Paclitaxel (Taxol) Effect



Paclitaxel (Taxol) Effect


Elizabeth A. Montgomery, MD





Key Facts


Terminology



  • Pattern of mitotic arrest and apoptosis of the gastrointestinal tract mucosa associated with administration of paclitaxel (Taxol)


Clinical Issues



  • Excellent prognosis in most cases



    • Usually findings are incidental, rather than reflection of toxicity


  • Reports of colonic perforation and acute abdomen following taxane administration


  • Often found incidentally in mucosal biopsies obtained within 1-4 days of drug administration



    • Important to correlate with clinical findings


  • Can be found in association with paclitaxel toxicity


Microscopic Pathology



  • Prominent apoptosis and mitotic arrest


  • Ring mitoses







Hematoxylin & eosin shows paclitaxel effect in squamous mucosa. The proliferative compartment of squamous mucosa is at the base, so this is the site of mitotic arrest.






Hematoxylin & eosin at a higher magnification than the previous image shows a striking mitotic arrest pattern.


TERMINOLOGY


Synonyms



  • Taxane effect, paclitaxel effect


Definitions



  • Pattern of mitotic arrest and apoptosis of gastrointestinal tract mucosa associated with administration of paclitaxel (Taxol)



    • Other drug in class of taxanes is docetaxel (Taxotere)



      • Paclitaxel originally isolated from bark of Pacific yew tree, Taxus brevifolia


      • Paclitaxel works by interfering with normal microtubule breakdown during cell division


      • Also activates apoptosis by inducing Bcl-2 phosphorylation, which inhibits Bcl-2 binding to BAX, with subsequent increase in apoptosis


    • Important chemotherapeutic agents



      • Used to treat cancer of esophagus, breast, and lung, as well as advanced Kaposi sarcoma


CLINICAL ISSUES


Presentation

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Jul 6, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Paclitaxel (Taxol) Effect

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