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Liu ZQ, Feng YF, Xiao Y, Zhang XM, Li JB, Xie FY, Mao YP. Clinical characteristics, prognostic factors, and treatment modalities for head and neck lymphoepithelioma-like carcinoma: A real-world study from southern China. Radiother Oncol 2023; 187:109814. [PMID: 37480992 DOI: 10.1016/j.radonc.2023.109814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 07/11/2023] [Accepted: 07/14/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND We aimed to elucidate the clinical characteristics, prognostic factors and optimal treatment modalities of head and neck lymphoepithelioma-like carcinoma (HNLELC). METHODS Consecutive patients newly-diagnosed with non-metastatic HNLELC between December 2001 and March 2021 treated with curative intent were retrospectively reviewed. RESULTS A total of 288 patients were included, of whom 87 (30.2%) underwent radical surgery alone, 43 (14.9%) underwent definitive radiotherapy with or without concurrent chemotherapy, and 158 (54.9%) underwent surgery followed by postoperative radiotherapy (SRT). Epstein-Barr virus-encoded small RNA (EBER) was positive in 94.8% (239/252) of patients. Cervical node infiltration was seen in 52.8% (152/288) of patients. No significant difference was found in nodal metastasis rate between T1-2 and T3-4 classifications (49.5% vs. 56.5%, p = 0.308). The 3-year overall survival (OS), disease-free survival, locoregional relapse-free survival, and distant metastasis-free survival rates were 89.4%, 78.7%, 89.2%, and 87.7%, respectively. Compared to SRT, surgery alone associated with significant reduced 3-year local (92.8% vs. 96.5%, p = 0.012) and regional relapse-free survival rates (89.3% vs. 96.8%, p = 0.002). Definitive radiotherapy and SRT demonstrated comparable results in all 3-year survival outcomes (all p>0.05). Multivariate analysis found EBER status was an independent favorable prognostic factor for OS (HR = 0.356, 95% CI: 0.144-0.882, p = 0.026). CONCLUSION HNLELC was observed to associate with EBV infection and cervical nodal infiltration. Definitive radiotherapy achieved similar survival outcomes compared to SRT, and may serve as a good substitute for patients unfit or unwilling to undergo surgery.
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Affiliation(s)
- Zhi-Qiao Liu
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, PR China
| | - Yan-Fen Feng
- Department of Pathology, Sun Yat-sen University Cancer Center, the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, PR China
| | - Yao Xiao
- Zhujiang Clinical Skill Training Center, Zhujiang Hospital of Southern Medical University, Guangzhou, PR China
| | - Xiao-Min Zhang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, PR China
| | - Ji-Bin Li
- Clinical Trials Centre, Sun Yat-sen University Cancer Center, the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, China
| | - Fang-Yun Xie
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, PR China.
| | - Yan-Ping Mao
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, PR China.
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Ward BJH, Schaal DL, Nkadi EH, Scott RS. EBV Association with Lymphomas and Carcinomas in the Oral Compartment. Viruses 2022; 14:2700. [PMID: 36560704 PMCID: PMC9783324 DOI: 10.3390/v14122700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 11/21/2022] [Accepted: 11/28/2022] [Indexed: 12/05/2022] Open
Abstract
Epstein-Barr virus (EBV) is an oncogenic human herpesvirus infecting approximately 90% of the world's population. The oral cavity serves a central role in the life cycle, transmission, and pathogenesis of EBV. Transmitted to a new host via saliva, EBV circulates between cellular compartments within oral lymphoid tissues. Epithelial cells primarily support productive viral replication, while B lymphocytes support viral latency and reactivation. EBV infections are typically asymptomatic and benign; however, the latent virus is associated with multiple lymphomas and carcinomas arising in the oral cavity. EBV association with cancer is complex as histologically similar cancers often test negative for the virus. However, the presence of EBV is associated with distinct features in certain cancers. The intrinsic ability of EBV to immortalize B-lymphocytes, via manipulation of survival and growth signaling, further implicates the virus as an oncogenic cofactor. A distinct mutational profile and burden have been observed in EBV-positive compared to EBV-negative tumors, suggesting that viral infection can drive alternative pathways that converge on oncogenesis. Taken together, EBV is also an important prognostic biomarker that can direct alternative therapeutic approaches. Here, we discuss the prevalence of EBV in oral malignancies and the EBV-dependent mechanisms associated with tumorigenesis.
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Affiliation(s)
| | | | | | - Rona S. Scott
- Department of Microbiology and Immunology, Center for Applied Immunology and Pathological Processes, Feist-Weiller Cancer Center, Louisiana State University Health-Shreveport, Shreveport, LA 71103, USA
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Chowdhury Z, Raphael V, Khonglah Y, Mishra J, Marbaniang E, Dey B. Mélange of Lymphoepithelial Lesions of Salivary Glands from a Tertiary Care Center of North East India: Diagnostic Conundrums. J Lab Physicians 2021; 13:338-345. [PMID: 34975253 PMCID: PMC8714313 DOI: 10.1055/s-0041-1731973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background
Lymphocytic infiltrates of the major salivary glands are involved in a spectrum of diseases that range from reactive to benign and malignant neoplasms. Occasionally, these pathologic entities present difficulties in the clinical and pathological diagnosis.
Aim and Objective
The aim of this study was to highlight the importance of meticulous cytopathological and histopathological examination (HPE) in solving the diagnostic challenges encountered in the analysis of these salivary gland lesions.
Materials and Methods
A retrospective analysis of salivary gland lesions was undertaken over a period of 5 years from 2013 to 2018 in the Department of Pathology at our institute. Salivary gland pathologies diagnosed either as chronic sialadenitis or reactive/benign/malignant lymphoepithelial lesions on fine-needle aspiration cytology (FNAC) and as lymphoepithelial carcinoma (LEC) were included in this study.
Results
A total of 86 cases of salivary gland lesions diagnosed as mentioned above were found during this period. Out of the 86 cases, 16 were subjected to HPE. Biopsy was not warranted in most of the cases diagnosed as chronic sialadenitis. HPE was concordant with the FNAC diagnoses in 13 out of the 16 cases (81.3%), with a single case misinterpreted as LEC on FNAC.
Conclusion
Benign and malignant lymphoepithelial lesions of salivary glands may sometimes be difficult to differentiate not only from one another on FNAC but also from other malignant lesions. FNAC is an effective tool for the diagnosis of nonneoplastic lesions, but in cases of benign lymphoepithelial lesions in the absence of salivary acini, biopsy is advisable.
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Affiliation(s)
- Zachariah Chowdhury
- Department of Pathology, Mahamana Pandit Madan Mohan Malaviya Cancer Centre and Homi Bhabha Cancer Hospital (Tata Memorial Hospital), Varanasi, Uttar Pradesh, India
| | - Vandana Raphael
- Department of Pathology, North Eastern Indira Gandhi Regional Institute of Health & Medical Sciences, Shillong, Meghalaya, India
| | - Yookarin Khonglah
- Department of Pathology, North Eastern Indira Gandhi Regional Institute of Health & Medical Sciences, Shillong, Meghalaya, India
| | - Jaya Mishra
- Department of Pathology, North Eastern Indira Gandhi Regional Institute of Health & Medical Sciences, Shillong, Meghalaya, India
| | - Evarisalin Marbaniang
- Department of Pathology, North Eastern Indira Gandhi Regional Institute of Health & Medical Sciences, Shillong, Meghalaya, India
| | - Biswajit Dey
- Department of Pathology, North Eastern Indira Gandhi Regional Institute of Health & Medical Sciences, Shillong, Meghalaya, India
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Harada H, Matsumoto H, Nakatsuka SI, Kurose A. Lymphoepithelial carcinoma of the parotid gland: a unique example showing p16 immunoreactivity. Med Mol Morphol 2021; 54:368-373. [PMID: 34091759 DOI: 10.1007/s00795-021-00295-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 06/01/2021] [Indexed: 12/01/2022]
Abstract
Lymphoepithelial carcinoma (LEC) shows characteristic histology of nesting growth of tumor cells with unclear differentiation against the lymphoid stroma background. Although rare in salivary glands, it has previously been recognized as a type of undifferentiated carcinoma but is currently clearly defined as an independent disease separate from undifferentiated carcinoma. We report a case of LEC that developed in the parotid gland and was immunohistochemically positive for p16, which suggested the causative involvement of human papillomavirus (HPV). The patient was a 38-year-old Japanese male aware of mass formation in the left parotid area for 8 years. Parotidectomy was performed and there have been no signs of recurrence or metastasis for 18 month post-operation. The tumor was histologically typical except for Epstein-Barr virus (EBV)-encoded small RNA (EBER)-negative in situ hybridization (ISH), but p16-positivity by immunohistochemistry, and also frequent contact with extended and expanded pre-existing ductal structures. Although usually strongly associated with EBV infection, the tumor could be regarded to have eventually reached completion as a LEC lesion associated with HPV infection possibly through the pathway shared with squamous cell carcinoma. EBER-ISH remains the most promising index for confirming diagnosis of LEC, but EBV-negative result alone should not prevent diagnosis of LEC.
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Affiliation(s)
- Hiroshi Harada
- Department of Anatomic Pathology, Hirosaki University Graduate School of Medicine, 5 Zaifu, Hirosaki, 036-8562, Japan.
| | | | | | - Akira Kurose
- Department of Anatomic Pathology, Hirosaki University Graduate School of Medicine, 5 Zaifu, Hirosaki, 036-8562, Japan
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Abstract
Lymphoepithelial carcinoma of salivary glands (LECSG) is an uncommon neoplasm. This article summarizes the findings of 438 cases in a review of the literature. Concurrent lymphoepithelial lesions may suggest a primary tumor. The tumor shows a nonkeratinizing carcinoma intimately associated with a rich lymphohistiocytic infiltrate, destroying adjacent salivary gland tissue. Irrespective of race or ethnicity, the tumors usually express Epstein-Barr virus, with Epstein-Barr virus encoded small RNA (EBER) and/or latent membrane protein-1 (LMP-1), although a subset does not. There is an overall good prognosis of about 80% at 5 years.
