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Arora M, Balasubramanian B, Mohammad Kamel Aljasem N, Arora S, Arora R. Lymphoepithelial Carcinoma of the Breast. Cureus 2023; 15:e42597. [PMID: 37521589 PMCID: PMC10375514 DOI: 10.7759/cureus.42597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2023] [Indexed: 08/01/2023] Open
Abstract
Lymphoepithelial malignancy is an extremely rare carcinoma of the breast characterized by a confusing histopathological picture resembling medullary carcinomas, lymphoma, etc. It has also been reported in other regions of the body like salivary glands, nasopharyngeal area and sometimes the lung. Due to its rare presence and difficult diagnosis, the treatment is often prolonged and delayed. Here we present a case report of a 56-year-old lady who was eventually diagnosed as lymphoepithelial carcinoma of the breast. Her journey of evaluation and treatment was fraught with pathological nuances and an elimination drill of multiple differentials before concluding this rare diagnosis. Although lymphoepithelial-like carcinoma is a rare entity, multiple cases have been reported in the literature and their review is mandated to further our clinical knowledge about the oncological treatment and expected prognosis of such cases in the future. Our patient underwent a simple mastectomy, followed by chemotherapy, radiotherapy, and is completely asymptomatic now. She has been cancer-free for the last seven years so far.
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Affiliation(s)
- Mamta Arora
- Department of Surgery, NMC Specialty Hospital, Abu Dhabi, Abu Dhabi, ARE
| | | | | | - Simran Arora
- Department of Surgery, University of Debrecen, Debrecen, HUN
| | - Ravi Arora
- Department of Internal Medicine and Endocrinology, NMC Specialty Hospital, Abu Dhabi, Abu Dhabi, ARE
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2
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Lentsch K, Dauterman LC, Fan B. Lymphoepithelial Carcinoma of the Breast Treated With Partial Mastectomy and Sentinel Lymph Node Biopsy. Cureus 2023; 15:e39190. [PMID: 37332460 PMCID: PMC10276649 DOI: 10.7759/cureus.39190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/13/2023] [Indexed: 06/20/2023] Open
Abstract
Lymphoepithelial carcinoma of the breast (LELC) is a rarely encountered form of breast carcinoma, and there is limited information treatment for this entity. We present a case of a 55-year-old postmenopausal female presenting with a left breast mass on screening mammogram with core needle biopsy showing lymphoepithelial carcinoma. The patient was treated with surgical resection of the mass and sentinel lymph node biopsy, followed by adjuvant chemotherapy and radiation. Given the rarity of this type of breast carcinoma, our case study continues to add to the treatment considerations in the literature, specifically the role of sentinel lymph node.
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Affiliation(s)
- Kristen Lentsch
- Surgery, Indiana University School of Medicine, Indianapolis, USA
| | - Leah C Dauterman
- Medical Education, Indiana University School of Medicine, Indianapolis, USA
| | - Betty Fan
- Surgical Oncology, Indiana University School of Medicine, Indianapolis, USA
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3
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Nanev V, Naneva S, Yordanov A, Strashilov S, Konsoulova A, Vasileva-Slaveva M, Betova T, Ivanov I. Lymphoepithelioma-like Carcinoma of the Breast Synchronous with a High-Grade Invasive Ductal Carcinoma and Ductal Carcinoma in Situ in a Different Quadrant of the Same Breast: A Case Report. Medicina (B Aires) 2022; 58:medicina58091146. [PMID: 36143823 PMCID: PMC9505786 DOI: 10.3390/medicina58091146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 08/19/2022] [Accepted: 08/19/2022] [Indexed: 11/16/2022] Open
Abstract
Lymphoepithelioma-like breast carcinoma (LELC) is a rare type of malignant breast tumor that is not included in the current edition of the World Health Organization (WHO) classification of breast tumors. Currently, there are no clearly defined therapeutic strategies, and the general information on breast LELC is based on sporadic clinical cases described in the medical literature. We present a clinical case that describes a 49-year-old woman with a tumor formation in the right breast, histologically verified as LELC, together with a non-palpable, synchronous high-grade invasive ductal carcinoma and ductal carcinoma in situ Grade 2 (DCIS G2) in a different quadrant of the same breast. To our knowledge, this is the first case described in the literature that combines a LELC with a synchronous carcinoma in the same breast.
