Table 1.
Endoscopic and pathological findings of immune-related diarrhea and colitis | |
Endoscopic findings | |
Endoscopic features | (1) Exudates; (2) loss of vascular pattern; (3) granular or edematous mucosa; (4) patch or diffuse erythema; (5) aphtha; (6) ulceration |
Inflammatory distribution | (1) Diffuse; (2) patchy (dominantly more diffuse than patchy) |
Risk factors for steroid-refractory colitis | (1) Extensively inflamed area (e.g., pancolitis); (2) deeper ulceration |
Pathological findings | |
Anti-CTLA-4 associated colitis | Like autoimmune colitis: (1) lamina propria expansion due to dense lymphoplasmacytic infiltrate; (2) increased intraepithelial lymphocytosis; (3) apoptosis in the crypts; (4) neutrophilic cryptitis and crypt abscess; (5) occasional prominent eosinophilia in the lamina propria; (6) the lack of findings of basal plasmacytosis, crypt distortion, or granulomas |
Anti-PD1/anti-PDL1-associated colitis | (1) Expansion of lamina propria by lymphoplasmacytic infiltrate; (2) the increase in intraepithelial neutrophils and neutrophilic crypt abscess; (3) crypt distortion; (4) increased crypt cell apoptosis |
CTLA-4: Cytotoxic T-lymphocyte antigen-4; PD1: Programmed cell death protein 1; PDL1: Programmed cell death receptor ligand 1.