title: Computed tomography characteristics of advanced primary pulmonary lymphoepithelioma-like carcinoma.
abstract: Our objectives were to document CT features of advanced primary pulmonary lymphoepithelioma-like carcinoma (LELC) and to determine features that may assist differentiation from other non-small cell lung cancers (NSCLC). Imaging and clinical data of all patients with biopsy-proven pulmonary LELC ( n=12) were retrieved from a database of all NSCLC patients over a 2-year period. Twenty-five controls were recruited from other inoperable non-LELC NSCLC patients from the database. Pre-treatment CT scans of the thorax of both study and control patients were reviewed for lobe involved; tumour site, borders and size; and pleural, vascular or pulmonary involvement. Presence of lymphangitis carcinomatosis was noted. Lymph node metastasis was characterised as ipsilateral or contralateral enlarged (>1 cm) mediastinal or hilar nodes, or as peribronchovascular nodal spread. Differences between the two groups were tested using Mann-Whitney rank-sum test. The LELC tumours were significantly larger (45.67 vs 17.71 cm(2)) than controls and were closely associated with the mediastinum. There were more LELC tumours with well-defined borders ( p<0.001) and fewer with spiculated borders ( p<0001) than non-LELC tumours. There was increased peribronchovascular nodal spread ( p=0.01) and vascular encasement ( p=0.02) in LELC compared with non-LELC tumours. Advanced primary pulmonary LELC has distinct radiological features, and can appear as well-defined tumour closely associated with the mediastinum, with peribronchovascular spread and vascular encasement.
authors.affiliation: Department of Diagnostic Radiology, HKU, Room 405, Block K, The University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong SAR. cgcooi@hkucc.hku.hk
authors.forename: G C
authors.initials: GC
authors.lastname: Ooi
authors.forename: J C M
authors.initials: JC
authors.lastname: Ho
authors.forename: P L
authors.initials: PL
authors.lastname: Khong
authors.forename: M P
authors.initials: MP
authors.lastname: Wong
authors.forename: W K
authors.initials: WK
authors.lastname: Lam
authors.forename: K W T
authors.initials: KW
authors.lastname: Tsang
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology; D001707:Biopsy, Needle; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000821:virology; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000473:pathology; D003937:Diagnosis, Differential; D020031:Epstein-Barr Virus Infections / Q000150:complications*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000821:virology*; D008297:Male; D009367:Neoplasm Staging; D011336:Probability; D012016:Reference Values; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014763:Viral Matrix Proteins / Q000032:analysis
chemical_list: C037662:EBV-associated membrane antigen, Epstein-Barr virus; D014763:Viral Matrix Proteins