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6
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Wang JQ, Deng RX, Liu H, Luo Y, Yang ZC. Clinicopathological characteristics and prognostic analysis of lymphoepithelial carcinoma of salivary gland: a population-based study. Gland Surg 2020; 9:1989-1997. [PMID: 33447549 DOI: 10.21037/gs-20-464] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background The purpose of this study was to elucidate the clinicopathological characteristics of patients with lymphoepithelial carcinoma of salivary gland (LEC-SG) and determine the factors associated with survival. Methods A total of 179 LEC-SG patients from the Surveillance, Epidemiology, and End Results (SEER) database between 1975 to 2016 were included. The clinicopathological characteristics and overall survival of LEC-SG patients were described, and the features affecting prognosis were further determined using Kaplan-Meier Curves and Cox survival analysis. Results The median overall survival of LEC-SG patients was 206 months, and the 1-, 5-, 10- and 20-year survival rates were 91.0%, 80.2%, 66.4%, and 37.6%, respectively. The prognoses were significantly associated with age, ethnicity, marital status, tumor invasion, as well as lymph node metastases [P<0.01 for all). Surgical resection could significantly improve the prognosis of this disease (median overall survival (mOS): 219 vs. 68 months, P<0.01]. Postoperative radiotherapy could improve long-term survival and decrease the risk of death among patients who survive exceed 10-year after surgery. The Cox regression analysis showed that old age (>60 years) and lymph node metastases were independently associated with poor survival (P<0.05 for both). Conversely, the use of surgery was an independent favorable prognostic factor [hazard ratio (HR) 0.29, 95% CI: 0.13-0.66]. Conclusions LEC-SG patients had a favorable prognosis with a mOS of 206 months. Old age, lymph node metastases, the use of surgery were independently associated with survival of LEC-SG patients.
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Affiliation(s)
- Jia-Qi Wang
- Department of Oral and Maxillofacial Surgery, Shanghai Stomatological Hospital, Fudan University, Shanghai, China
| | - Rong-Xin Deng
- Department of Oral and Maxillofacial Surgery, Shanghai Stomatological Hospital, Fudan University, Shanghai, China
| | - Hui Liu
- Department of Oral and Maxillofacial Surgery, Shanghai Stomatological Hospital, Fudan University, Shanghai, China
| | - Yuan Luo
- Department of Oral and Maxillofacial Surgery, Shanghai Stomatological Hospital, Fudan University, Shanghai, China
| | - Zhi-Cheng Yang
- Department of Oral and Maxillofacial Surgery, Shanghai Stomatological Hospital, Fudan University, Shanghai, China
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Whaley RD, Carlos R, Bishop JA, Rooper L, Thompson LDR. Lymphoepithelial Carcinoma of Salivary Gland EBV-association in Endemic versus Non-Endemic Patients: A Report of 16 Cases. Head Neck Pathol 2020; 14:1001-1012. [PMID: 32462279 PMCID: PMC7669917 DOI: 10.1007/s12105-020-01172-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 05/11/2020] [Indexed: 02/07/2023]
Abstract
Lymphoepithelial carcinoma of salivary glands (LECSG) are rare neoplasms, reported in endemic populations (southeastern Chinese) with a strong Epstein-Barr virus (EBV) association. A retrospective series comparing EBV status within an ethnically diverse population (endemic vs. non-endemic patients) has not been reported. Sixteen LECSG were equally distributed between males (n = 8) and females (n = 8) with a median age of 54 years (range 18 to 85 years) at initial diagnosis. Ten patients were white, 4 Asian, and 2 black. The patients typically presented with swelling or mass for an average of 11.6 months. Tumors affected only major salivary glands: parotid (n = 13); submandibular (n = 3). Tumors were an average of 2.9 cm (range 1.5 to 5.8 cm). Nine of 16 (56%) patients had cervical lymph node metastases at presentation. No patients had nasopharyngeal or oropharyngeal tumors. Microscopically, the tumors were widely infiltrative, characterized by large polygonal to spindled cells arranged in a syncytial, lattice-like network in a background of lymphoplasmacytic cells. The neoplastic cells showed an open-vesicular nuclear chromatin to a more basaloid-morphology, the latter showing hyperchromatic nuclei and less cytoplasm, while nearly all of the cases had associated lymphoepithelial lesions/sialadenitis. By in situ hybridization, 8 of 16 cases had a strong, diffuse EBER expression (4 of 4 Asians; 4 of 12 non-Asians), while with immunohistochemistry all cases tested were pan-cytokeratin, CK5/6 and p63 reactive; none of the cases tested were p16 reactive. All patients were managed with wide or radical excision, 4 with concurrent chemoradiation, and 6 with radiation alone. Distant metastasis (lung, brain, and bone) developed in 2 patients. Overall follow-up (mean 3.8 years) revealed 12 patients alive and 2 dead, none with evidence of disease (mean 4.3 years); one white male alive with disease at 1.9 years, and one Asian female dead of disease at 4.2 years; both of these latter patients had Group IV stage disease. High stage (Group IV) patients had a shorter mean survival than lower stage patients: 3.1 versus 4.8 years, respectively. In conclusion, LECSG are uncommon primary neoplasms. Concurrent lymphoepithelial lesions may help suggest a primary tumor. The tumors, irrespective of race or ethnicity, may express EBER. There is an overall good survival, perhaps better for EBV-negative patients and for those with lower stage disease.
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Affiliation(s)
- Rumeal D. Whaley
- grid.257413.60000 0001 2287 3919Department of Pathology & Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN USA
| | - Roman Carlos
- Centro Clinico de Cabeza Y Cuello, Guatemala City, Guatemala
| | - Justin A. Bishop
- grid.267313.20000 0000 9482 7121Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX USA
| | - Lisa Rooper
- grid.411935.b0000 0001 2192 2723Department of Pathology, Johns Hopkins Hospital, Baltimore, MD USA
| | - Lester D. R. Thompson
- grid.280062.e0000 0000 9957 7758Southern California Permanente Medical Group, Department of Pathology, 5601 De Soto Avenue, Woodland Hills, CA 91365 USA
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Guidry JT, Birdwell CE, Scott RS. Epstein-Barr virus in the pathogenesis of oral cancers. Oral Dis 2018; 24:497-508. [PMID: 28190296 PMCID: PMC5554094 DOI: 10.1111/odi.12656] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 01/30/2017] [Accepted: 01/31/2017] [Indexed: 12/28/2022]
Abstract
Epstein-Barr virus (EBV) is a ubiquitous gamma-herpesvirus that establishes a lifelong persistent infection in the oral cavity and is intermittently shed in the saliva. EBV exhibits a biphasic life cycle, supported by its dual tropism for B lymphocytes and epithelial cells, which allows the virus to be transmitted within oral lymphoid tissues. While infection is often benign, EBV is associated with a number of lymphomas and carcinomas that arise in the oral cavity and at other anatomical sites. Incomplete association of EBV in cancer has questioned if EBV is merely a passenger or a driver of the tumorigenic process. However, the ability of EBV to immortalize B cells and its prevalence in a subset of cancers has implicated EBV as a carcinogenic cofactor in cellular contexts where the viral life cycle is altered. In many cases, EBV likely acts as an agent of tumor progression rather than tumor initiation, conferring malignant phenotypes observed in EBV-positive cancers. Given that the oral cavity serves as the main site of EBV residence and transmission, here we review the prevalence of EBV in oral malignancies and the mechanisms by which EBV acts as an agent of tumor progression.
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Affiliation(s)
- Joseph T. Guidry
- Department of Microbiology and Immunology, Center for Tumor and Molecular Virology, and Feist-Weiller Cancer Center. Louisiana State University Health Sciences Center-Shreveport. Shreveport, LA 71103
| | - Christine E. Birdwell
- Department of Microbiology and Immunology, Center for Tumor and Molecular Virology, and Feist-Weiller Cancer Center. Louisiana State University Health Sciences Center-Shreveport. Shreveport, LA 71103
| | - Rona S. Scott
- Department of Microbiology and Immunology, Center for Tumor and Molecular Virology, and Feist-Weiller Cancer Center. Louisiana State University Health Sciences Center-Shreveport. Shreveport, LA 71103
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Radoï L, Barul C, Menvielle G, Carton M, Matrat M, Sanchez M, Pilorget C, Velten M, Stücker I, Luce D. Risk factors for salivary gland cancers in France: Results from a case-control study, the ICARE study. Oral Oncol 2018; 80:56-63. [PMID: 29706189 DOI: 10.1016/j.oraloncology.2018.03.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 03/14/2018] [Accepted: 03/30/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Epidemiological studies on the risk factors for salivary gland cancers (SGC) are rare, concern a small sample size, and show inconsistent results. The aim of the present work was to analyze several risk factors for SGC, using the data from the ICARE study, a multicenter, population-based case-control study. MATERIALS AND METHODS Data from 73 SGC cases and 3555 controls were collected using a standardized questionnaire on lifestyle habits, personal and family medical history, and lifetime occupational history. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using unconditional logistic regressions. RESULTS Tobacco use and alcohol consumption were not associated with the risk of SGC. A history of head and neck cancer or that of cervicofacial radiotherapy was associated with a higher risk of SGC (OR = 17.06, 95% CI: 4.34-67.05, and OR = 31.74, 2.48-405.25, respectively). Significantly increased risks were observed for some occupations: waiter (OR = 2.94, 1.11-7.78), charworker (OR = 3.02, 1.38-6.60), electrical and electronic equipment assembler (OR = 7.16, 2.02-25.38), plumber (OR = 3.95, 1.33-11.67), electric arc welder (OR = 6.15, 1.76-21.48), sheet-metal worker (OR = 2.89, 1.01-8.32), building painter (OR = 3.42, 1.01-11.49), and material handling equipment operator (OR = 5.05, 1.71-14.84). Results for industries were consistent with those observed for occupations. CONCLUSION Our results showed that a history of head and neck cancer, cervicofacial radiotherapy, and several occupations and industries, were associated with an increased risk of SGC. Further studies with larger sample sizes are indicated to confirm our results.
