Epstein-Barr virus-associated lymphoepithelioma-like carcinoma of the esophagus.
Epstein-Barr virus (EBV)-associated lymphoepithelioma-like carcinoma (LELC) rarely occurs in the esophagus. We report a case of such tumor arising in the esophagus of a 64-year-old Taiwanese woman. No tumors were detected outside the esophagus including nasopharynx by thorough clinical studies. She underwent subtotal esophagectomy. Light microscopy disclosed a poorly differentiated carcinoma morphologically reminiscent of nasopharyngeal undifferentiated carcinoma (lymphoepithelioma). Immunohistochemical stain for latent membrane protein-1 showed positivity on the tumor cells. The infiltrating lymphocytes were chiefly composed of CD8-positive cytotoxic T cells. EBV DNA was demonstrated by both nested polymerase chain reaction (PCR) in the main tumor and metastatic lymph node, and localization in the tumor cells by in situ PCR in situ hybridization (ISH). However, the result of EBV-encoded small RNA-1 ISH was negative. Our case suggests that LELC of the esophagus may be associated with EBV in the endemic area. Due to its distinct histological features, the association with EBV, and possible prognostic implication, LELC of the esophagus should be precisely diagnosed and discerned from the usual poorly differentiated carcinoma.
Department of Pathology, Veterans General Hospital, Taipei, Taiwan.
Paul Chih-Hsueh
PC
Chen
Chin-Chen
CC
Pan
Wen-Hu
WH
Hsu
Huan-Jang
HJ
Ka
An-Hang
AH
Yang
D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery / Q000821:virology; D017931:DNA Primers / Q000737:chemistry; D004279:DNA, Viral / Q000032:analysis; D004847:Epithelial Cells / Q000473:pathology; D020031:Epstein-Barr Virus Infections / Q000150:complications / Q000473:pathology*; D004938:Esophageal Neoplasms / Q000473:pathology* / Q000601:surgery / Q000821:virology; D005260:Female; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D017403:In Situ Hybridization; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000032:analysis; D016601:RNA-Binding Proteins / Q000032:analysis; D012269:Ribosomal Proteins; D016896:Treatment Outcome
D017931:DNA Primers; D004279:DNA, Viral; D012367:RNA, Viral; D016601:RNA-Binding Proteins; D012269:Ribosomal Proteins; C067169:RPL22 protein, human