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Affiliation(s)
- Vasil Nanev
- Department of Surgical Oncology, Dr. Georgi Stranski University Hospital, Medical University—Pleven, 5800 Pleven, Bulgaria
| | - Silvia Naneva
- Hematology Clinic, Dr. Georgi Stranski University Hospital, Medical University—Pleven, 5800 Pleven, Bulgaria
| | - Angel Yordanov
- Department of Gynaecologic Oncology, Medical University—Pleven, 5800 Pleven, Bulgaria
- Correspondence:
| | - Strahil Strashilov
- Department of Plastic, Reconstructive and Aesthetic Surgery, Dr. Georgi Stranski University Hospital, Medical University—Pleven, 5800 Pleven, Bulgaria
| | - Assia Konsoulova
- USHATO—Sofia National University Cancer Hospital, 1000 Sofia, Bulgaria
- Women for Oncology, 1000 Sofia, Bulgaria
- Department of Preclinical and Clinical Disciplines, Faculty of Social Health and Healthcare, University Prof. A. Zlatarov, 8000 Burgas, Bulgaria
| | - Mariela Vasileva-Slaveva
- Department of Breast surgery, Shterev Hospital, 1000 Sofia, Bulgaria
- Research Institute, Medical University—Pleven, 5800 Pleven, Bulgaria
| | - Tatyana Betova
- Department of Clinical Pathology, Dr. Georgi Stranski University Hospital, Medical University—Pleven, 5800 Pleven, Bulgaria
| | - Ivan Ivanov
- Department of Clinical Pathology, Dr. Georgi Stranski University Hospital, Medical University—Pleven, 5800 Pleven, Bulgaria
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4
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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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5
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Sinclair AJ, Moalwi MH, Amoaten T. Is EBV Associated with Breast Cancer in Specific Geographic Locations? Cancers (Basel) 2021; 13:cancers13040819. [PMID: 33669217 PMCID: PMC7919813 DOI: 10.3390/cancers13040819] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/04/2021] [Accepted: 02/11/2021] [Indexed: 12/18/2022] Open
Abstract
Simple Summary Epstein–Barr virus (EBV) is a virus that infects people and then remains within their bodies for life. Almost everyone is infected with EBV by the time they are an adult. EBV is called a cancer virus because it causes some cancers of blood cells and some cancers of the stomach and nose. Some scientists think that EBV may also cause some cases of breast cancer, but others disagree. It is difficult to be sure whether a pathogen that most people are infected with is the cause of any disease. Here, we review and discuss the evidence for and against the link between EBV and breast cancer and pose the questions that could help to answer whether EBV is a cause of breast cancer. Abstract Epstein–Barr virus (EBV) is a virus that establishes a life-long infection in people, and infection with EBV is nearly ubiquitous by adulthood. EBV was identified from biopsy material from a child with Burkitt’s lymphoma (BL) in sub-Saharan Africa. EBV has a well-characterised role in the development of some cancers, notably, Burkitt’s lymphoma (BL), Hodgkin’s disease (HD), gastric carcinoma (GC), and nasopharyngeal carcinoma (NPC). Links have also been made between EBV and breast cancer (BC), but these have been controversial. For all EBV-associated cancers, the ubiquitous nature of infection with EBV, contrasted with the relatively rare development of cancer, highlights a problem of determining whether EBV is an aetiological agent of cancer. In addition, the geographic distributions of some EBV-associated cancers point to contributions from additional co-factors. Recent meta-analyses of the incidence of EBV within BC biopsies has revealed that the diversity in the conclusions remain, however, they also show more of an association between EBV and BC biopsies in some study locations. Here, we review the evidence linking EBV with BC, and conclude that the evidence for the presence of EBV in BC biopsies is concentrated in specific geographic regions but is currently insufficient to provide a causal link. We pose some questions that could help to resolve the question of whether EBV contributes to BC and probe the contribution EBV might make to the aetiology of BC.
