Pure Lymphoepithelioma-Like Carcinoma Originating from the Urinary Bladder.
Lymphoepithelioma-like carcinoma of the urinary bladder (LELCB) is a rare variant of infiltrating urothelial carcinoma. We report a case of LELCB in a 43-year-old man. Ultrasonography and cystoscopy revealed two bladder tumors, one on the left side of the trigone and the other on the right side of the trigone. Transurethral resection of the bladder tumors was performed and pathological analysis revealed undifferentiated carcinoma. We therefore performed radical cystectomy and urinary diversion. Immunohistochemically the tumor cells were positive for cytokeratin, but negative for Epstein-Barr virus-encoded small RNA in situ hybridization as found for previous cases of LELCB. The final pathological diagnosis was a lymphoepithelioma-like variant of urothelial carcinoma with perivesical soft tissue invasion. For adjuvant systemic chemotherapy, three courses of cisplatin were administered. The patient subsequently became free of cancer 72 months postoperatively. Based on the literature, pure or predominant LELCB types show favorable prognoses due to their sensitivity to chemotherapy or radiotherapy. An analysis of the apparent diffusion coefficient (ADC) values of bladder tumors examined in our institution revealed that the ADC value measured for this LELCB was relatively low compared to conventional urothelial carcinomas. This suggests that measuring the ADC value of a lymphoepithelioma-like carcinoma prior to operation may be helpful in predicting LELCB.
Department of Nephro-Urology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan.
Takashi
T
Nagai
Department of Nephro-Urology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan.
Taku
T
Naiki
Department of Nephro-Urology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan.
Noriyasu
N
Kawai
Department of Nephro-Urology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan.
Keitaro
K
Iida
Department of Nephro-Urology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan.
Toshiki
T
Etani
Department of Nephro-Urology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan.
Ryosuke
R
Ando
Department of Nephro-Urology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan.
Shuzo
S
Hamamoto
Department of Pharmacy, Nagoya City University Hospital, Nagoya, Japan.
Yosuke
Y
Sugiyama
Department of Nephro-Urology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan.
Atsushi
A
Okada
Department of Nephro-Urology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan.
Kentaro
K
Mizuno
Department of Nephro-Urology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan.
Yukihiro
Y
Umemoto
Department of Nephro-Urology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan.
Takahiro
T
Yasui
Apparent diffusion coefficient value; Epstein-Barr virus; Lymphoepithelioma-like carcinoma; Urinary bladder