Difference between revisions of "Intratumoural lymphocytic response in colorectal carcinoma"

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This article deals with '''intratumoural lymphocytic response in colorectal carcinoma'''. It is usually just referred as '''intratumoural lymphocytic response'''.
[[Image:Tumour-infiltrating lymphocytes - 2 -- very high mag.jpg|thumb|right|Intratumoural lymphocytic response in colorectal carcinoma, as may be seen in [[Microsatellite instability in colorectal cancer|microsatellite instability]]. [[H&E stain]]. (WC)]]
This article deals with the '''intratumoural lymphocytic response in colorectal carcinoma'''. It is usually referred to as '''intratumoural lymphocytic response'''.


It is also known as '''tumour-infiltrating lymphocytes''', abbreviated '''TILs'''.
It is also known as '''tumour-infiltrating lymphocytes''', abbreviated '''TILs'''.
A general discussion about TILs is in the ''[[tumour-infiltrating lymphocytes]]'' article.


==General==
==General==
*Finding is suggestive of microsatellite instabillity.<ref name=pmid21114775>{{Cite journal  | last1 = Iacopetta | first1 = B. | last2 = Grieu | first2 = F. | last3 = Amanuel | first3 = B. | title = Microsatellite instability in colorectal cancer. | journal = Asia Pac J Clin Oncol | volume = 6 | issue = 4 | pages = 260-9 | month = Dec | year = 2010 | doi = 10.1111/j.1743-7563.2010.01335.x | PMID = 21114775 }}</ref>
*Finding is suggestive of [[Microsatellite instability in colorectal cancer|microsatellite instability]].<ref name=pmid21114775>{{Cite journal  | last1 = Iacopetta | first1 = B. | last2 = Grieu | first2 = F. | last3 = Amanuel | first3 = B. | title = Microsatellite instability in colorectal cancer. | journal = Asia Pac J Clin Oncol | volume = 6 | issue = 4 | pages = 260-9 | month = Dec | year = 2010 | doi = 10.1111/j.1743-7563.2010.01335.x | PMID = 21114775 }}</ref>
**May be seen in the context of [[Lynch syndrome]].
**May be seen in the context of [[Lynch syndrome]].


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Features:
Features:
*>10 lymphocytes/0.94 mm<sup>2</sup>.<ref name=pmid12717242>{{Cite journal  | last1 = Greenson | first1 = JK. | last2 = Bonner | first2 = JD. | last3 = Ben-Yzhak | first3 = O. | last4 = Cohen | first4 = HI. | last5 = Miselevich | first5 = I. | last6 = Resnick | first6 = MB. | last7 = Trougouboff | first7 = P. | last8 = Tomsho | first8 = LD. | last9 = Kim | first9 = E. | title = Phenotype of microsatellite unstable colorectal carcinomas: Well-differentiated and focally mucinous tumors and the absence of dirty necrosis correlate with microsatellite instability. | journal = Am J Surg Pathol | volume = 27 | issue = 5 | pages = 563-70 | month = May | year = 2003 | doi =  | PMID = 12717242 }}</ref> †
*>10 lymphocytes/0.94 mm<sup>2</sup>.<ref name=pmid12717242>{{Cite journal  | last1 = Greenson | first1 = JK. | last2 = Bonner | first2 = JD. | last3 = Ben-Yzhak | first3 = O. | last4 = Cohen | first4 = HI. | last5 = Miselevich | first5 = I. | last6 = Resnick | first6 = MB. | last7 = Trougouboff | first7 = P. | last8 = Tomsho | first8 = LD. | last9 = Kim | first9 = E. | title = Phenotype of microsatellite unstable colorectal carcinomas: Well-differentiated and focally mucinous tumors and the absence of dirty necrosis correlate with microsatellite instability. | journal = Am J Surg Pathol | volume = 27 | issue = 5 | pages = 563-70 | month = May | year = 2003 | doi =  | PMID = 12717242 }}</ref> †
**Lymphocytes should be between the tumour cells.<ref name=pmid12717242/><ref name=pmid19638537/> ††
**Lymphocytes must be between the tumour cells.<ref name=pmid12717242/><ref name=pmid19638537/> ††
***Other lymphocytes do not count.
***Lymphocytes elsewhere, e.g. in the peritumoural stroma, do ''not'' count.
***Typically, the lymphocytes have a halo around them.