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Affiliation(s)
- Loredana Radoï
- University Paris Sud, Paris Saclay University, UVSQ, CESP, INSERM, Environmental Epidemiology of Cancer Team, Villejuif, France; University Paris Descartes, Faculty of dental surgery, Oral surgery department, Paris, France.
| | - Christine Barul
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Pointe-à-Pitre, France
| | - Gwenn Menvielle
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Matthieu Carton
- Institut Curie, PSL Research University, DRCI, Biométrie, Saint-Cloud, France
| | - Mireille Matrat
- Université Paris Est Créteil, Faculté de médecine, Créteil, France; Centre Hospitalier Intercommunal, Service des Pathologies Professionnelles et de l'Environnement, Créteil, France
| | - Marie Sanchez
- University Paris Sud, Paris Saclay University, UVSQ, CESP, INSERM, Environmental Epidemiology of Cancer Team, Villejuif, France
| | - Corinne Pilorget
- The French Public Health Agency, Department of Occupational Health, Saint Maurice, France; University Lyon, Claude Bernard Lyon1 University, Ifsttar, UMRESTTE, UMR T_9405, Lyon, France
| | | | - Isabelle Stücker
- University Paris Sud, Paris Saclay University, UVSQ, CESP, INSERM, Environmental Epidemiology of Cancer Team, Villejuif, France
| | - Danièle Luce
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Pointe-à-Pitre, France
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Mozaffari HR, Ramezani M, Janbakhsh A, Sadeghi M. Malignant Salivary Gland Tumors and Epstein-Barr Virus (EBV) Infection: A Systematic Review and Meta-Analysis. Asian Pac J Cancer Prev 2017; 18:1201-1206. [PMID: 28610402 PMCID: PMC5555523 DOI: 10.22034/apjcp.2017.18.5.1201] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: Salivary gland tumors are rare head and neck tumors with lymphoepithelial carcinoma (LEC) as a particularly infrequent variant. This study was an evaluation of the incidence of EBV infection in malignant salivary gland tumors with the emphasis on tumor type and geographical area. Methods: Five databases (PubMed, ScienceDirect, Scopus, Web of Science and Cochrane library) were searched for data on the prevalence of EBV in malignant salivary gland tumors. A random-effects meta-analysis was conducted with Comprehensive Meta-Analysis software version 2.0 (CMA 2.0) using the event rate (ER) for estimation of the incidence of EBV in the salivary gland tumor patients. Publication bias was lacking as assessed through funnel plot analysis with the Begg’s and Egger’s tests (P>0.05). Results: Out of 618 studies searched in databases, 19 reported the prevalence of EBV in malignant salivary gland tumors and were included in the present meta-analysis. The pooled ER of all studies was 44% [95%CI=21.5-69.2%] with extreme heterogeneity that for the studies in America was 44.2% [95%CI=4.1-93.6%], in Asia (249 patients) was 70% [95%CI= 33.4-91.6%] and in Europe was 11.8% [95%CI=7.4-85.5%] with extreme heterogeneity for three subgroups. The pooled ER for patients with undifferentiated carcinoma was 86.7% [95%CI=71.5-94.4%] compared with 6.6% [95%CI=2.5-16.5%] for other carcinomas. Conclusions: The incidence of EBV infection in malignant salivary gland tumors in Asia was greater than in Europe and America and the higher presence of EBV infection in LEC cases implies that EBV may be a major factor in its etiology or pathogenesis. Genetic, environmental and other geographic factors may also be involved.
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Affiliation(s)
- Hamid Reza Mozaffari
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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11
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Seim NB, Philips RHW, Schoenfield L, Teknos TN, Rocco JW, Agrawal A, Ozer E, Carrau RL, Kang SY, Old MO. NUT Midline Carcinoma of the Sublingual Gland: Clinical Presentation and Review. Head Neck Pathol 2017; 11:460-468. [PMID: 28349372 PMCID: PMC5677058 DOI: 10.1007/s12105-017-0809-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 03/11/2017] [Indexed: 10/19/2022]
Abstract
NUT midline carcinoma (NMC) is a rare and aggressive disease encountered in the midline of the head and neck or mediastinum. Due to its sparse incidence and subtle pathologic features, we aim to increase knowledge and awareness for this pathologic entity. We present an exemplary case of a young, healthy male presenting with oral cavity pain and cervical lymphadenopathy. This patient was initially diagnosed with an unspecified, highly aggressive sublingual gland malignancy and underwent locoregional resection with free flap reconstruction however suffered a rapid local recurrence and widely extensive metastasis within just 1 month. After rigorous analysis, final pathologic diagnosis revealed a poorly differentiated carcinoma with evidence of squamous differentiation that eventually, post-mortem tested positive for NMC. Only one prior case of sublingual gland NMC has been previously reported as we discuss the literature regarding all sublingual gland malignancies as well as the pathologic features and treatment options for NMC. We recommend consideration of testing for the NUT proto-oncogene at the time of biopsy in the clinical setting of a poorly differentiated midline carcinoma, especially with squamous differentiation, of the head or neck in order to identify patients for clinical trial enrollment and appropriately counsel on the poor clinical prognosis. Improving clinician awareness is critical to increase diagnostic accuracy and need to study prospective treatment outcomes as the first step toward improving management of this difficult disease.
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Affiliation(s)
- Nolan B. Seim
- 0000 0001 1545 0811grid.412332.5Department of Otolaryngology-Head and Neck Surgery, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University Wexner Medical Center, 4000 Eye and Ear Institute, 915 Olentangy River Road, Columbus, OH 43212 USA
| | - Ramez H. W. Philips
- 0000 0001 2285 7943grid.261331.4The Ohio State University College of Medicine, 370 W. 9th Ave, Columbus, OH 43210 USA
| | - Lynn Schoenfield
- 0000 0001 1545 0811grid.412332.5Department of Pathology, The Ohio State University Wexner Medical Center, Doan Hall, N337B, 410 West 10th Ave., Columbus, OH 43210 USA
| | - Theodoros N. Teknos
- 0000 0001 1545 0811grid.412332.5Department of Otolaryngology-Head and Neck Surgery, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University Wexner Medical Center, 4000 Eye and Ear Institute, 915 Olentangy River Road, Columbus, OH 43212 USA
| | - James W. Rocco
- 0000 0001 1545 0811grid.412332.5Department of Otolaryngology-Head and Neck Surgery, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University Wexner Medical Center, 4000 Eye and Ear Institute, 915 Olentangy River Road, Columbus, OH 43212 USA
| | - Amit Agrawal
- 0000 0001 1545 0811grid.412332.5Department of Otolaryngology-Head and Neck Surgery, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University Wexner Medical Center, 4000 Eye and Ear Institute, 915 Olentangy River Road, Columbus, OH 43212 USA
| | - Enver Ozer
- 0000 0001 1545 0811grid.412332.5Department of Otolaryngology-Head and Neck Surgery, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University Wexner Medical Center, 4000 Eye and Ear Institute, 915 Olentangy River Road, Columbus, OH 43212 USA
| | - Ricardo L. Carrau
- 0000 0001 1545 0811grid.412332.5Department of Otolaryngology-Head and Neck Surgery, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University Wexner Medical Center, 4000 Eye and Ear Institute, 915 Olentangy River Road, Columbus, OH 43212 USA
| | - Stephen Y. Kang
- 0000 0001 1545 0811grid.412332.5Department of Otolaryngology-Head and Neck Surgery, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University Wexner Medical Center, 4000 Eye and Ear Institute, 915 Olentangy River Road, Columbus, OH 43212 USA
| | - Matthew O. Old
- 0000 0001 1545 0811grid.412332.5Department of Otolaryngology-Head and Neck Surgery, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University Wexner Medical Center, 4000 Eye and Ear Institute, 915 Olentangy River Road, Columbus, OH 43212 USA ,0000 0001 2285 7943grid.261331.4Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, Wexner Medical Center, The Ohio State University, Starling Loving Hall, B217, 320 West 10th Ave, Columbus, OH 43210 USA
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Kikuchi K, Inoue H, Miyazaki Y, Ide F, Kojima M, Kusama K. Epstein-Barr virus (EBV)-associated epithelial and non-epithelial lesions of the oral cavity. JAPANESE DENTAL SCIENCE REVIEW 2017; 53:95-109. [PMID: 28725300 PMCID: PMC5501733 DOI: 10.1016/j.jdsr.2017.01.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 12/28/2016] [Accepted: 01/31/2017] [Indexed: 12/12/2022] Open
Abstract
Epstein–Barr virus (EBV) is known to be associated with the development of malignant lymphoma and lymphoproliferative disorders (LPDs) in immunocompromised patients. EBV, a B-lymphotropic gamma-herpesvirus, causes infectious mononucleosis and oral hairy leukoplakia, as well as various pathological types of lymphoid malignancy. Furthermore, EBV is associated with epithelial malignancies such as nasopharyngeal carcinoma (NPC), salivary gland tumor, gastric carcinoma and breast carcinoma. In terms of oral disease, there have been several reports of EBV-related oral squamous cell carcinoma (OSCC) worldwide. However, the role of EBV in tumorigenesis of human oral epithelial or lymphoid tissue is unclear. This review summarizes EBV-related epithelial and non-epithelial tumors or tumor-like lesions of the oral cavity. In addition, we describe EBV latent genes and their expression in normal epithelium, inflamed gingiva, epithelial dysplasia and SCC, as well as considering LPDs (MTX- and age-related) and DLBCLs of the oral cavity.