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Golrokh Mofrad M, Kazeminezhad B, Faghihloo E. Prevalence of Epstein-Barr virus (EBV) in Iranian Breast Carcinoma Patients. Asian Pac J Cancer Prev 2020; 21:133-137. [PMID: 31983175 PMCID: PMC7294004 DOI: 10.31557/apjcp.2020.21.1.133] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Indexed: 11/25/2022] Open
Abstract
Introduction: Breast cancer (BC) is the most common malignancy affecting females worldwide. Various
risk factors play a role in the developing of BC. Infectious agents like viruses have
been proposed for this cancer and Epstein-Barr virus (EBV) is a widely researched
candidate virus. This study detects the presence of EBV-DNA in breast cancer patients.
Methods: The study was conducted on 59 formalin-fixed paraffin-embedded (FFPE) tissue blocks
samples of women with breast carcinoma and 11 non-neoplastic breast controls. The DNA
was extracted for all the samples. Then detection of EBNA1 EBV was done by polymerase
chain reaction (PCR). Results: EBV was detected in 6.7% (4/59) of patients while all breast control samples were
negative. All patients with positive EBV-DNA were high tumor grades (II, and III). Also,
they had a low level of educations. Conclusions: According to our findings, it can be suggested that EBV may have a potential role in
breast cancer development. However, this study provides substantial but not conclusive
evidence for the involvement of viruses in BC disease development. Therefore, future
investigations are needed to elucidate the exact role of EBV in breast cancer.
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Affiliation(s)
- Morvarid Golrokh Mofrad
- Human Viral Vaccine Department, Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran
| | - Behrang Kazeminezhad
- Department of Pathology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ebrahim Faghihloo
- Departments of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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7
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Lymphoepithelioma-Like Carcinoma of the Breast: A Case Report Unveiling Several Clinical and Histopathological Challenges. Case Rep Surg 2018; 2018:8240534. [PMID: 30123609 PMCID: PMC6079566 DOI: 10.1155/2018/8240534] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 06/07/2018] [Indexed: 12/28/2022] Open
Abstract
Lymphoepithelioma-like carcinoma (LELC) of the breast is an extremely rare tumor type. Histologically, it mimics undifferentiated nasopharyngeal carcinoma by demonstrating nests of neoplastic epithelial cells in a background of lymphoplasmacytic infiltrates. This paper reports a 62-year-old female patient with a 3 × 1.5 cm BI-RADS type IV breast mass diagnosed on excisional biopsy as LELC. The tumor is negative for estrogen and progesterone receptors and did not overexpress HER2/neu. Routine tests for clearance before surgery were performed, and patient was managed by a modified radical mastectomy with axillary lymph node dissection showing no residual tumor. Surgical CAse REports (SCARE) guidelines were followed for reporting our case. The rarity of LELC of the breast warrants the establishment and implementation of well-defined guidelines and criteria for diagnosis and management.
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8
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Primary lymphoepithelial-like carcinoma of the parotid gland-case presentation. BALKAN JOURNAL OF DENTAL MEDICINE 2018. [DOI: 10.2478/bjdm-2018-0008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background/Aim: Primary Lymphoepithelial carcinoma (PLEC) is a rare subtype of salivary gland cancers, which comprises only 0.4% of salivary malignant neoplasms and only a few cases have been presented previously. Case report: A patient with PLEC of the parotid gland, its management and the available literature are presented. A 53-year-old woman with initial lesion of a lump in the region of the right parotid received treatment with antibiotics which did not lead to improvement. MRI was performed that recorded the presence of a tumor in the right parotid gland and the patient subsequently underwent excision biopsy. The histopathological evaluation together with additional immunohistochemical positive staining of EMA+, EGFR+, p63+, CK 5/6+, AE1/AE3+ established the diagnosis of PLEC. A PET-CT scanning has shown nor primary mucosal source neither skin lesion to account for any possible metastatic disease, consequently a course of adjuvant post-operative radiotherapy to the region of the right parotid gland was performed. Conclusions: In the differential diagnosis of a parotid gland lump should be included the possibility of a rare salivary gland neoplasm such as PLEC. Surgical excision and radiotherapy have been proposed for the treatment of early and advanced neoplasm stages. Ages of the patient, stage of the neoplasm as well as type of therapy are significant and individual variables for the prediction of the prognosis.