Note:
Notes:
* † Greenson ''et al.'' says ''>2 lymphocytes/HPF, where 5 HPF are sampled''. Since the sample area given by Greenson ''et al.'' is 0.94 mm<sup>2</sup>, their field diameter is ~ 0.4892 mm. This field diameter corresponds to a 20 mm eye piece (0.4892 mm * 40x = 19.57 mm).  
* † Greenson ''et al.'' says ''>2 lymphocytes/HPF, where 5 HPF are sampled with the 40x objective''. Since the sample area given by Greenson ''et al.'' is 0.94 mm<sup>2</sup>, the field diameter is ~ 0.4892 mm. This field diameter corresponds to a 20 mm eye piece (0.4892 mm * 40x = 19.57 mm).  
**Many microscopes in use today have a field diameter at 40x of ~ 0.55 mm; thus, 4 fields would be approximately 0.95 mm<sup>2</sup>.  
**Many microscopes in use today have a field diameter (at 40x) of ~ 0.55 mm; thus, 4 fields would be approximately 0.95 mm<sup>2</sup>.  
* †† Definitions vary substantially - some authors consider lymphocytes adjacent to the tumour (in the stroma around the tumour cells) "intratumoural".<reF name=pmid9349235>{{Cite journal  | last1 = Ropponen | first1 = KM. | last2 = Eskelinen | first2 = MJ. | last3 = Lipponen | first3 = PK. | last4 = Alhava | first4 = E. | last5 = Kosma | first5 = VM. | title = Prognostic value of tumour-infiltrating lymphocytes (TILs) in colorectal cancer. | journal = J Pathol | volume = 182 | issue = 3 | pages = 318-24 | month = Jul | year = 1997 | doi = 10.1002/(SICI)1096-9896(199707)182:3318::AID-PATH8623.0.CO;2-6 | PMID = 9349235 |URL = http://onlinelibrary.wiley.com/doi/10.1002/%28SICI%291096-9896%28199707%29182:3%3C318::AID-PATH862%3E3.0.CO;2-6/pdf}}</ref>
* †† Definitions vary substantially - some authors consider lymphocytes adjacent to the tumour (in the stroma around the tumour cells) "intratumoural".<reF name=pmid9349235>{{Cite journal  | last1 = Ropponen | first1 = KM. | last2 = Eskelinen | first2 = MJ. | last3 = Lipponen | first3 = PK. | last4 = Alhava | first4 = E. | last5 = Kosma | first5 = VM. | title = Prognostic value of tumour-infiltrating lymphocytes (TILs) in colorectal cancer. | journal = J Pathol | volume = 182 | issue = 3 | pages = 318-24 | month = Jul | year = 1997 | doi = 10.1002/(SICI)1096-9896(199707)182:3318::AID-PATH8623.0.CO;2-6 | PMID = 9349235 |URL = http://onlinelibrary.wiley.com/doi/10.1002/%28SICI%291096-9896%28199707%29182:3%3C318::AID-PATH862%3E3.0.CO;2-6/pdf}}</ref>


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*[http://jcp.bmjjournals.com/content/62/8/679/F3.large.jpg TILs in endometrial carcinoma (bmjjournals.com)].<ref name=pmid19638537>{{Cite journal  | last1 = Garg | first1 = K. | last2 = Soslow | first2 = RA. | title = Lynch syndrome (hereditary non-polyposis colorectal cancer) and endometrial carcinoma. | journal = J Clin Pathol | volume = 62 | issue = 8 | pages = 679-84 | month = Aug | year = 2009 | doi = 10.1136/jcp.2009.064949 | PMID = 19638537 | URL = http://jcp.bmjjournals.com/content/62/8/679.full?related-urls=yes&legid=jclinpath;62/8/679 }}</ref>
*[http://jcp.bmjjournals.com/content/62/8/679/F3.large.jpg TILs in endometrial carcinoma (bmjjournals.com)].<ref name=pmid19638537>{{Cite journal  | last1 = Garg | first1 = K. | last2 = Soslow | first2 = RA. | title = Lynch syndrome (hereditary non-polyposis colorectal cancer) and endometrial carcinoma. | journal = J Clin Pathol | volume = 62 | issue = 8 | pages = 679-84 | month = Aug | year = 2009 | doi = 10.1136/jcp.2009.064949 | PMID = 19638537 | URL = http://jcp.bmjjournals.com/content/62/8/679.full?related-urls=yes&legid=jclinpath;62/8/679 }}</ref>
*[http://ajcp.ascpjournals.org/content/134/3/478/F2.expansion.html TILs 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 }}</ref>
*[http://ajcp.ascpjournals.org/content/134/3/478/F2.expansion.html TILs 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 }}</ref>
==See also==
==See also==
*[[Colorectal adenocarcinoma]].
*[[Colorectal adenocarcinoma]].
*[[Crohn's like response]].
*[[Peritumoural lymphocytic response]] - also known as ''Crohn's like response''.


