TheraSpheres gastritis was prospectively identified from a separate patient with a history of HCC and 90Y-TheraSpheres. In conclusion, recognition of 90Y-TheraSpheres is important so that one may consider the possibility of a nearby malignancy and or establish the cause of the background inflammatory or radiation-related injury. These structures can be easy to miss because the subtle morphology is distinct from previously reported 90Y-SIRSphere. Clues to the diagnosis include a history of HCC and background radiation change. We report the characteristic morphology as microspheres that overlap in size with 90Y-SIRSphere, but can be differentiated based on 90Y-TheraSpheres' colorless appearance with occasional internal bulls'-eyes with the condenser out and an internal cross with polarized light.

AB - Selective internal radiation therapy with 90Y-TheraSphere or 90Y-SIRSphere is used in the treatment of unresectable hepatic malignancies. To the best of our knowledge, this is the first 90Y-TheraSpheres series. BTG International Canada Inc. provided nonradiated microspheres from the Nordion manufacturer. The histologic processed microspheres were colorless, refractile, polarizable, 20 to 30 μm in diameter, and an occasional internal bulls'-eye seen with the condenser out and an internal cross seen with polarized light. Identical microspheres were identified in 15 hepatectomy specimens from four centers between February 2016 and March 2018. The patients were usually male (male=10, female=5) with a mean age of 59 years. All patients had a prior diagnosis of hepatocellular carcinoma (HCC) and documented 90Y-TheraSphere (mean duration from last deployment=32 wk). All surgical pathology specimens in these 15 patients were reviewed, but the microspheres were only identified in the hepatectomy specimens. During manuscript preparation, one case of 90Y-TheraSpheres gastritis was prospectively identified from a separate patient with a history of HCC and 90Y-TheraSpheres. In conclusion, recognition of 90Y-TheraSpheres is important so that one may consider the possibility of a nearby malignancy and or establish the cause of the background inflammatory or radiation-related injury. These structures can be easy to miss because the subtle morphology is distinct from previously reported 90Y-SIRSphere. Clues to the diagnosis include a history of HCC and background radiation change. We report the characteristic morphology as microspheres that overlap in size with 90Y-SIRSphere, but can be differentiated based on 90Y-TheraSpheres' colorless appearance with occasional internal bulls'-eyes with the condenser out and an internal cross with polarized light.

KW - Y-SIRSphere

KW - Y-TheraSphere

KW - hepatocellular carcinoma

KW - microspheres

KW - selective internal radiation therapy (SIRT)

KW - transarterial chemoembolization (TACE)

KW - transarterial radioembolization

UR - http://www.scopus.com/inward/record.url?scp=85061102682&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85061102682&partnerID=8YFLogxK

U2 - 10.1097/PAS.0000000000001223

DO - 10.1097/PAS.0000000000001223

M3 - Article

JO - American Journal of Surgical Pathology

JF - American Journal of Surgical Pathology

SN - 0147-5185

ER -