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Affiliation(s)
- Kentaro Kikuchi
- Division of Pathology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado, Saitama 350-0283, Japan
| | - Harumi Inoue
- Division of Pathology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado, Saitama 350-0283, Japan
| | - Yuji Miyazaki
- Division of Pathology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado, Saitama 350-0283, Japan
| | - Fumio Ide
- Division of Pathology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado, Saitama 350-0283, Japan
| | - Masaru Kojima
- Department of Anatomic and Diagnostic Pathology, Dokkyo Medical University School of Medicine, 880 Oaza-kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi 321-0293, Japan
| | - Kaoru Kusama
- Division of Pathology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado, Saitama 350-0283, Japan
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Chan JKC, Yip TTC, Tsang WYW, Seneviratne S, Poon Y, Wong CSC, Ma VWS. Lack of Evidence of Pathogenetic Role of Epstein-Barr Virus in Thymic Lymphoid Hyperplasia and Thymomas in the Chinese Population of Hong Kong. Int J Surg Pathol 2016. [DOI: 10.1177/106689699400200104] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A previous study from Hong Kong by McGuire et al. reported frequent demonstration of Epstein-Barr virus (EBV) DNA by Southern blot analysis in thymoma, thymic lymphoepithelioma-like carcinoma, and thymic lymphoid hyperplasia. This provoca tive finding, however, could not be confirmed by studies in the Western populations using the Southern blot technique and/or polymerase chain reaction to detect EBV- DNA or in situ hybridization to detect EBV encoded RNA (EBER), raising the possibility that the association with EBV may be restricted to Asians. This study was performed to clarify this issue by using a highly sensitive localization technique for EBER on a larger series from the Asian population of Hong Kong. Paraffin sections obtained from 10 cases of thymic lymphoid hyperplasia, 42 noninvasive thymomas (including one case previously reported to be EBV positive), 11 invasive thymomas, and 9 thymic carcinomas (including 5 cases of lymphoepithelioma-like carcinoma) were studied. EBER signal was not detected in the epithelial cells in any of the cases except for two cases of lymphoepithelioma-like carcinoma. In two thymomas, a few small lympho cytes (<0.1%) were EBER positive. Failure to detect EBER was not an artifact due to RNA denaturation, because preserved mRNA could be demonstrated by oligo-dT labelling in 56 of the 72 cases. Thus, the results of this study on Hong Kong Chinese are in keeping with those reported in Caucasians, and more recently in Japanese and Taiwan Chinese, in that there is no association of EBV with thymic lymphoid hyperpla sia or thymoma, and that EBV may be demonstrated in a proportion of thymic lymph oepithelioma-like carcinomas. The positive results previously reported cannot be ex plained, because the occasional EBV-carrying lymphocytes detected in rare cases of thymoma should be insufficient to give a positive EBV result by Southern blot tech nique. Int J Surg Pathol 2(1):17-22, 1994
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Hsu YC, Lu HF, Huang CC, Hsu RF, Su CY. Malignant Lymphoepithelial Lesions of the Salivary Gland. Otolaryngol Head Neck Surg 2016; 134:661-6. [PMID: 16564393 DOI: 10.1016/j.otohns.2005.10.034] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2004] [Indexed: 11/27/2022]
Abstract
OBJECTIVES: To describe a relatively large series of patients with uncommon malignant lymphoepithelial lesions (MLEL) in the salivary glands, to present treatment-outcome data to support therapeutic decision-making, and to evaluate the incidence of cooccurrence of MLEL and Epstein-Barr virus (EBV). STUDY DESIGN AND SETTING: Ten patients with MLEL were treated between 1987 and 2002. All lesions were surgically removed, with or without neck dissection, and the patients treated with radiotherapy or radiotherapy and chemotherapy. Histopathology and in situ hybridization studies for EBV-encoded RNA (EBER1) were performed. RESULTS: With aggressive treatment, outcomes were good, regardless of the presenting stage, except when distal metastases were present. All 10 patients tested positive for EBV. CONCLUSION AND SIGNIFICANCE: This and previous investigations support the use of aggressive surgical excision of the tumor and local metastases and radiotherapy or radiotherapy and chemotherapy, as optimal treatment for MLEL. The EBV finding may indicate a role for EBV in the pathogenesis of MLEL.
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Affiliation(s)
- Yao-Chung Hsu
- Department of Otolaryngology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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15
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Kikuchi K, Noguchi Y, de Rivera MWGN, Hoshino M, Sakashita H, Yamada T, Inoue H, Miyazaki Y, Nozaki T, González-López BS, Ide F, Kusama K. Detection of Epstein-Barr virus genome and latent infection gene expression in normal epithelia, epithelial dysplasia, and squamous cell carcinoma of the oral cavity. Tumour Biol 2015; 37:3389-404. [PMID: 26449822 DOI: 10.1007/s13277-015-4167-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 09/27/2015] [Indexed: 12/26/2022] Open
Abstract
A relationship between Epstein-Barr virus (EBV) infection and cancer of lymphoid and epithelial tissues such as Burkitt's lymphoma, Hodgkin's disease, nasopharyngeal carcinoma (NPC), gastric carcinoma, and oral cancer has been reported. EBV is transmitted orally and infects B cells and epithelial cells. However, it has remained uncertain whether EBV plays a role in carcinogenesis of oral mucosal tissue. In the present study, we detected the EBV genome and latent EBV gene expression in normal mucosal epithelia, epithelial dysplasia, and oral squamous cell carcinoma (OSCC) to clarify whether EBV is involved in carcinogenesis of the oral cavity. We examined 333 formalin-fixed, paraffin-embedded tissue samples (morphologically normal oral mucosa 30 samples, gingivitis 32, tonsillitis 17, oral epithelial dysplasia 83, OSCC 150, and NPC 21). EBV latent infection genes (EBNA-2, LMP-1) were detected not only in OSCC (50.2 %, 10.7 %) but also in severe epithelial dysplasia (66.7 %, 44.4 %), mild to moderate epithelial dysplasia (43.1 %, 18.5 %), gingivitis (78.1 %, 21.9 %), and normal mucosa (83.3 %, 23.3 %). Furthermore, the intensity of EBV latent infection gene expression (EBER, LMP-1) was significantly higher in severe epithelial dysplasia (94.4 %, 72.2 %) than in OSCC (34.7 %, 38.7 %). These results suggest that EBV latent infection genes and their increased expression in severe epithelial dysplasia might play an important role in the dysplasia-carcinoma sequence in the oral cavity.
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Affiliation(s)
- Kentaro Kikuchi
- Division of Pathology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado, Saitama, 350-0283, Japan.
| | - Yoshihiro Noguchi
- Division of Pathology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado, Saitama, 350-0283, Japan
| | | | - Miyako Hoshino
- Second Division of Oral and Maxillofacial Surgery, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado, Saitama, 350-0283, Japan
| | - Hideaki Sakashita
- Second Division of Oral and Maxillofacial Surgery, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado, Saitama, 350-0283, Japan
| | - Tsutomu Yamada
- Department of Pathology, Nihon University School of Medicine, 30-1 Oyaguchi-Kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Harumi Inoue
- Division of Pathology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado, Saitama, 350-0283, Japan
| | - Yuji Miyazaki
- Division of Pathology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado, Saitama, 350-0283, Japan
| | - Tadashige Nozaki
- Department of Pharmacology, Osaka Dental University, 8-1 Kuzuhahanazono-cho, Hirakata, Osaka, 573-1211, Japan
| | - Blanca Silvia González-López
- Department of Oral Pathology, Faculty of Dentistry, Autonomous University State of México, Jesús Carranza esquina paseo Tollocan, C.P. 50130, Toluca, Mexico
| | - Fumio Ide
- Division of Pathology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado, Saitama, 350-0283, Japan
| | - Kaoru Kusama
- Division of Pathology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado, Saitama, 350-0283, Japan
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Chan JYK, Wong EWY, Ng SK, Vlantis AC. Non-nasopharyngeal head and neck lymphoepithelioma-like carcinoma in the United States: A population-based study. Head Neck 2015; 38 Suppl 1:E1294-300. [DOI: 10.1002/hed.24215] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Revised: 06/25/2015] [Accepted: 07/10/2015] [Indexed: 01/10/2023] Open
Affiliation(s)
- Jason Y. K. Chan
- Department of Otorhinolaryngology; Head and Neck Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong; Hong Kong SAR
| | - Eddy W. Y. Wong
- Department of Otorhinolaryngology; Head and Neck Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong; Hong Kong SAR
| | - Siu-Kwan Ng
- Department of Otorhinolaryngology; Head and Neck Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong; Hong Kong SAR
| | - Alexander C. Vlantis
- Department of Otorhinolaryngology; Head and Neck Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong; Hong Kong SAR
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17
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She YY, Liu YH, Lin YS, Wu CC. Primary Lymphoepithelial Carcinoma of the Parotid Gland: A Rare Case. JOURNAL OF MEDICAL SCIENCES 2015. [DOI: 10.4103/1011-4564.173004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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18
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19
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A clinical analysis of 37 cases with lymphoepithelial carcinoma of the major salivary gland treated by surgical resection and postoperative radiotherapy: a single institution study. Med Oncol 2014; 31:957. [DOI: 10.1007/s12032-014-0957-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Accepted: 03/31/2014] [Indexed: 11/30/2022]
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20
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Lymphoepithelial Carcinoma—Review of the Treatment Modalities and Report of a Rare Case in the Sublingual Gland. J Oral Maxillofac Surg 2014; 72:823-8. [DOI: 10.1016/j.joms.2013.10.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 10/05/2013] [Accepted: 10/08/2013] [Indexed: 11/19/2022]
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21
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Ma H, Lin Y, Wang L, Rao H, Xu G, He Y, Liang Y. Primary lymphoepithelioma-like carcinoma of salivary gland: sixty-nine cases with long-term follow-up. Head Neck 2014; 36:1305-12. [PMID: 23966284 DOI: 10.1002/hed.23450] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Revised: 03/11/2013] [Accepted: 08/12/2013] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Lymphoepithelioma-like carcinoma (LELC) in the salivary glands is a rare but unique malignancy. METHODS Sixty-nine patients with salivary gland LELC with long-term follow-up were reviewed for this study. RESULTS There were 52 cases in the parotid gland and 17 cases in the submandibular gland. All patients underwent complete tumor excision, 41 underwent neck dissection, and 39 received postoperative radiotherapy. The 5-year, 10-year, and 15-year overall survival (OS) rates were 90%, 75%, and 54%, respectively. Patients with higher neutrophil/lymphocyte ratio (NLR ≥ 4.0) and advanced stage (stage III and IV) had significantly poorer OS. Patients who received postoperative radiotherapy had significantly better relapse-free survival (RFS). In multivariate analysis, stage, NLR, and neck dissection were associated independently with OS, whereas stage and postoperative radiotherapy were associated independently with RFS. CONCLUSION Salivary gland LELC is a rare malignancy with a better prognosis that partially attributes to surgery with neck dissection and postoperative radiotherapy. Preoperative NLR is an independent prognostic factor.