==References==
==References==

Latest revision as of 14:33, 25 May 2016

Intratumoural lymphocytic response in colorectal carcinoma, as may be seen in microsatellite instability. H&E stain. (WC)

This article deals with the intratumoural lymphocytic response in colorectal carcinoma. It is usually referred to as intratumoural lymphocytic response.

It is also known as tumour-infiltrating lymphocytes, abbreviated TILs.

A general discussion about TILs is in the tumour-infiltrating lymphocytes article.

General

Microscopic

Features:

  • >10 lymphocytes/0.94 mm2.[2]
    • Lymphocytes must be between the tumour cells.[2][3] ††
      • Lymphocytes elsewhere, e.g. in the peritumoural stroma, do not count.
      • Typically, the lymphocytes have a halo around them.

Notes:

  • † Greenson et al. says >2 lymphocytes/HPF, where 5 HPF are sampled with the 40x objective. Since the sample area given by Greenson et al. is 0.94 mm2, the field diameter is ~ 0.4892 mm. This field diameter corresponds to a 20 mm eye piece (0.4892 mm * 40x = 19.57 mm).
    • Many microscopes in use today have a field diameter (at 40x) of ~ 0.55 mm; thus, 4 fields would be approximately 0.95 mm2.
  • †† Definitions vary substantially - some authors consider lymphocytes adjacent to the tumour (in the stroma around the tumour cells) "intratumoural".[4]

Images

www:

See also

References

  1. Iacopetta, B.; Grieu, F.; Amanuel, B. (Dec 2010). "Microsatellite instability in colorectal cancer.". Asia Pac J Clin Oncol 6 (4): 260-9. doi:10.1111/j.1743-7563.2010.01335.x. PMID 21114775.
  2. 2.0 2.1 Greenson, JK.; Bonner, JD.; Ben-Yzhak, O.; Cohen, HI.; Miselevich, I.; Resnick, MB.; Trougouboff, P.; Tomsho, LD. et al. (May 2003). "Phenotype of microsatellite unstable colorectal carcinomas: Well-differentiated and focally mucinous tumors and the absence of dirty necrosis correlate with microsatellite instability.". Am J Surg Pathol 27 (5): 563-70. PMID 12717242.
  3. 3.0 3.1 Garg, K.; Soslow, RA. (Aug 2009). "Lynch syndrome (hereditary non-polyposis colorectal cancer) and endometrial carcinoma.". J Clin Pathol 62 (8): 679-84. doi:10.1136/jcp.2009.064949. PMID 19638537.
  4. Ropponen, KM.; Eskelinen, MJ.; Lipponen, PK.; Alhava, E.; Kosma, VM. (Jul 1997). "Prognostic value of tumour-infiltrating lymphocytes (TILs) in colorectal cancer.". J Pathol 182 (3): 318-24. doi:10.1002/(SICI)1096-9896(199707)182:3318::AID-PATH8623.0.CO;2-6. PMID 9349235.
  5. Ross, JS.; Torres-Mora, J.; Wagle, N.; Jennings, TA.; Jones, DM. (Sep 2010). "Biomarker-based prediction of response to therapy for colorectal cancer: current perspective.". Am J Clin Pathol 134 (3): 478-90. doi:10.1309/AJCP2Y8KTDPOAORH. PMID 20716806.