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9
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Abouelfad DM, Yassen NN, Amin HAA, Shabana ME. Lymphoepithelioma-Like Carcinoma of the Breast Mimicking Granulomatous Mastitis- Case Report and Review of the Literature. Asian Pac J Cancer Prev 2017; 18:1737-1741. [PMID: 28749097 PMCID: PMC5648373 DOI: 10.22034/apjcp.2017.18.7.1737] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Lymphoepithelioma-like carcinoma (LELC) of the breast is an exceedingly rare variant of mammary cancer. To our knowledge, only twenty - one cases have been reported in the literature. Diagnosis of this type of mammary carcinoma may be challenging, owing to its rarity and the histopathological similarity to common inflammatory and malignant lesions of the breast mainly granulomatous mastitis, medullary carcinoma, pleomorphic lobular carcinoma, lymphoma and other hematological malignancies. Our case is the 22nd case of lymphoepithelioma-like carcinoma reported in the breast, presenting with a palpable tender mass in a post-menopausal female. Her clinical picture had been mistaken for inflammatory disease. We present our case, with its detailed clinical history, radiological findings, histopathological and immune-histochemical findings along with a review of the literature. Highlighting this type of tumors may help in appropriate diagnosis. Moreover, studying the behavior of these rare neoplasms is essential to expedite treatment for this tumor type.
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Affiliation(s)
- Dalia M Abouelfad
- Pathology Department, Medical Division, National Research Centre, Cairo, Egypt.
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10
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Pai T, Gupta S, Gurav M, Nag S, Shet T, Patil A, Desai S. Evidence for the association of Epstein-Barr Virus in breast cancer in Indian patients using in-situ hybridization technique. Breast J 2017; 24:16-22. [PMID: 28557251 DOI: 10.1111/tbj.12828] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 08/18/2016] [Accepted: 08/22/2016] [Indexed: 11/30/2022]
Abstract
Epstein-Barr Virus (EBV) is etiologically linked to Burkitt lymphoma (BL), nasopharyngeal carcinoma, post-transplant lymphomas, Hodgkin disease, and possibly other tumors. However, the association of oncogenic EBV with breast carcinoma (BC) is still controversial and a matter of debate. We aimed to study the presence of EBV genome in BC cases in Indian patients and its association with the clinicopathological features. The formalin fixed paraffin embedded tissues from 83 women with primary invasive BC were studied for the presence of EBV by in-situ hybridization (ISH) technique for Epstein-Barr Virus Encoded RNA (EBER) with appropriate controls. Correlation of EBER-ISH positivity with clinicopathological features was performed using Fisher exact test and P<.05 was considered as significant. Eighty-three BC cases were comprised of 47 (56.5%) triple negative breast cancers (TNBC), 17 (20.5%) hormone positive and 19 (22.9%) HER2 positive cases. Of 83 cases, 25 cases (30.1%) were positive for EBER-ISH test. The positivity was restricted to the tumor cells and not seen in the surrounding breast lobules. EBER-ISH positivity was statistically associated with larger tumor size (52.6% in >5 cm tumors vs 19.3% in ≤5 cm; P=.014) and with TNBCs (21/47 [44.7%] in TNBCs vs 4/36 [11.1%] in non-TNBCs; P=.001). A possible causal association of EBV in BC cases in Indian patients is suggested by high frequency of EBER-ISH positivity noted in our study. This might have therapeutic significance because of the possible role of EBV specific cytotoxic T cells in targeting EBV associated tumor cells and can be considered as a potential targeted therapy. To the best of our knowledge, this is the first study from India to address this issue using EBER-ISH technique.