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Affiliation(s)
- Huali Ma
- Department of Radiology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, China; State Key Laboratory of Oncology in South China/Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, China
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22
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Slukvin II, Schink JC, Warner TF. Lymphoepithelioma-like carcinoma of the vulva: a case report. J Low Genit Tract Dis 2013; 7:136-9. [PMID: 17051058 DOI: 10.1097/00128360-200304000-00010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This report describes a lymphoepithelioma-like carcinoma of the vulva in a 64-year-old woman. The tumor showed distinct morphologic features including syncytial sheets of malignant epithelioid cells and a dense lymphoplasmacytoid infiltrate. In situ hybridization and immunohistochemistry for Epstein-Barr virus were negative. The tumor was treated by surgical excision. No evidence of recurrence has been detected 3 years after treatment. To our knowledge this is the second reported case of lymphoepithelioma-like carcinoma of the vulva.
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Affiliation(s)
- Igor I Slukvin
- Department of Pathology and Laboratory Medicine, University of Wisconsin, Madison, WI
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23
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THERKILDSEN MARIANNEHAMILTON. Epithelial salivary gland tumours. An immunohistological and prognostic investigation. APMIS 2011. [DOI: 10.1111/j.1600-0463.1999.tb05379.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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24
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Shebl FM, Bhatia K, Engels EA. Salivary gland and nasopharyngeal cancers in individuals with acquired immunodeficiency syndrome in United States. Int J Cancer 2010; 126:2503-8. [PMID: 19810095 DOI: 10.1002/ijc.24930] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Individuals with acquired immunodeficiency syndrome (AIDS) manifest an increased risk of cancer, particularly cancers caused by oncogenic viruses. Because some salivary gland and nasopharyngeal cancers are associated with Epstein Barr virus, the impact of AIDS on these cancers needs further evaluation. We used linked U.S. AIDS and cancer registry data (N = 519,934 people with AIDS) to derive standardized incidence ratios (SIRs) comparing risk of salivary gland and nasopharyngeal cancers to the general population. For salivary gland cancers (N = 43 cases), individuals with AIDS had strongly elevated risks for lymphoepithelial carcinoma (SIR 39, 95% CI 16-81) and squamous cell carcinoma (SIR 4.9, 95% CI 2.5-8.6). Among nasopharyngeal cancers (N = 39 cases), risks were elevated for both keratinizing and nonkeratinizing carcinomas (SIR 2.4, 95% CI 1.5-3.7 and SIR 2.4, 95% CI 1.2-4.4, respectively). The elevated risks of salivary gland and nasopharyngeal cancers among people with AIDS suggest that immunosuppression and oncogenic viral infections are etiologically important.
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25
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Abdelkrim SB, Trabelsi A, Hammedi F, Omezzine M, Rammeh S, Abdelkader AB, Sriha B. Primary lymphoepithelial carcinoma of the parotid gland in a North African woman. Rare Tumors 2009; 1:e16. [PMID: 21139887 PMCID: PMC2994432 DOI: 10.4081/rt.2009.e16] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2009] [Accepted: 06/29/2009] [Indexed: 11/23/2022] Open
Abstract
Lymphoepithelial carcinoma of the salivary glands is a rare neoplasm that is characterized by a non-neoplastic lymphocytic infiltration associated with an epithelial proliferation. It involves mainly the parotid gland. Racial and geographical factors contribute to the pathogenesis of this tumor. We report a case of a 70-year old woman from a non-endemic area who presented with several months history of swelling in the parotid region. Magnetic resonance imaging showed a parotid mass suggestive of a pleomorphic adenoma. The diagnosis of lymphoepithelial carcinoma of the parotid gland was performed on the surgical specimen. A primitive nasopharyngeal carcinoma was ruled out by random biopsies of the nasopharynx mucosa. The Epstein-Barr virus (EBV) was absent in neoplastic cells. We insist that, even in non-endemic areas and when clinical and radiological characteristics are not suggestive of malignancy, intra-operative frozen section analysis should be used in order to ensure the appropriate treatment.
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EBV-associated gastric carcinoma in high- and low-incidence areas for nasopharyngeal carcinoma. Br J Cancer 2009; 101:530-3. [PMID: 19603026 PMCID: PMC2720225 DOI: 10.1038/sj.bjc.6605168] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Approximately 10% of gastric carcinomas are associated with Epstein-Barr virus (EBV). The Inuit in Greenland have a high incidence of EBV-associated nasopharyngeal carcinoma. METHODS We conducted a population-based case-control study comparing gastric carcinomas in Greenland and in Denmark. RESULTS The prevalence rate of EBV-associated gastric carcinomas was 8.5% in both populations. CONCLUSION The findings of this study argue against a general susceptibility to EBV-associated carcinomas among the Inuit.
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Shamaa AA, Zyada MM, Wagner M, Awad SS, Osman MM, Abdel Azeem AA. The significance of Epstein Barr virus (EBV) & DNA topoisomerase II alpha (DNA-Topo II alpha) immunoreactivity in normal oral mucosa, oral epithelial dysplasia (OED) and oral squamous cell carcinoma (OSCC). Diagn Pathol 2008; 3:45. [PMID: 19021895 PMCID: PMC2611966 DOI: 10.1186/1746-1596-3-45] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2008] [Accepted: 11/20/2008] [Indexed: 12/04/2022] Open
Abstract
Background Head and neck cancer including oral cancer is considered to develop by accumulated genetic alterations and the major pathway is cancerization from lesions such as intraepithelial dysplasia in oral leukoplakia and erythroplakia. The relationship of proliferation markers with the grading of dysplasia is uncertain. The involvement of EBV in oral carcinogenesis is not fully understood. Aim The present study was designed to investigate the role of EBV and DNA Topoisomerase II∝ (DNA-Topo II∝) during oral carcinogenesis and to examine the prognostic significance of these protein expressions in OSCCs. Methods Using specific antibodies for EBV and DNA-Topo II∝, we examined protein expressions in archival lesion tissues from 16 patients with oral epithelial dysplasia, 22 oral squamous cell carcinoma and 20 normal oral mucosa by immunohistochemistry. Clinical information was obtained through the computerized retrospective database from the tumor registry. Results DNA-Topo II∝ was expressed in all examined specimens. Analysis of Variance ANOVA revealed highly significant difference (P < 0.01) in young aged labial tissues and significant (P ≤ 0.05) in gingival and not significant (P > 0.05) in inferior surface of tongue and in hard palatal tissues. Significant differences were observed between OEDs and NSE (P < 0.001) and SCCs and controls (P < 0.001), also, significant differences could be observed between SCCs and OEDs. DNA-Topo II∝ expression was significantly higher in tumors of low differentiation versus tumors of moderate and high differentiation (P < 0.001), DNA-Topo II∝ expression was correlated with age, tumor size, tumor stage, node metastasis and tumor differentiation, but not with gender and tumor site. None of normal squamous epithelium (NSE) expressed EBV. Heterogenous reactivity for EBV was observed through the series of dysplasia and squamous cell carcinoma. Its expression increased progressively with lymph node metastasis and low tumor differentiation, but no significant association could be observed with other clinicopathological parameters. EBV protein expression was increased with elevated Topo II-∝ LI in OEDs and OSCCs. A tendency to positive correlation between EBV and Topo II∝ expression was observed in OEDs but not in OSCCs. Conclusion EBV and DNA Topo II-αLI expression are possible indicators in oral carcinogenesis and may be valuable diagnostic and prognostic indices in oral carcinoma.
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Affiliation(s)
- Ali A Shamaa
- Oral Biology Department, Faculty of Dentistry, Minia University, Minia, Egypt.
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29
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Expression of Epstein–Barr-virus-encoded small nuclear RNA in nasopharyngeal carcinomas of Aegean Turkish patients. Virchows Arch 2008; 452:411-4. [DOI: 10.1007/s00428-008-0589-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2007] [Revised: 01/11/2008] [Accepted: 01/23/2008] [Indexed: 11/26/2022]
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30
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Schneider M, Rizzardi C. Lymphoepithelial carcinoma of the parotid glands and its relationship with benign lymphoepithelial lesions. Arch Pathol Lab Med 2008; 132:278-82. [PMID: 18251590 DOI: 10.5858/2008-132-278-lcotpg] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2007] [Indexed: 11/06/2022]
Abstract
The salivary glands, despite their relatively simple morphology, give rise to more than 30 histologically distinct benign and malignant tumors. Salivary gland neoplasms comprise less than 2% of all tumors in humans and 3% of all head and neck tumors. They arise in the parotid gland in 80% of cases, and approximately 80% are benign and 20% are malignant. Among them are lymphoepithelial lesions, rare lesions of the salivary glands and especially of the parotid gland that are characterized by lymphocytic infiltration associated with an epithelial proliferation. They are divided into benign, which is considered as a tumorlike condition, and malignant, which is a rare carcinoma of the salivary glands. This article provides a review of the current knowledge on lymphoepithelial carcinoma with a look at its association with benign lesions and on the importance of making the correct diagnosis for the appropriate treatment.
