Lymphoepithelioma-like carcinoma of the lung: Analysis of two cases for Epstein-Barr virus infection

doi:10.1016/0046-8177(95)90206-6

Human Pathology

Volume 26, Issue 11, November 1995, Pages 1278-1282

https://doi.org/10.1016/0046-8177(95)90206-6 Get rights and content

Abstract

Lymphoepithelioma-like carcinoma, which is an uncommon histological type of epithelial tumor, has been described as being closely associated with Epstein-Barr virus (EBV) infection in organs other than the lung. Recently, we experienced two surgically resected cases of pulmonary tumors mimicking lymphoepithelioma-like carcinoma. Both cases contained EBV DNA genomes as shown by polymerase chain reaction (PCR) using EBV DNA-specific primers, one positive for EBV DNA in virtually all cancer cells, and the other showing positive hybridization in a small number of cancer cells by in situ hybridization (ISH) using digoxigenin-labeled olignucletide probes for each of EBV DNA for EBV DNA. EBV-encoded RNA-1 (EBER1) was typically detected in one case. These results are highly suggestive of EBV-associated tumors in one of the current cases, although in the other case, no such close association was determined. It seems that lymphoepithelioma-like pulmonary carcinoma, which seems extremely unusual, may be closely associated with EBV infection in tumorigenesis.

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Background: Squamous cell carcinoma is the most frequently encountered malignant tumour of the conjunctiva. The objective of this study was to describe the clinicopathological features of patients with squamous cell carcinoma of the conjunctiva seen at a large ophthalmologic hospital in Mexico City.
Methods: We reviewed the clinical and pathological files of all patients with documented squamous cell carcinoma of the conjunctiva seen at the hospital between 1957 and 1996.
Results: A total of 287 cases (286 patients) were reviewed. The mean age of the patients was 60.4 (range 12 to 99) years; 55% were male. The clinical diagnosis was accurate in 41 % of cases. Typical keratinized squamous cell carcinoma of the conjunctiva accounted for 98% of the lesions, and there were small numbers of histologic variants: lymphoepithelioma-like carcinoma (three cases), spindle cell carcinoma (two cases) and mucoepidermoid carcinoma (one case). Evidence of local extension of the tumour was found in 150 patients (52%), with the cornea being most frequently involved (108 cases [38%]). Regional metastasis was found in two patients, to a submandibular lymph node in one and to a preauricular lymph node in the other. The most common form of treatment was local resection (258 cases [90%]). The mean length of follow-up was 7.7 (range 2 to 24) months. The recurrence rate was 5.2%.
Interpretation: We report a large series of patients with squamous cell carcinoma of the conjunctiva. The incidence of local extension was high. Three cases of lymphoepithelioma-like carcinoma, a variant not previously reported in the conjunctiva, were encountered and were confirmed by immunohistochemical reactions.
Contexte : L'épithélioma spinocellulaire est la tumeur maligne de la conjonctive la plus fréquemment observée. Cette étude a pour objet de décrire les caractéristiques clinicopathologiques des patients qui ont été examines pour un epithelioma spinocellulaire de la conjonctive, dans un important hôpital ophtalmologique de Mexico.
Méthodes: Nous avons examine les dossiers cliniques et pathologiques documentant un epithelioma spinocellulaire de la conjonctive chez les patients examines au dit h6pital entre 1957 et 1996.
Résultats : En tout, 287 cas (286 patients) ont été examinés. L'âge moyen des patients, qui avaient entre 12 et 99 ans, etait de 60,4 ans; 55 % étaient de sexe masculin. Le diagnostic clinique était exact dans 41 % des cas. Les épithéliomas spinocellulaires kératinisés de la conjonctive typiques représentaient 98 % des lésions et l'on a compté un petit nombre de variantes histologiques : épithélioma ayant l'apparence d'un lymphoépithéliome (trois cas); épithélioma cutané papillaire (deux cas) et épithélioma mucoépidermoïde (un cas). On a constaté une extension locale de la tumeur chez 150 patients (52 %), impliquant la plupart du temps la cornée (108 cas [38 %]). On a trouvé des metastases régionales chez deux patients, l'un au ganglion sous-maxillaire et l'autre au ganglion de l'oreille. La forme la plus commune de traitement a été la résection locale (258 cas [90 %]). Sur une période de suivi moyenne de 7,7 mois (allant de 2 à 24 mois), le taux de récurrence était de 5,2 %.
Interprétation: Nous faisons état d'un important groupe de patients ayant un épithelioma spinocellulaire de la conjonctive ainsi qu'une forte incidence d'extension locale. On a constaté trois cas d'épithélioma ayant l'apparence d'un lymphoépithéliome, variante non signalée jusque-la pour la conjonctive, lesquels étaient confirmés par des réactions immunohistochimiques.
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Case studyLymphoepithelioma-like carcinoma of the lung: Analysis of two cases for Epstein-Barr virus infection

Abstract

Clin Lab Med

Lancet

Hum Pathol

Hum Pathol

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CRC Crit Rev Clin Lab Sci

Development of non-Hodgkin lymphoma in a cohort of patients with severe human immunodeficiency virus (HIV) infection on long-term antiretrovial therapy

Ann Intern Med

Epstein-Barr virus in pyothoraxassociated pleural lymphoma

Am J Pathol

Epstein-Barr virus-latent gene expression and tumor cell phenotype in acquired immunodeficiency syndrome-related non-Hodgkin's lymphoma

Lymphoepithelioma-like carcinoma and its relationship to Epstein-Barr virus

Am J Clin Pathol

EBV DNA in biopsies of Burkitt's tumors and anaplastic carcinomas of the nasopharynx

Nature

Expression of Epstein-Barr virus-encoded proteins in nasopharyngeal carcinoma

Int J Cancer

Epstein-Barr virus and nasopharyngeal carcinoma

Semin Cancer Biol

Epstein-Barr virus-associated gastric adenocarcinoma

Am J Pathol

Association of Epstein-Barr virus with gastric carcinoma with lymphoid stroma

Am J Pathol

Epstein-Barr virus in gastric carcinoma

Am J Pathol

Epstein-Barr virus and carcinomas: Rare association of the virus with gastric adenocarcinomas

Br J Cancer

Epstein-Barr virus in gastric carcinoma with lymphoid stroma

Carcinoma of stomach and breast with lymphoid stroma: Localisation of Epstein-Barr virus

J Clin Pathol

Epstein-Barr virus-associated gastric carcinoma and Epstein-Barr virus infection of the stomach

Lab Invest

Case study
Lymphoepithelioma-like carcinoma of the lung: Analysis of two cases for Epstein-Barr virus infection