Colon
Noninfectious colitis
Ipilimumab associated colitis


Topic Completed: 1 May 2016

Minor changes: 30 September 2020

Copyright: 2016-2020, PathologyOutlines.com, Inc.

PubMed Search: colon colitis Ipilimumab

Raul S. Gonzalez, M.D.
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Cite this page: Gonzalez R. Ipilimumab associated colitis. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/coloncolitisipilimumab.html. Accessed October 28th, 2020.
Definition / general
  • Colitis caused by use of the anti-CTLA4 medication, ipilimumab
Essential features
  • Colitis is a somewhat common side effect of ipilimumab
  • Can be mild (diarrhea) or severe (perforation, death)
  • Histology: increased intraepithelial lymphocytes, increased apoptosis, cryptitis
Epidemiology
  • Occurs in up to 29% of patients taking ipilimumab, an immunologic agent used for melanoma and other malignancies (Melanoma Res 2015;25:321)
Sites
Pathophysiology
  • Causes dysregulation of gastrointestinal mucosal immunity
Clinical features
  • Diarrhea, colitis
Radiology description
Prognostic factors
Case reports
Treatment
Clinical images

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Ipilimumab associated colitis
on colonoscopy

Gross images

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Cecal perforation due to severe colitis

Microscopic (histologic) description
  • Lymphoplasmacytic expansion of lamina propria; increased apoptosis and intraepithelial lymphocytes; cryptitis and crypt elongation (Am J Surg Pathol 2008;32:1130)
  • Severe cases may show ulceration/perforation, pseudopolyp formation and crypt dilation, without lymphocytosis or apoptosis (J Clin Gastroenterol 2013;47:781)
Microscopic (histologic) images

Contributed by Raul S. Gonzalez, M.D.
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Various images

Positive stains
  • Immunohistochemistry (CD3, CD4, CD8) shows increase in T cell subsets
Differential diagnosis
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