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Affiliation(s)
- Trupti Pai
- Division of Molecular Pathology, Tata Memorial Hospital, Mumbai, India.,Department of Pathology, Tata Memorial Hospital, Mumbai, India
| | - Sudeep Gupta
- Department of Medical Oncology, Tata Memorial Hospital - Advanced Centre for Therapy and Research in Cancer (ACTREC), Mumbai, India
| | - Mamta Gurav
- Division of Molecular Pathology, Tata Memorial Hospital, Mumbai, India.,Department of Pathology, Tata Memorial Hospital, Mumbai, India
| | | | - Tanuja Shet
- Department of Pathology, Tata Memorial Hospital, Mumbai, India
| | - Asawari Patil
- Department of Pathology, Tata Memorial Hospital, Mumbai, India
| | - Sangeeta Desai
- Division of Molecular Pathology, Tata Memorial Hospital, Mumbai, India.,Department of Pathology, Tata Memorial Hospital, Mumbai, India
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11
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Lymphoepithelial Carcinoma of the Nasolacrimal Duct: Clinical, Radiologic, and Immunopathologic Features. Ophthalmic Plast Reconstr Surg 2017; 33:S18-S21. [DOI: 10.1097/iop.0000000000000478] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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12
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Shet T, Pai T, Shetty O, Desai S. Lymphoepithelioma-like carcinoma of breast-evaluation for Epstein-Barr virus-encoded RNA, human papillomavirus, and markers of basal cell differentiation. Ann Diagn Pathol 2016; 25:42-47. [PMID: 27806845 DOI: 10.1016/j.anndiagpath.2016.05.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Revised: 05/05/2016] [Accepted: 05/26/2016] [Indexed: 12/26/2022]
Abstract
This is a largest series of 5 cases of lymphoepithelioma-like carcinoma (LEC) of the breast attempting to look at the expression of basal cytokeratins (CKs), human papillomavirus, and Epstein-Barr virus-encoded RNAs in these tumors. Five cases were selected after stringent evaluation of all breast carcinomas showing dense lymphoid infiltration. Histologically, all these tumors showed the typical histology except 1 tumor that showed an unusual granulomatous response. All tumors were negative for estrogen and progesterone receptors and HER2 (triple negative). Three tumors expressed CK5/6 and high-molecular-weight CK, whereas only the case with nodal metastasis expressed CK14. Analysis for in situ hybridization for Epstein-Barr virus-encoded RNAs and human papillomavirus DNA on paraffin-processed tissues was negative in all tumors. All of these patients received adjuvant therapy. One patient with tumor expressing basal marker, CK5/6, had contralateral breast malignancy after a duration of 53 months of treatment completion. The rest were disease free with the follow-up period in the range of 6 to 105 months. The lymphoepithelioma-like carcinoma of breast expressed basal CK profile that is more CK5/6 positive than CK14. Analysis of basal markers within these tumors may help in refining the definition of these tumors and in classifying them into prognostically relevant groups.
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Affiliation(s)
- Tanuja Shet
- Divisions of Surgical and Molecular Pathology, Department of Pathology, Tata Memorial Hospital (TMH) & Advanced Centre for Training, Research & Education in Cancer (ACTREC), Mumbai, India.
| | - Trupti Pai
- Divisions of Surgical and Molecular Pathology, Department of Pathology, Tata Memorial Hospital (TMH) & Advanced Centre for Training, Research & Education in Cancer (ACTREC), Mumbai, India
| | - Omshree Shetty
- Divisions of Surgical and Molecular Pathology, Department of Pathology, Tata Memorial Hospital (TMH) & Advanced Centre for Training, Research & Education in Cancer (ACTREC), Mumbai, India
| | - Sangeeta Desai
- Divisions of Surgical and Molecular Pathology, Department of Pathology, Tata Memorial Hospital (TMH) & Advanced Centre for Training, Research & Education in Cancer (ACTREC), Mumbai, India
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13
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Sato A, Kawasaki T, Abo-Yashima A, Yoshida T, Kobayashi S, Kashiwaba M, Sugai T, Ichihara S. Cytological features of lymphoepithelioma-like carcinoma of the breast. Cytopathology 2016; 28:169-172. [PMID: 27478161 DOI: 10.1111/cyt.12363] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- A Sato