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Affiliation(s)
- Manuela Schneider
- Sezione Complessa Anatomia Patologica, Dipartimento di Patologia e Medicina Legale, Ospedale di Cattinara, Strada di Fiume 447, Trieste, Italy I-34149.
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Al-Khateeb TH, Ababneh KT. Salivary tumors in north Jordanians: a descriptive study. ACTA ACUST UNITED AC 2007; 103:e53-9. [PMID: 17368055 DOI: 10.1016/j.tripleo.2006.11.017] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2006] [Revised: 10/27/2006] [Accepted: 11/08/2006] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To evaluate the types and distribution of tumors of salivary glands in north Jordanians. STUDY DESIGN The records of the Department of Pathology at Jordan University of Science and Technology were reviewed for patients who were treated for salivary gland tumors from 1991 to 2002. The tumors were analyzed for age of patient, sex of patient, tumor site, and tumor type. RESULTS One hundred two true neoplasms (70% benign and 30% malignant) were found. The most frequent benign and malignant neoplasms found were pleomorphic adenoma (54%) and adenoid cystic carcinoma (13%), respectively. The most common major and minor salivary gland sites were the parotid (51%) and palatal glands (20%), respectively. Although most of major gland tumors were adenomas, carcinomas of the minor glands were only slightly less frequent than adenomas. The most frequent malignant parotid tumors were adenoid cystic carcinoma and mucoepidermoid carcinoma. The most frequent minor salivary gland malignant tumors were palatal adenoid cystic carcinoma. Age ranged from 1 to 94 (mean 40) years, with a male to female ratio of 1:1.2. CONCLUSION North Jordanians with salivary gland tumors were found to have similar characteristics with patients of other countries with regard to tumor type, tumor site distribution, and age and sex of patients.
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Affiliation(s)
- Taiseer Hussain Al-Khateeb
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan.
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Wakisaka N, Murono S, Minato H, Furukawa M, Yoshizaki T. A case report: Epstein-Barr virus-associated undifferentiated carcinoma of the tongue base. Auris Nasus Larynx 2006; 33:487-91. [PMID: 16934421 DOI: 10.1016/j.anl.2006.05.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2005] [Revised: 04/26/2006] [Accepted: 05/26/2006] [Indexed: 10/24/2022]
Abstract
Outside the nasopharynx, undifferentiated carcinomas occur only rarely at other head and neck locations. Although the association between undifferentiated nasopharyngeal carcinoma and Epstein-Barr virus (EBV) is consistent, there is conflicting evidence as to the association of EBV with undifferentiated carcinomas outside the nasopharynx. Here, we report on a case of undifferentiated carcinoma of the tongue base. A 71-year-old male, who had been treated with irradiation for primary unknown right neck metastatic EBV-positive undifferentiated carcinoma 9 years previously, was referred to our clinic with masses at the tongue base and right neck. The lesion at the tongue base was revealed to be an EBV-positive undifferentiated carcinoma. He was treated with resection of tongue base tumor and bilateral-neck dissection, and the defect at the tongue base was reconstructed with a free rectus abdominis myocutaneous flap. Re-irradiation was added post-operatively because of a positive surgical margin at the tongue base. The patient is presently alive without recurrence or distant metastasis 20 months after treatment. Although it is unclear whether our case is recurrent or newly developed EBV-latently infected undifferentiated carcinoma, we propose that EBV-associated tumors should be carefully observed after treatment at least for more than 10 years.
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Affiliation(s)
- Naohiro Wakisaka
- Department of Otolaryngology, School of Medicine, Kanazawa University, Takara-Machi 13-1, Kanazawa, Ishikawa, Japan
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Ueo T, Kashima K, Daa T, Kondo Y, Yokoyama S. Coexistence of Epstein-Barr virus-associated gastric carcinoma with malignant lymphoma: report of two cases. Virchows Arch 2006; 449:215-9. [PMID: 16609909 DOI: 10.1007/s00428-006-0193-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2005] [Accepted: 12/09/2005] [Indexed: 12/26/2022]
Abstract
Epstein-Barr virus (EBV)-associated gastric carcinoma (EBV-GC) is not rare, accounting for 5 to 18% of all gastric carcinomas. Recently, we encountered two cases of EBV-GC of ordinary histopathological type coexistent with malignant lymphoma. One patient was a 71-year-old Japanese man who had two lesions, one in the cardia and the other in the antrum of the stomach. The former was EBV-GC without lymphoma, and antral one was EBV-GC with diffuse large B-cell lymphoma (DLBCL). The other patient was a 49-year-old Japanese man who had received chemotherapy for pelvic DLBCL 3 years earlier. He had EBV-GC with follicular lymphoma in the fundus of the stomach. In both cases, gastric carcinomas were positive for EBV-encoded small RNA by in situ hybridization, whereas the lymphoma cells, infiltrating nonneoplastic lymphocytes, and nonneoplastic epithelial cells were negative. The present cases suggest that focal immunosuppression by adjacent gastric lymphomas might be related to the alteration of the microenvironment and development of EBV-GC.
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Affiliation(s)
- Tetsuya Ueo
- Department of Pathology, Faculty of Medicine, Oita University, Hasama-machi, Oita 879-5593, Japan
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Saqui-Salces M, Martinez-Benitez B, Gamboa-Dominguez A. EBV+ lymphoepithelial carcinoma of the parotid gland in Mexican Mestizo patients with chronic autoimmune diseases. Pathol Oncol Res 2006; 12:41-5. [PMID: 16554915 DOI: 10.1007/bf02893430] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2005] [Accepted: 12/10/2005] [Indexed: 10/21/2022]
Abstract
Lymphoepithelial carcinomas of the salivary gland are rare tumors constantly associated with Epstein-Barr virus (EBV) and mainly identified in Asiatic and Greenlander population. Four cases have been described in Caucasians, only two with EBV infection. We describe two cases of parotid gland lymphoepithelial carcinomas in Mexican mestizo women in which chronic latent EBV infection was documented by immunohistochemistry and in situ hybridization. One patient had primary Sjögren's syndrome and the other systemic lupus erythematosus of six and three years of evolution, respectively. Epithelial neoplastic cells showed latency pattern II (LMP1+, EBNA-2-, EBER+) with a dense inflammatory infiltrate composed mainly by CD8+ T lymphocytes. Follow-up excluded nasopharyngeal involvement in both patients. This report expands the ethnic groups in which salivary lymphoepithelial carcinomas associated with chronic latent EBV infection have been described, and illustrates for the first time its association with autoimmune diseases in two women living in a region non-endemic for this unusual neoplasm.
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Affiliation(s)
- Milena Saqui-Salces
- Department of Pathology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, 14000, México
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35
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Herbst H, Niedobitek G. Sporadic EBV-associated lymphoepithelial salivary gland carcinoma with EBV-positive low-grade myoepithelial component. Virchows Arch 2006; 448:648-54. [PMID: 16508782 DOI: 10.1007/s00428-005-0109-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2005] [Accepted: 09/29/2005] [Indexed: 01/17/2023]
Abstract
Salivary gland lymphoepithelial carcinomas (LECs) are associated with Epstein-Barr virus (EBV) in endemic areas, whereas sporadic cases are usually EBV negative. We have studied two EBV-associated LECs from Caucasian patients for their EBV gene expression profile and their immunophenotype. Tumour cells of case 1 showed expression of EBNA1 only, corresponding to an EBV latency type I. Tumour cells of this case expressed various basal and glandular cytokeratins. In case 2, the LEC was accompanied by a low-grade spindle cell lesion with an immunophenotype of myoepithelial cells, whereas the high-grade tumour expressed cytokeratin (Ck) 8 only. In case 2, the high-grade tumour showed an EBV lantency II pattern with expression of EBNA1, LMP1 and LMP2A (latency II). The spindle cell lesion of this case was also EBV-infected and showed low levels of EBNA1 and LMP1 expression, while LMP2A was not detectable. The detection of EBV in both components of case 2 together with immunophenotypic evidence of transition between both components supports the notion that at least some LECs arise through a low-grade myoepithelial intermediate. Expression of LMP2A may be of therapeutic interest because it may make such cases amenable to immunotherapy with EBV-specific cytotoxic T cells.
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Affiliation(s)
- Hermann Herbst
- Institute of Pathology, University Hospital Münster, Münster, Germany.
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Takahashi T, Otani Y, Yoshida M, Furukawa T, Kameyama K, Akiba Y, Saikawa Y, Kubota T, Kumai K, Kuramochi S, Mukai M, Ishii H, Kitajima M. Gastric cancer mimicking a submucosal tumor diagnosed by laparoscopic excision biopsy. J Laparoendosc Adv Surg Tech A 2005; 15:51-6. [PMID: 15772477 DOI: 10.1089/lap.2005.15.51] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
We report a case of advanced gastric cancer exhibiting the features of a submucosal tumor (SMT) of the gastric body. The patient was a 50-year-old male in whom a gastric SMT was detected during a mass screening examination. Upper gastrointestinal endoscopy revealed a protuberant tumor, 2 cm in diameter, covered with normal-appearing mucosa. Examination of an endoscopic biopsy specimen of the tumor revealed chronic gastritis with regenerative and erosive changes. An endoscopic ultrasound examination demonstrated a hypoechoic mass in the third layer of the gastric wall. The clinical diagnosis was gastric SMT, and the patient's course was monitored. Twenty-six months after the initial visit to our hospital, an endosonograph-guided biopsy revealed Group III (borderline lesion). Three months after the biopsy, the size of the SMT had increased slightly. Laparoscopic wedge resection of the tumor was performed to make a pathologic diagnosis and we were able to make a diagnosis of gastric lymphoepithelioma-like carcinoma intraoperatively. Gastrectomy with lymph node dissection was followed as curative surgery. Laparoscopic total excision biopsy is a useful technique in patients with a gastric SMT whose diagnosis has not been confirmed pathologically.
