title: Intrahepatic cholangiocarcinoma with lymphoepithelioma-like component.
abstract: We present two cases of intrahepatic cholangiocarcinoma with lymphoepithelioma-like component. The patients included one woman and one man, aged 67 and 41 years, respectively. They presented with right upper quadrant pain and epigastralgia. Histologically, both tumors showed two distinct histological patterns with dense lymphoplasma cell infiltration. The first pattern was a well to moderately differentiated adenocarcinoma; the second component showed a feature similar to lymphoepithelioma-like carcinoma. Granulomatous reaction was noted in one case. Immunohistochemical study revealed that both tumors were immunoreactive with AE1/AE3, cytokeratin 7, and cytokeratin 19 but negative for carcinoembryonic antigen and cytokeratin 20. The stromal lymphocytes were composed of predominantly CD3(+) T cells. In situ hybridization for Epstein-Barr virus (EBV)-encoded RNA (EBER) showed positive nuclear signal in tumor cells but not in inflammatory cells in one case. The presence or absence of EBV genome was confirmed by polymerase chain reaction of LMP-1 gene in both cases. The LMP-1 gene also had a 30-bp deletion in Exon 3 as compared with the products from B95-8 cells. We further sequenced the PCR product and confirmed a 30-bp deletion between Nucleotide (nt) 168,282 and nt 168,253 corresponding to the B95-8 sequence. The clinical significance of 30-bp deletion in Exon 3 of the LMP-1 gene in lymphoepithelioma-like carcinoma of the liver warrants further investigation.
authors.affiliation: Department of Pathology, Chang Gung Memorial Hospital, Chang Gung University School of Medicine, Kwei San, Tao Yuan, Taiwan. ctc323@mail.cgu.edu.tw
authors.forename: T C
authors.initials: TC
authors.lastname: Chen
authors.forename: K F
authors.initials: KF
authors.lastname: Ng
authors.forename: T
authors.initials: T
authors.lastname: Kuo
mesh_terms: D048868:Adaptor Proteins, Signal Transducing; D000368:Aged; D001650:Bile Duct Neoplasms / Q000737:chemistry / Q000235:genetics / Q000473:pathology* / Q000821:virology; D001653:Bile Ducts, Intrahepatic / Q000473:pathology*; D014408:Biomarkers, Tumor / Q000032:analysis; D002294:Carcinoma, Squamous Cell / Q000737:chemistry / Q000235:genetics / Q000473:pathology* / Q000821:virology; D002352:Carrier Proteins / Q000032:analysis / Q000235:genetics; D018281:Cholangiocarcinoma / Q000737:chemistry / Q000235:genetics / Q000473:pathology* / Q000821:virology; D003598:Cytoskeletal Proteins; D004273:DNA, Neoplasm / Q000032:analysis; D005260:Female; D017353:Gene Deletion; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D007124:Immunoenzyme Techniques; D017403:In Situ Hybridization; D047908:Intracellular Signaling Peptides and Proteins; D060588:LIM Domain Proteins; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000032:analysis; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000032:analysis; D016601:RNA-Binding Proteins / Q000032:analysis; D012269:Ribosomal Proteins
chemical_list: D048868:Adaptor Proteins, Signal Transducing; D014408:Biomarkers, Tumor; D002352:Carrier Proteins; D003598:Cytoskeletal Proteins; D004273:DNA, Neoplasm; D047908:Intracellular Signaling Peptides and Proteins; D060588:LIM Domain Proteins; D009363:Neoplasm Proteins; C484380:PDLIM7 protein, human; D012367:RNA, Viral; D016601:RNA-Binding Proteins; D012269:Ribosomal Proteins; C067169:RPL22 protein, human