23 Outcomes of resected SST after CRT Table 1. Criteria for scoring histology (continued) Item/category 0 1 2 3 41 Presence of dyselastosis None Focal Extensive Acute vasculopathy8 (present in 1 or more vessels) None Mainly neutrophils in vessel wall, no thrombi Mainly neutrophils in vessel wall with thrombi or necrosis Mainly lymphocytes in the vessel wall, fibroblastic intima thickening, no thrombi Mainly lymphocytes in vessel wall, fibroblastic intima thickening with thrombi Chronic vasculopathy9 (present in 1 or more vessels) None Slight intima thickening Clear intima thickening Nearly obliterated vessels (pinpoint lumina) Obliterated vessels; no recanalization Boundary tumourlung tissue Sharp all around Mainly sharp (> 75%) Mainly irregular (> 75%) Completely irregular Amount of reactive changes lung parenchyma None Focal (close to mass) Multifocal (one segment) Diffuse Changes lung parenchyma next to mass None Slight (septal thickening, mild inflammation) Moderate septal thickening or inflammation, no structure loss Severe reactive or inflammation, structure loss10 Cytonuclear atypia epithelial cells in lung parenchyma5 None Slight (uniform nuclei, small nucleoli) Moderate (variation nuclear size, stratification, prominent nucleoli) Severe (bizarre nuclei, macronucleoli) 1 Items having more than 4 scores are mentioned below 2 According to WHO classification 200432, not in a semi-quantative order 3 Modified from Dworak grading for colorectal cancer33 4 Cut-off points according to the proposed IASLC staging for lung cancer 200934 Longest axis was used. 5 Most severe atypia accounts for the score 6 Pre-operative specimen not available or cytological 7 At least 3x HPF (1HPF=2mm2) counted35 8 Scores 5-9 as follows: Score 5: mainly lymphocytes within the vessel wall with fibrotic intima thickening without thrombi Score 6: mainly lymphocytes within the vessel wall with fibrotic intima thickening with thrombi Score 7: extensive inflammatory infiltrate within the vessel wall with fibrinoid necrosis Score 8: vasculitis distant from the tumour mass including score 1-7 Score 9: vasculitis distant from the tumour mass including score 0 9 Score 5 as follows: Score 5: obliterated vessels with recanalization (eccentric lumina) 10 Or classifiable as interstitial lung disease pattern To estimate the percentage of vital tumour cells, the area of vital tumour cells was related to the total tumour visible in the microscopy slides, including areas of fibrosis, inflammation and necrosis (Figure 1a-e). 2
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