We report the case of a 64-year-old man who presented with a hepatic mass and macronodular cirrhosis. The pathologic findings revealed a lymphoepithelioma-like carcinoma arising in the hepatobiliary tract that was morphologically identical to nasopharyngeal undifferentiated carcinoma. However, this tumor was not associated with Epstein-Barr virus infection in molecular studies. Macronodular cirrhosis associated with hepatitis C virus was present in the background liver.
"Unlike carcinomas of other organ sites, the majority of lymphoepithelioma-like cholangiocarcinomas are composed of two different components – an adenocarcinoma and a lymphoepithelioma-like carcinoma. There is only 1 reported case of the pure form of lymphoepithelioma-like carcinoma without well-formed tubules . In the present case, the adenocarcinoma and lymphoepithelioma-like carcinoma components presented several identical characteristics; for example, both had a considerable amount of lymphocyte infiltrate without any conspicuous desmoplastic stroma, the nuclei of the adenocarcinoma and the lymphoepithelioma-like carcinoma resembled each other, and both components revealed diffuse immunoreactivity for p53 protein. "
[Show abstract][Hide abstract] ABSTRACT: Lymphoepithelioma-like cholangiocarcinomas are rare tumors and most of them are related with Epstein-Barr virus (EBV) infection. Here, a case of a patient with lymphoepithelioma-like cholangiocarcinoma not associated with EBV infection is presented. In a 79-year-old man with hepatitis B virus-associated cirrhosis, a liver mass was detected on abdominal CT. Macroscopically, the resected tumor was pale gray, rubbery and well defined. Histologically, the tumor was composed of two components: an adenocarcinoma that formed irregular small glands and a lymphoepithelioma-like carcinoma that exhibited sheets of undifferentiated epithelial cells with lymphoid stroma. Lymphoplasmacytic infiltrates were more predominant in the lymphoepithelioma-like carcinoma than in the adenocarcinoma. Both components were roughly divided, but they gradually merged. Immunohistochemically, the adenocarcinoma component was diffusely positive for AE1/AE3, cytokeratin 7, cytokeratin 19 and epithelial membrane antigen, while the lymphoepithelioma-like carcinoma component was focally positive for them. However, both components were diffusely positive for p53 protein, and in situ hybridization using EBV-encoded RNA 1 was negative in both components as well. Examination of a resected para-aortic lymph node revealed metastasis exclusively of the lymphoepithelioma-like carcinoma component.
Case Reports in Oncology 02/2011; 4(1):68-73. DOI:10.1159/000324485
"The occurrence of LELC in the liver is rare. Only twelve cases of LELC arising in the hepatobiliary tract have been reported        . Most of these tumors were positive for EBV by EBER-1 in situ hybridization. "
[Show abstract][Hide abstract] ABSTRACT: Primary lymphoepithelioma-like carcinomas (LELC) of the hepatobiliary tract are quite rare and the majority are associated with the Epstein-Barr virus (EBV). Here we report an unusual case of intrahepatic cholangiocarcinoma (ICC), admixed with LELC in a 63 year-old Filipino woman who presented clinically with right flank and back pain. Histologically, the tumor showed a dense lymphocytic infiltrate, predominantly composed of CD3 (+) T cells, and two components: an undifferentiated carcinoma, morphologically similar to nasopharyngeal carcinoma, and a poorly differentiated ICC intimately admixed. Immunohistochemical studies revealed that both components were immunoreactive for AE1/AE3, cytokeratin 7 and, focally, for monoclonal CEA. Both components were negative for cytokeratin 20 and HePar 1. EBER-1 in situ hybridization was uniformly positive in the tumor cells. The presence of EBV in ICC and LELC suggests that the virus may be linked to the pathogenesis of both components of the tumor. The mechanism of virus-driven neoplastic transformation needs further study.
International journal of clinical and experimental pathology 01/2010; 3(7):736-41. · 1.89 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Lymphoepithelioma-like carcinomas (LELC) of the liver are rare. Only nine cases have been reported. All of them were considered to be cholangiocarcinoma and the majority were positive for Epstein-Barr virus (EBV) on EBER in situ hybridization. Here we report a case of hepatocellular carcinoma (HCC) mainly composed of LELC. The patient was a 56-year-old man with chronic hepatitis C virus (HCV) infection and cirrhosis. A right-side hepatectomy was performed to remove a 3-cm diameter tumor. Microscopically, the tumor was mainly composed of undifferentiated carcinoma with heavy lymphocytic infiltration, consistent with LELC. The tumor cells of the LELC component were focally positive for HePar 1, CK19 and CK7 and more diffusely positive (50% of tumor cells) for AE1/AE3 on immuno-histochemical study. EBER in situ hybridization was negative. This is the first confirmed case of HCC with an LELC component. In the available literature, all three cases of LELC of the liver that were negative for EBV were associated with chronic viral hepatitis and cirrhosis, suggesting a different carcinogenesis of EBV-positive LELC of the liver.
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