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Affiliation(s)
- Tsunehiro Takahashi
- Department of Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
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Jen KY, Higuchi M, Cheng J, Li J, Wu LY, Li YF, Lin HL, Chen Z, Gurtsevitch V, Fujii M, Saku T. Nucleotide sequences and functions of the Epstein-Barr virus latent membrane protein 1 genes isolated from salivary gland lymphoepithelial carcinomas. Virus Genes 2005; 30:223-35. [PMID: 15744579 DOI: 10.1007/s11262-004-5630-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 09/16/2004] [Accepted: 09/16/2004] [Indexed: 10/25/2022]
Abstract
Epstein-Barr virus (EBV) infection is associated with salivary gland lymphoepithelial carcinoma (SLEC) and nasopharyngeal carcinoma (NPC). EBV is a ubiquitous herpes virus world wide, but EBV-associated SLEC and NPC are prevalent in restricted regions such as south areas of China, Southeastern Asia and Greenland (Eskimos). To examine whether particular EBV variants play roles in the development of SLEC and NPC, we isolated the complete EBV LMP1 genes from 12 paraffin-embedded biopsy samples of SLECs isolated from China, Taiwan and Russia, and compared these LMP1 genes with those of NPC (CAO) and the prototype B95-8 EBV. Nucleotide sequence analysis showed that SLECs LMP1 is more similar to that of CAO than that of prototype B95-8. The analysis also identified several conserved (67-100%) variations in SLEC-LMP1 and CAO-LMP1 distinct from B95-8-LMP1. These included 10-amino acid deletion, 5-amino acid deletion and 12-single amino acid variations. A SLEC-LMP1 gene with the aforementioned conserved variations inhibited the growth of an embryonic kidney cell line (293T), highly activated the NF-kappaB pathway, and these activities were equivalent to those of B95-8 and CAO. These findings suggest that the biological functions of SLEC-LMP 1 are similar to those of B95-8-LMP1 and CAO-LMP1, and that these amino acid variations including the well-known 10-aa deletion did not affect these two prominent activities. While the present results could not uncover functional differences between SLEC-LMP1 and B95-8-LMP1, the nucleotide sequences and the molecular clone of LMP1 directly isolated from SLEC patients will be a useful tool to identify the high-pathogenic EBV strain(s), associated with SLEC and NPC.
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Affiliation(s)
- Kai Yu Jen
- Division of Oral Pathology, Department of Tissue Regeneration and Reconstruction, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Niigata, 951-8510, Japan
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Kurose A, Ichinohasama R, Kanno H, Kobayashi T, Ishida M, Nishinari N, Sawai T. Lymphoepithelioma-like carcinoma of the breast. Report of a case with the first electron microscopic study and review of the literature. Virchows Arch 2005; 447:653-9. [PMID: 15947950 DOI: 10.1007/s00428-004-1195-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2004] [Accepted: 12/06/2004] [Indexed: 12/17/2022]
Abstract
Lymphoepithelioma-like carcinoma (LELC) is a tumor which occurs outside the nasopharynx and has morphological features identical to nasopharyngeal lymphoepithelioma. LELC of the breast (LELC-B) is uncommon, and its resemblance to medullary carcinoma of the breast (MC-B) obscures distinction between these two tumors. We report a case of LELC-B occurring in a 47-year-old woman. The tumor consisted of multinodules without circumscription. The tumor cells mainly exhibited loose clusters being permeated by numerous lymphocytes. The tumor cell clusters showed inconspicuous margins, which were far from syncytial patterns. The epithelial nature of the tumor cells was demonstrated by positivity for epithelial membrane antigen, AE1/AE3 and CAM5.2. Furthermore, glandular differentiation of the tumor cells was confirmed using electron microscopy for the first time. Epstein-Barr virus (EBV) was not detected using either in situ hybridization or polymerase chain reaction. These findings, together with former reports of LELC-B, suggest that the distinction between LELC-B and MC-B depends on whether circumscription and syncytial growth patterns exist. The other findings, including absence of EBV and immunohistochemical aspects of the tumor cells, are not considered different thus far. Although the prognosis of LELC-B is thought to be favorable, which is also similar to MC-B, distant metastasis was detected in the present case. To confirm the clinicopathological entity of these two tumors, it is important to recognize the difference between LELC-B and MC-B.
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Affiliation(s)
- Akira Kurose
- Department of Pathology, Iwate Medical University, Morioka, 020-8505 Iwate, Japan.
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39
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Wang CP, Chang YL, Ko JY, Lou PJ, Yeh CF, Sheen TS. Lymphoepithelial carcinoma versus large cell undifferentiated carcinoma of the major salivary glands. Cancer 2004; 101:2020-7. [PMID: 15389474 DOI: 10.1002/cncr.20614] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Undifferentiated carcinomas of the major salivary glands are rare malignant neoplasms of the head and neck region, and patients with these lesions have a poor prognosis. Patients with lymphoepithelial carcinoma (LEC), a specific subtype of undifferentiated carcinoma, however, have a better prognosis, and LEC seems to differ from large cell undifferentiated carcinoma (LCUC) clinically. METHODS Sixteen patients with LEC and 12 patients with LCUC were retrieved from the records of 295 patients who had malignancies of the major salivary glands. A retrospective study on clinical manifestations, treatments, long-term outcomes, and an association with Epstein-Barr virus (EBV) by EBV-encoded small RNA-1 in situ hybridization was conducted to identify their differences. RESULTS The median patient age was 44.5 years in the LEC group and 56 years in the LCUC group. At the time of presentation, patients with LCUC had a history of rapid-growing tumor and more advanced locoregional disease (Stage IV in 75% of patients with LCUC compared with 13% of patients with LEC). All 16 patients with LEC underwent curative surgery and radiotherapy, and their 5-year survival rate was 85.6%. In the LCUC group, only 7 patients were eligible to undergo radical surgery and receive radiotherapy, and their 2-year survival rate was only 36%. Age > 50 years was associated with a significantly worse prognosis for patients with LCUC. Neck metastasis and tumor size > 6 cm tended to be poor prognostic factors. Tumors were positive for harboring the EBV genome in all 16 LEC samples but in none of the LCUC samples. CONCLUSIONS The clinicopathologic features of LEC and LCUC of the major salivary glands were different. LEC was associated with EBV, and patients with LEC had a much better prognosis compared with the prognosis for patients with LCUC. Therefore, LEC should be put in an independent group and should not be included in the same category as undifferentiated carcinomas of the salivary gland.
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Affiliation(s)
- Cheng-Ping Wang
- Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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40
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Chen TZ, Yang WT, Zhu XZ. 30-bp Deletion in latent membrane protein 1 (LMP-1) oncogene in lymphoepithelial carcinoma of salivary glands. Chin J Cancer Res 2004. [DOI: 10.1007/s11670-004-0020-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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41
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Mrad K, Ben Brahim E, Driss M, Abbes I, Marakchi M, Ben Romdhane K. Lymphoepithelioma-like carcinoma of the submandibular salivary gland associated with Epstein?Barr virus in a North African woman. Virchows Arch 2004; 445:419-20. [PMID: 15258757 DOI: 10.1007/s00428-004-1072-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2004] [Accepted: 06/02/2004] [Indexed: 10/26/2022]
Affiliation(s)
- Karima Mrad
- Department of Pathology, Salah Azaiez Institute, 1006 Bab, Saadoun, Tunis, Tunisia.
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42
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Kobayashi M, Ito M, Sano K, Honda T, Nakayama J. Pulmonary lymphoepithelioma-like carcinoma: predominant infiltration of tumor-associated cytotoxic T lymphocytes might represent the enhanced tumor immunity. Intern Med 2004; 43:323-6. [PMID: 15168777 DOI: 10.2169/internalmedicine.43.323] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Lymphoepithelioma-like carcinoma (LELC) of the lung is an undifferentiated carcinoma with prominent lymphoid stroma. We encountered a case of synchronous primary lung cancers of LELC and papillary adenocarcinoma in a 67-year-old Japanese woman. By in situ hybridization, Epstein-Barr virus (EBV) genome was detected in malignant epithelial cells of LELC but not in the papillary adenocarcinoma. Tumor-infiltrating lymphocytes in LELC were predominantly CD8+ and T cell intracytoplasmic antigen (TIA-1)+ cytotoxic T cells with closely associated with HLA-DR-positive LELC cells by double immunostaining. These data indicate that the exaggerated lymphoid infiltration in and around the EBV-infected carcinoma cells may represent the enhanced tumor immunity, suggesting a better prognostic indicator.
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Affiliation(s)
- Motohiro Kobayashi
- Department of Pathology, Shinshu University School of Medicine, Matsumoto
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43
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Herbst H, Hamilton-Dutoit S, Jäkel KT, Niedobitek G. [Undifferentiated salivary gland carcinomas]. DER PATHOLOGE 2004; 25:56-62. [PMID: 14767613 DOI: 10.1007/s00292-003-0674-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Undifferentiated salivary gland carcinomas may be divided into small cell and large cell types. Among large cell undifferentiated carcinomas, lymphoepithelial carcinomas have to be distinguished, the latter of which are endemic in the Arctic regions and southern China where virtually all cases of these tumors are associated with the Epstein-Barr virus (EBV). Association with EBV may also be observed in sporadic cases, and detection of EBV gene products may aid their diagnosis. Immunohistology may be employed to resolve the differential diagnosis of undifferentiated salivary gland carcinomas, comprising malignant lymphomas, amelanotic melanomas, Merkel cell carcinomas, and adenoid cystic carcinomas, in particular in small biopsy materials. Because of the rarity of undifferentiated salivary gland carcinomas, the differential diagnosis should always include metastases of undifferentiated carcinomas arising at other primary sites, particularly when expressing the thyroid transcription factor-1 (TTF-1).
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Affiliation(s)
- H Herbst
- Gerhard-Domagk-Institut für Pathologie, Universitätsklinikum Münster.