- Department of Molecular Diagnostic Pathology, Iwate Medical University School of Medicine, Morioka, Japan
| | - T Kawasaki
- Department of Molecular Diagnostic Pathology, Iwate Medical University School of Medicine, Morioka, Japan.,Department of Pathology, National Hospital Organisation Nagoya Medical Centre, Aichi, Japan
| | - A Abo-Yashima
- Department of Pathology, Iwate Medical University School of Medicine, Morioka, Japan
| | - T Yoshida
- Department of Cytopathology, Gunma University, Maebashi, Japan
| | - S Kobayashi
- Department of Cytopathology, Gunma University, Maebashi, Japan
| | - M Kashiwaba
- Department of Surgery, Iwate Medical University School of Medicine, Morioka, Japan
| | - T Sugai
- Department of Molecular Diagnostic Pathology, Iwate Medical University School of Medicine, Morioka, Japan
| | - S Ichihara
- Department of Pathology, National Hospital Organisation Nagoya Medical Centre, Aichi, Japan
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14
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Hipp JA, Jing X, Zarka MA, Schmitt AC, Siddiqui MT, Wakely P, Bishop J, Ali SZ. Cytomorphologic characteristics and differential diagnoses of lymphoepithelial carcinoma of the parotid. J Am Soc Cytopathol 2016; 5:93-99. [PMID: 31042496 DOI: 10.1016/j.jasc.2015.09.216] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 09/28/2015] [Accepted: 09/29/2015] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Lymphoepithelial carcinoma of the salivary gland is an extremely rare neoplasm and is challenging to diagnose by fine needle aspiration (FNA). There are rare reports on the cytopathologic features of lymphoepithelial carcinoma, which may be mistaken for other high-grade salivary gland neoplasm or a metastasis to the salivary gland. MATERIALS AND METHODS A retrospective review was undertaken of 7 cases of lymphoepithelial carcinoma of the parotid diagnosed on FNA with histologic confirmation from 4 major medical centers. RESULTS Cytomorphologic features of lymphoepithelial carcinoma include smears with moderate cellularity displaying a rich nonneoplastic population of lymphoplasmacytic cells admixed with tissue fragments of high grade, malignant undifferentiated epithelial cells with high nuclear to cytoplasm ratio, hyperchromasia, prominent nucleoli, and scant to abundant, indistinct cytoplasm. DISCUSSION Diagnostic pitfalls of lymphoepithelial carcinoma include metastatic squamous cell carcinoma, metastatic nasopharyngeal carcinoma, and other high grade primary salivary gland neoplasms. Recognizing this lesion may help guide clinicians to perform additional imaging studies to exclude a primary from other sites.
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Affiliation(s)
- Jennifer A Hipp
- Department of Pathology, The Johns Hopkins Hospital, 600 N. Wolfe Street, PATH 406 Baltimore, Maryland 21287-6940
| | - Xin Jing
- Department of Pathology, University of Michigan, Ann Arbor, Michigan
| | | | | | - Momin T Siddiqui
- Department of Pathology, Emory University Hospital, Atlanta, Georgia
| | - Paul Wakely
- Department of Pathology, The Ohio State University, Wexner Medical Center, Columbus, Ohio
| | - Justin Bishop
- Department of Pathology, The Johns Hopkins Hospital, 600 N. Wolfe Street, PATH 406 Baltimore, Maryland 21287-6940
| | - Syed Z Ali
- Department of Pathology, The Johns Hopkins Hospital, 600 N. Wolfe Street, PATH 406 Baltimore, Maryland 21287-6940; Department of Radiology, The Johns Hopkins Hospital, Baltimore, Maryland.
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15
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Abstract
Lymphoepithelioma-like carcinoma of the breast is a rare malignancy, with fewer than 20 cases documented in the literature. Given the paucity of reported cases, there is limited information available to guide the diagnosis and management of patients with this tumor. We present a case of a 39-year-old woman with a palpable right breast mass that was initially diagnosed by core needle biopsy as infiltrating carcinoma with prominent lymphoplasmacytic stroma. Subsequent neoadjuvant chemotherapy with docetaxel, doxorubicin, and cyclophosphamide resulted in a marked decrease in the size of the mass. After wide local surgical excision, pathology revealed a lymphoepithelioma-like carcinoma of the breast. Given the excellent treatment response, our experience may help clinicians determine future therapeutic strategies for this rare breast tumor.
