Lymphoepithelioma-like carcinoma of the uterine cervix.
BACKGROUND
It has been proposed that Epstein-Barr virus (EBV) plays a role in the etiology of lymphoepithelioma-like carcinoma (LELC) in diverse anatomic locations. In contrast to Asian women, Western women have a low prevalence of LELC of the uterine cervix, and EBV genomes have not been identified.


OBJECTIVE
To assess the presence of EBV in LELC of the uterine cervix in 4 white Western women.


METHODS
We collected 4 cases of LELC of the uterine cervix between 1990 and 2000. We performed histologic and immunohistochemical analyses of formalin-fixed, paraffin-embedded tumor samples. We amplified tumor DNA with polymerase chain reaction to detect EBV, human papillomavirus, and simian virus 40 DNAs.


RESULTS
Immunohistochemically, tumor cells were positive for cytokeratins and showed strong expression of p53 and MIB-1. Staining for the oncoprotein c-Erb-B2 was focally positive, and staining for Bcl-2 and progesterone receptors was negative. Only one case showed focal nuclear staining for estrogen receptors. All cases had a dense infiltrate of mature lymphocytes expressing T-cell antigens CD45RO, CD3, and CD8. Polymerase chain reaction analysis did not detect EBV, human papillomavirus, or simian virus 40 DNA sequences in any of the 4 cases. One case had positive serologic results for anti-EBV antibodies, indicating a mild or chronic infection.


CONCLUSIONS
LELC of the uterine cervix shows the immunohistochemical profile of an aggressive tumor in spite of its good prognosis, in which CD8 cytotoxic suppressor lymphocytes could play an important role. Based on our results, the role of EBV, human papillomavirus, or simian virus 40 in the pathogenesis of LELC of the uterine cervix in Western women remains unclear.
Martorell
Miguel A
MA
Servicio Anatomía Patológica, Hospital General Universitario, Valencia, Spain. miguel.martorell@uv.es
Julian
Jose M
JM
Calabuig
Consuelo
C
García-García
José A
JA
Pérez-Vallés
Ana
A
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000821:virology; D005260:Female; D004854:Herpesvirus 4, Human / Q000302:isolation & purification*; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D027383:Papillomaviridae / Q000302:isolation & purification*; D013539:Simian virus 40 / Q000302:isolation & purification*; D016159:Tumor Suppressor Protein p53 / Q000032:analysis; D002583:Uterine Cervical Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000821:virology
D016159:Tumor Suppressor Protein p53