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44
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Abstract
The Epstein-Barr virus (EBV) is associated with several human tumours including lymphoid and epithelial malignancies. Most EBV-associated tumours are rare or occur at higher incidence only in certain geographical regions. The recently reported detection of EBV in gastric, breast, and hepatocellular carcinomas raises the possibility of involvement of the virus in the pathogenesis of common cancers. This article reviews the evidence linking EBV infection to epithelial tumours. It is concluded that at present, there is no convincing evidence to suggest that breast carcinoma and hepatocellular carcinoma are EBV-associated tumours.
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Affiliation(s)
- Kathrin Herrmann
- Pathologisches Institut, Friedrich-Alexander-Universität, Erlangen, Germany
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45
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Hidaka H, Nakamura N, Asano S, Yokoyama J, Yoshida N, Toshima M. A case of lymphoepithelioma-like carcinoma arising from the palatine tonsil. TOHOKU J EXP MED 2002; 198:133-40. [PMID: 12512998 DOI: 10.1620/tjem.198.133] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Lymphoepithelioma is the designation that has been given to describe undifferentiated squamous cell carcinoma variants of nasopharyngeal neoplasms (World Health Organization type 3), and a strong association with Epstein-Barr virus (EBV) infection has been established. Outside the nasopharynx, lymphoepithelioma-like carcinomas (LEC) are exceedingly rare in other head and neck lesions. This report features a rare case of LEC of the palatine tonsil occurring in a 60-year-old Japanese man who presented with a three-month history of a neck mass. The surface of tonsils were smooth, not ulcerated macroscopically, and the ipsilateral tonsil showed only slight enlargement on radiological findings. Diagnosis of lymphoepithelioma was finally made based on the pathological review of the tonsillectomy specimens, preceded by a cervical lymph node biopsy. The patient was treated with irradiation and adjuvant chemotherapy. RNA in situ hybridization as well as polymerase chain reaction (PCR) techniques, and serological testing did not demonstrate an association with EBV infection. The clinical presentation, pathological features and association with EBV are described with a review of the literature.
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Affiliation(s)
- Hiroshi Hidaka
- Department of Otorhinolaryngology, Iwaki Kyoritsu General Hospital, Iwaki 973-8555, Japan.
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Chow TL, Chow TK, Lui YH, Sze WM, Yuen NWF, Kwok SPY. Lymphoepithelioma-like carcinoma of oral cavity: report of three cases and literature review. Int J Oral Maxillofac Surg 2002; 31:212-8. [PMID: 12102423 DOI: 10.1054/ijom.2001.0148] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Lymphoepithelioma-like carcinoma is a rare tumour in the oral cavity and is characterized histologically by non-keratinizing, undifferentiated squamous cell carcinoma with lymphocytic infiltration. Three consecutive cases of intraoral lymphoepithelioma-like carcinoma are reported. A review of the literature reveals a similar biological behaviour to that of nasopharyngeal lymphoepithelioma: a high incidence of cervical nodal spread and remarkable radiosensitivity. Chemotherapy should be considered when nodal or distant metastases are present. The association of the Epstein-Barr virus with this tumour remains unclear but our experience suggests a positive correlation in Chinese individuals.
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Affiliation(s)
- T L Chow
- Department of Surgery, United Christian Hospital, Kowloon, Hong Kong
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47
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Kon S, Kasai K, Tsuzuki N, Nishibe M, Kitagawa T, Nishibe T, Sato N. Lymphoepithelioma-like carcinoma of rectum: possible relation with EBV. Pathol Res Pract 2002; 197:577-82. [PMID: 11518052 DOI: 10.1078/0344-0338-00130] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Lymphoepithelioma-like carcinoma (LEC) of the colon is very rare. Here we report a case of LEC originating in the rectum that was closely associated with Epstein-Barr virus (EBV) infection. The histologic and immunohistologic features, namely, poorly differentiated adenocarcinoma with lymphoid stroma, showed this tumor to be an LEC. The EBV genome was detected by PCR using DNA obtained from tumor tissue sections. Immunohistochemically, EBV-determined nuclear antigen 2 was detected in the tumor cells, and in situ hybridization using EBV-encoded small RNAs probe showed positive labeling in some tumor cells together with a few stromal lymphoid cells. There are some reports of LEC cases that originated in the colon; however, a relation with EBV was not demonstrated. We report here a case of LEC of the rectum demonstrating a possible relation with EBV.
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Affiliation(s)
- S Kon
- Department of Pathology, School of Medicine, Sapporo Medical University, Japan.
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48
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Kijima Y, Hokita S, Takao S, Baba M, Natsugoe S, Yoshinaka H, Aridome K, Otsuji T, Itoh T, Tokunaga M, Eizuru Y, Aikou T. Epstein-Barr virus involvement is mainly restricted to lymphoepithelial type of gastric carcinoma among various epithelial neoplasms. J Med Virol 2001; 64:513-8. [PMID: 11468737 DOI: 10.1002/jmv.1079] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
To demonstrate the association of Epstein-Barr virus (EBV) with primary epithelial neoplasms in the south part of Kyushu, Japan, 761 carcinomas consisting of 75 lung, 61 breast, 107 esophagus, 102 colon, 58 pancreas, 45 thyroid, and 313 gastric cancers were examined by EBER-1 in situ hybridization. EBER-1 was detected in 23 cases (7.3%) out of 313 gastric carcinomas, while none of the other carcinomas was positive for EBER-1. Twenty-eight (9.4%) out of 313 gastric carcinomas were differentiated poorly to moderately carcinomas with prominent lymphoid cell infiltration, similar to so-called lymphoepithelioma-like carcinoma, and 19 cases (67.9%) were positive for EBER-1. Although two (2.6%) and 11(10.3%) out of 75 lung and 107 esophagus carcinomas were so-called lymphoepithelioma-like carcinomas, respectively, but EBER-1 was not detected in other epithelial neoplasms that originated from the lung, esophagus, breast, colon, pancreas, and thyroid in the south of Kyushu, Japan. As a result, EBV was associated with only some gastric carcinomas but not with other epithelial neoplasms originating from the lung, esophagus, breast, colon, pancreas, and thyroid in southern Japan.
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Affiliation(s)
- Y Kijima
- The First Department of Surgery, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
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Castro CY, Ostrowski ML, Barrios R, Green LK, Popper HH, Powell S, Cagle PT, Ro JY. Relationship between Epstein-Barr virus and lymphoepithelioma-like carcinoma of the lung: a clinicopathologic study of 6 cases and review of the literature. Hum Pathol 2001; 32:863-72. [PMID: 11521232 DOI: 10.1053/hupa.2001.26457] [Citation(s) in RCA: 94] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Lymphoepithelioma-like carcinoma (LELC) is a rare form of lung cancer, usually encountered in Chinese patients. Similar to nasopharyngeal carcinoma, LELC of the lung is strongly associated with Epstein-Barr virus (EBV) infection in Asian patients, but there is controversy over whether an association exists in patients from Western countries. To determine whether such a relationship exists, we retrospectively studied 6 cases of primary LELC of the lung, all of which were in Western patients. There were 4 men and 2 women, ranging in age from 49 to 75 years. The tumors ranged from 1 to 4.5 cm in diameter. Four patients had stage I disease, 1 had stage IIb disease, and 1 had stage IIIa disease. All patients are alive without evidence of disease with a follow-up of 18 to 30 months. Formalin-fixed, paraffin-embedded tissue was stained with hematoxylin-eosin for routine evaluation and immunostained for keratin and leukocyte common antigen (LCA). LCA staining was performed to exclude large-cell lymphoma. Immunoperoxidase staining (1:500 clone CS1-4; Dako, Carpinteria, CA) and in situ hybridization were performed to detect EBV. Tumors consisted of solid nests of undifferentiated tumor cells in a syncytial arrangement surrounded by heavy lymphoplasmacytic infiltrate. Tumor cells stained positively for keratin but negative for LCA. All 6 cases were negative for EBV, suggesting no association between EBV and LELC in the Western population.
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Affiliation(s)
- C Y Castro
- Division of Pathology, the University of Texas M.D. Anderson Cancer Center, Baylor College of Medicine, Houston, TX, USA
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Emile JF, Adam R, Sebagh M, Marchadier E, Falissard B, Dussaix E, Bismuth H, Reynès M. Hepatocellular carcinoma with lymphoid stroma: a tumour with good prognosis after liver transplantation. Histopathology 2000; 37:523-9. [PMID: 11122434 DOI: 10.1046/j.1365-2559.2000.00952.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
AIMS Carcinomas with lymphoid stroma arising in non-liver-organs have a better prognosis than other carcinomas and may be associated with Epstein-Barr virus. We determined the frequency, characteristics and prognosis of hepatocellular carcinomas with lymphoid stroma. METHODS AND RESULTS Histology of the livers of 162 patients with hepatocellular carcinoma, who underwent an orthotopic liver transplantation, was reviewed independently by three pathologists. Hepatocellular carcinoma with lymphoid stroma was diagnosed when all tumour samples contained more lymphocytes than tumour cells. Epstein-Barr virus was detected by in-situ hybridization and by polymerase chain reaction. Five patients (3.6%) were classified as hepatocellular carcinomas with lymphoid stroma. All patients were males. Cirrhosis was present in four/five patients. Serum alpha-fetoprotein levels were normal. Inter-observer histological reproducibility was good. Tumour cells did not contain Epstein-Barr virus. The five patients were alive without tumour at three years, although two of them had adverse prognostic factors at the time of transplantation (more than one tumour with a diameter > or = 40 mm). Only one patient had tumour recurrence, but he survived 7.6 years post-transplantation. The 5-year survival of patients with hepatocellular carcinoma with lymphoid stroma was better than that of the patients with other types of hepatocellular carcinomas (P = 0.04). CONCLUSIONS Hepatocellular carcinoma with lymphoid stroma should be considered as a distinct clinicopathological and prognostic entity.
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Affiliation(s)
- J F Emile
- Service d'Anatomopathologie,Centre Hépatobiliaire, Hôpital Paul Brousse and UPRES 1596 'Virus Hépatotropes et Cancer', Université Paris Sud, France.
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