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16
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HPV Infection, but Not EBV or HHV-8 Infection, Is Associated with Salivary Gland Tumours. BIOMED RESEARCH INTERNATIONAL 2015; 2015:829349. [PMID: 26618178 PMCID: PMC4651650 DOI: 10.1155/2015/829349] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 10/21/2015] [Indexed: 11/24/2022]
Abstract
Benign and malignant salivary gland tumours are clinically heterogeneous and show different histology. Little is known about the role of human herpes virus 8 (HHV-8), Epstein-Barr virus (EBV), and human papillomavirus (HPV) infection in salivary gland neoplasms. We investigated the presence of the three viruses in formalin-fixed, paraffin-embedded tissue samples in a cohort of 200 different salivary gland tumours. We performed EBV-LMP-1 and HHV-8 and p16 immunohistochemistry, a specific chip based hybridization assay for detection and typing of HPV and a chromogenic in situ hybridization for EBV analysis. Only one case, a polymorphic low-grade carcinoma, showed HHV-8 expression and one lymphoepithelial carcinoma was infected by EBV. In 17 cases (9%) moderate or strong nuclear and cytoplasmic p16 expression was detected. The HPV type was investigated in all of these cases and additionally in 8 Warthin's tumours. In 19 cases HPV type 16 was detected, mostly in Warthin's tumour, adenoid cystic carcinoma, and adenocarcinoma NOS. We concluded that HHV-8 infection and EBV infection are not associated with salivary gland cancer, but HPV infection may play a role in these tumour entities.
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Ali AS, Al-Shraim M, Al-Hakami AM, Jones IM. Epstein- Barr Virus: Clinical and Epidemiological Revisits and Genetic Basis of Oncogenesis. Open Virol J 2015; 9:7-28. [PMID: 26862355 PMCID: PMC4740969 DOI: 10.2174/1874357901509010007] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2015] [Revised: 06/08/2015] [Accepted: 09/18/2015] [Indexed: 12/21/2022] Open
Abstract
Epstein-Barr virus (EBV) is classified as a member in the order herpesvirales, family herpesviridae, subfamily gammaherpesvirinae and the genus lymphocytovirus. The virus is an exclusively human pathogen and thus also termed as human herpesvirus 4 (HHV4). It was the first oncogenic virus recognized and has been incriminated in the causation of tumors of both lymphatic and epithelial nature. It was reported in some previous studies that 95% of the population worldwide are serologically positive to the virus. Clinically, EBV primary infection is almost silent, persisting as a life-long asymptomatic latent infection in B cells although it may be responsible for a transient clinical syndrome called infectious mononucleosis. Following reactivation of the virus from latency due to immunocompromised status, EBV was found to be associated with several tumors. EBV linked to oncogenesis as detected in lymphoid tumors such as Burkitt's lymphoma (BL), Hodgkin's disease (HD), post-transplant lymphoproliferative disorders (PTLD) and T-cell lymphomas (e.g. Peripheral T-cell lymphomas; PTCL and Anaplastic large cell lymphomas; ALCL). It is also linked to epithelial tumors such as nasopharyngeal carcinoma (NPC), gastric carcinomas and oral hairy leukoplakia (OHL). In vitro, EBV many studies have demonstrated its ability to transform B cells into lymphoblastoid cell lines (LCLs). Despite these malignancies showing different clinical and epidemiological patterns when studied, genetic studies have suggested that these EBV- associated transformations were characterized generally by low level of virus gene expression with only the latent virus proteins (LVPs) upregulated in both tumors and LCLs. In this review, we summarize some clinical and epidemiological features of EBV- associated tumors. We also discuss how EBV latent genes may lead to oncogenesis in the different clinical malignancies
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Affiliation(s)
- Abdelwahid Saeed Ali
- Department of Microbiology and Clinical Parasitology, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia
| | - Mubarak Al-Shraim
- Department of Pathology, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia
| | - Ahmed Musa Al-Hakami
- Department of Microbiology and Clinical Parasitology, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia
| | - Ian M Jones
- Department of Biomedical Sciences, School of Biological Sciences, Faculty of Life Sciences, University of Reading, G37 AMS Wing, UK
