|
|
Line 122: |
Line 122: |
| *<50% of tumour = high-grade (''poorly-differentiated'' and ''undifferentiated''). | | *<50% of tumour = high-grade (''poorly-differentiated'' and ''undifferentiated''). |
|
| |
|
| ===Peritumour lymphocytic response=== | | ===Peritumoural lymphocytic response=== |
| *[[AKA]] ''Crohn's-like lymphoid reaction''. | | *[[AKA]] ''Crohn's-like lymphoid reaction''. |
| *[[AKA]] ''Crohn's like reaction''.<ref name=pmid19825961>{{Cite journal | last1 = Ogino | first1 = S. | last2 = Nosho | first2 = K. | last3 = Irahara | first3 = N. | last4 = Meyerhardt | first4 = JA. | last5 = Baba | first5 = Y. | last6 = Shima | first6 = K. | last7 = Glickman | first7 = JN. | last8 = Ferrone | first8 = CR. | last9 = Mino-Kenudson | first9 = M. | title = Lymphocytic reaction to colorectal cancer is associated with longer survival, independent of lymph node count, microsatellite instability, and CpG island methylator phenotype. | journal = Clin Cancer Res | volume = 15 | issue = 20 | pages = 6412-20 | month = Oct | year = 2009 | doi = 10.1158/1078-0432.CCR-09-1438 | PMID = 19825961 }}</ref> | | *[[AKA]] ''Crohn's like reaction''.<ref name=pmid19825961>{{Cite journal | last1 = Ogino | first1 = S. | last2 = Nosho | first2 = K. | last3 = Irahara | first3 = N. | last4 = Meyerhardt | first4 = JA. | last5 = Baba | first5 = Y. | last6 = Shima | first6 = K. | last7 = Glickman | first7 = JN. | last8 = Ferrone | first8 = CR. | last9 = Mino-Kenudson | first9 = M. | title = Lymphocytic reaction to colorectal cancer is associated with longer survival, independent of lymph node count, microsatellite instability, and CpG island methylator phenotype. | journal = Clin Cancer Res | volume = 15 | issue = 20 | pages = 6412-20 | month = Oct | year = 2009 | doi = 10.1158/1078-0432.CCR-09-1438 | PMID = 19825961 }}</ref> |
| *[[AKA]] ''Crohn-like response''.<ref>URL: [http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2012/Colon_12protocol_3200.pdf http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2012/Colon_12protocol_3200.pdf]. Accessed on: 14 September 2012.</ref> | | *[[AKA]] ''Crohn-like response''.<ref>URL: [http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2012/Colon_12protocol_3200.pdf http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2012/Colon_12protocol_3200.pdf]. Accessed on: 14 September 2012.</ref> |
| | | {{Main|Peritumoural lymphocytic response}} |
| ====General====
| |
| *Finding associated with improved survival in CRC.<ref name=pmid7821914 >{{Cite journal | last1 = Harrison | first1 = JC. | last2 = Dean | first2 = PJ. | last3 = el-Zeky | first3 = F. | last4 = Vander Zwaag | first4 = R. | title = Impact of the Crohn's-like lymphoid reaction on staging of right-sided colon cancer: results of multivariate analysis. | journal = Hum Pathol | volume = 26 | issue = 1 | pages = 31-8 | month = Jan | year = 1995 | doi = | PMID = 7821914 }}</ref>
| |
| | |
| ====Microscopic====
| |
| There are two sets of criteria (''Ueno'' and ''Graham''). The Ueno criteria have a better inter-rater reproducibility than the older Graham criteria<ref name=pmid2362940/> and are less complicated.
| |
| | |
| =====Ueno criteria (2013)=====
| |
| Required criteria:<ref name=pmid23525613>{{Cite journal | last1 = Ueno | first1 = H. | last2 = Hashiguchi | first2 = Y. | last3 = Shimazaki | first3 = H. | last4 = Shinto | first4 = E. | last5 = Kajiwara | first5 = Y. | last6 = Nakanishi | first6 = K. | last7 = Kato | first7 = K. | last8 = Maekawa | first8 = K. | last9 = Miyai | first9 = K. | title = Objective Criteria for Crohn-like Lymphoid Reaction in Colorectal Cancer. | journal = Am J Clin Pathol | volume = 139 | issue = 4 | pages = 434-41 | month = Apr | year = 2013 | doi = 10.1309/AJCPWHUEFTGBWKE4 | PMID = 23525613 }}</ref>
| |
| *Non-MALT lymphoid aggregates (peritumoural) >= 1 mm.
| |
| | |
| Ignore:
| |
| #Muscosa-associated lymphoid tissue (MALT) = mucosal lymphoid aggregates, submucosal lymphoid aggregates adjacent to the musuclaris mucosae.
| |
| #Lymph nodes - these have a (fibrous) capsule.
| |
| #Irregular shape (not round).
| |
| | |
| =====Graham criteria (1990)=====
| |
| Required criteria:<ref name=pmid2362940>{{Cite journal | last1 = Graham | first1 = DM. | last2 = Appelman | first2 = HD. | title = Crohn's-like lymphoid reaction and colorectal carcinoma: a potential histologic prognosticator. | journal = Mod Pathol | volume = 3 | issue = 3 | pages = 332-5 | month = May | year = 1990 | doi = | PMID = 2362940 }}</ref>
| |
| *Peritumoral:
| |
| *#Lymphoid aggregates with germinal centres focally.
| |
| *#Stellate fibrosis.
| |
| *#No previous clinical and pathologic evidence of [[Crohn's disease]].
| |
| | |
| Note:
| |
| *Should '''not''' be confused with [[intratumoural lymphocytic response]].
| |
| **The intratumoural lymphocytic response is associated with MSI-H cancers.
| |
| | |
| =====Images=====
| |
| <gallery>
| |
| Image:Peritumour lymphocytic response - low mag.jpg | PLR - low mag. (WC)
| |
| Image:Peritumour lymphocytic response - intermed mag.jpg | PLR - intermed. mag. (WC)
| |
| </gallery>
| |
| www:
| |
| *[http://jcp.bmjjournals.com/content/62/8/679/F2.large.jpg Peritumour lymphocytic response in endometrial carcinoma (bmjjournals.com)].
| |
| *[http://ajcp.ascpjournals.org/content/134/3/478/F3.expansion.html Peritumour lymphocytic response in CRC (ascpjournals.org)].<ref name=pmid20716806>{{Cite journal | last1 = Ross | first1 = JS. | last2 = Torres-Mora | first2 = J. | last3 = Wagle | first3 = N. | last4 = Jennings | first4 = TA. | last5 = Jones | first5 = DM. | title = Biomarker-based prediction of response to therapy for colorectal cancer: current perspective. | journal = Am J Clin Pathol | volume = 134 | issue = 3 | pages = 478-90 | month = Sep | year = 2010 | doi = 10.1309/AJCP2Y8KTDPOAORH | PMID = 20716806 | URL = http://ajcp.ascpjournals.org/content/134/3/478.full}}</ref>
| |
|
| |
|
| ===Intratumoural lymphocytic response=== | | ===Intratumoural lymphocytic response=== |