title: Occurrence of multiple lymphoepithelioma-like carcinomas and MALT-type lymphoma in the stomach: detection of EBV in carcinomas but not in lymphoma.
abstract: A multifocal lymphoepithelioma-like carcinoma and a low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT-type) were found simultaneously in the stomach of a 65-year-old patient. Carcinoma and lymphoma were intimately associated forming complexes resembling lymphoepithelial lesions at the primary gastric site and in lymph node metastases. The two tumours had developed on a background of severe chronic-atrophic gastritis of the mucosa of antrum and fundus. Autoantibodies to normal gastric glandular tissue could be demonstrated in the patient's sera. Using non-radioactive in situ hybridization (ISH), Epstein-Barr virus (EBV) sequences were detected in virtually all carcinoma cells but neither in the non-neoplastic mucosa nor in the lymphoma. These findings suggest that a focal EBV infection occurred early in the development of the carcinoma followed by a subsequent clonal expansion of the EBV-containing tumour cells. A neoplastic transformation in MALT-type lymphoma is not EBV-related but might be triggered by altered immune mechanisms.
authors.affiliation: Institut für Pathologie, Julius Maximilian Universität Würzburg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Greiner
authors.forename: T
authors.initials: T
authors.lastname: Kirchner
authors.forename: G
authors.initials: G
authors.lastname: Ott
authors.forename: A
authors.initials: A
authors.lastname: Marx
authors.forename: W
authors.initials: W
authors.lastname: Fischbach
authors.forename: H K
authors.initials: HK
authors.lastname: Müller-Hermelink
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000821:virology*; D004854:Herpesvirus 4, Human / Q000302:isolation & purification*; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000473:pathology / Q000821:virology*; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000473:pathology* / Q000821:virology*; D013274:Stomach Neoplasms / Q000473:pathology* / Q000821:virology*