Primary lymphoepithelioma-like carcinoma of the lung: distinct computed tomography features and associated clinical outcomes.
OBJECTIVE
The aim of the study was to describe the clinical and computed tomography (CT) findings of primary lymphoepithelioma-like carcinoma (LELC) of the lung.


METHODS
The clinical data and CT findings of 35 patients with histologically proven primary LELC of the lung were retrospectively reviewed. The clinical data included age, sex, smoking history, signs and symptoms, tumor location, tumor size, stage, Epstein-Barr virus (EBV)-encoded small nuclear RNA status, treatment, and outcomes. Pretreatment CT scans of the thorax were used to access the tumor site, size, contour, density, vascular and/or bronchial involvement, relationship with pleura, and lymphadenopathy.


RESULTS
The distinct clinical features of primary lung LELC include no significant predilection for sex, minimal association with a history of smoking, strong association with EBV in Asians, and a predilection for early or locally advanced stage of the disease. Most patients received complete resection and/or chemotherapy and radiotherapy. The 2- and 5-year overall survival rates for all patients were 81% and 51%, respectively. The common CT findings of primary lung LELC include peripheral nodules that have direct contact with the adjacent pleural surface, with a lesion density that is homogenous and sometimes heterogenous.


CONCLUSIONS
Radiologists should consider the diagnosis of LELC when encountering solitary peripheral pulmonary nodules that have direct contact with the pleural surface in EBV endemic areas, and an EBV-encoded small nuclear RNA test should be performed on histologic specimens of patients meeting these clinical criteria.
Department of Radiology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, PR China.
Yunxian
Y
Mo
Jingxian
J
Shen
Yun
Y
Zhang
Lie
L
Zheng
Fei
F
Gao
Lizhi
L
Liu
Chuanmiao
C
Xie
D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome