Intratumoural lymphocytic response in colorectal carcinoma

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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.




  • >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.


  • † 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]



See also


  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.