Peritumoural lymphocytic response
Peritumoural lymphocytic response. H&E stain.
Peritumoural lymphocytic response is an uncommon finding in colorectal carcinoma that is associated with a better prognosis and microsatellite instability.[1]
It is also known as Crohn's like reaction,[2] Crohn's-like lymphoid reaction and Crohn-like response.[3]
General
- Finding associated with improved survival in colorectal carcinoma.[1]
Microscopic
There are two sets of criteria (Ueno and Graham). The Ueno criteria have a better inter-rater reproducibility than the older Graham criteria[4] and are less complicated.
Ueno criteria (2013)
Required criteria:[5]
- 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:[4]
- 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
PLR - very low mag. (WC)
PLR - low mag. (WC)
PLR - intermed. mag. (WC)
See also
- Colorectal carcinoma.
- Crohn's disease.
- Tumour-infiltrating lymphocytes.
- Intraepithelial lymphocytes.
References
- ↑ 1.0 1.1 Harrison, JC.; Dean, PJ.; el-Zeky, F.; Vander Zwaag, R. (Jan 1995). "Impact of the Crohn's-like lymphoid reaction on staging of right-sided colon cancer: results of multivariate analysis.". Hum Pathol 26 (1): 31-8. PMID 7821914.
- ↑ Ogino, S.; Nosho, K.; Irahara, N.; Meyerhardt, JA.; Baba, Y.; Shima, K.; Glickman, JN.; Ferrone, CR. et al. (Oct 2009). "Lymphocytic reaction to colorectal cancer is associated with longer survival, independent of lymph node count, microsatellite instability, and CpG island methylator phenotype.". Clin Cancer Res 15 (20): 6412-20. doi:10.1158/1078-0432.CCR-09-1438. PMID 19825961.
- ↑ URL: http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2012/Colon_12protocol_3200.pdf. Accessed on: 14 September 2012.
- ↑ 4.0 4.1 Graham, DM.; Appelman, HD. (May 1990). "Crohn's-like lymphoid reaction and colorectal carcinoma: a potential histologic prognosticator.". Mod Pathol 3 (3): 332-5. PMID 2362940.
- ↑ Ueno, H.; Hashiguchi, Y.; Shimazaki, H.; Shinto, E.; Kajiwara, Y.; Nakanishi, K.; Kato, K.; Maekawa, K. et al. (Apr 2013). "Objective Criteria for Crohn-like Lymphoid Reaction in Colorectal Cancer.". Am J Clin Pathol 139 (4): 434-41. doi:10.1309/AJCPWHUEFTGBWKE4. PMID 23525613.