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Xiao W, He Z, Xing C, Zhen W, Wang S, Lin H. Clinicopathologic features and treatment of breast metastasis from nasopharyngeal carcinoma: A report of two cases and literature review. Oncol Lett 2015; 10:3675-3681. [PMID: 26788190 DOI: 10.3892/ol.2015.3818] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 06/16/2015] [Indexed: 11/05/2022] Open
Abstract
Breast metastasis is a rare pattern of distant metastasis from nasopharyngeal carcinoma (NPC) following curative treatment. The present study reported two patients with breast metastasis from NPC and reviewed four such patients reported in the literature, including the analysis of clinical profiles, pathological diagnoses, treatment strategies and outcomes. The breast is a potential metastatic site for patients with NPC following curative treatment; however, thus far, only metachronous breast metastasis has been reported. Infection with Epstein-Barr virus (EBV) was identified in the breast metastasis sites of the two patients investigated in the current study using in situ hybridization for EBV-encoded small RNAs. Patients with breast metastases from NPC consistently and simultaneously develop metastases in other sites. In addition, the two current patients had poor prognoses. Therefore, chemotherapy was the primary treatment strategy administered. A solitary breast metastasis was identified in the male patient. At the most recent follow-up 10 years subsequent to undergoing a Halsted mastectomy, the patient remained alive, however the patient is now lost to follow-up. This case indicates that patients exhibiting NPC with a solitary breast metastasis may still gain long-term survival by undergoing radical mastectomy; therefore, radical mastectomy should be considered in such patients.
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Affiliation(s)
- Weiwei Xiao
- Department of Radiotherapy, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China; State Key Laboratory of Oncology in South China, Guangzhou, Guangdong 510060, P.R. China; Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong 510060, P.R. China
| | - Zhenyu He
- Department of Radiotherapy, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China; State Key Laboratory of Oncology in South China, Guangzhou, Guangdong 510060, P.R. China; Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong 510060, P.R. China
| | - Chao Xing
- Department of Oncology, Tengzhou Center People's Hospital, Tengzhou, Shandong 277500, P.R. China
| | - Wei Zhen
- State Key Laboratory of Oncology in South China, Guangzhou, Guangdong 510060, P.R. China; Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong 510060, P.R. China; Department of Ultrasonography, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China
| | - Shaoxiang Wang
- Institute of Molecular Medicine, Medical School of Shenzhen University, Shenzhen University, Shenzhen, Guangdong 518000, P.R. China
| | - Huanxin Lin
- Department of Radiotherapy, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China; State Key Laboratory of Oncology in South China, Guangzhou, Guangdong 510060, P.R. China; Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong 510060, P.R. China
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Lymphoepithelioma-like Carcinoma of Endometrium; A Rare Case Report. Indian J Surg Oncol 2015; 6:130-4. [PMID: 26405421 DOI: 10.1007/s13193-015-0405-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Accepted: 03/20/2015] [Indexed: 10/23/2022] Open
Abstract
Lymphoepithelioma -like carcinomas (LELCs) are tumors with histological features similar to those of lymphoepithelioma of nasopharynx. They have been described in many organs including female genital tract. Their histology is characterized by sheets, nests and cords of large syncytial tumor cells containing round nuclei with prominent nucleoli and dense lymphoplasmacytic infiltrate in the stoma. The association of Epstein-Barr virus (EBV) with LELCs has not been observed in western patients. But a few Asian patients with these tumors in uterine cervix have shown positive association of EBV. Cervical LELCs harbor EBV more frequently than cervical squamous cell carcinomas. These tumors are rarer in endometrium. Only 3 cases have been reported and the association of EBV has not been observed. We present here a rare case of LELC in endometrial polyp from India, who presented with postmenopausal vaginal bleeding. The tumor cells were positive for cytokeratin and EBV Latent membrane protein-1.
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Abstract
Since its discovery 50 years ago, Epstein-Barr virus (EBV) has been linked to the development of cancers originating from both lymphoid and epithelial cells. Approximately 95% of the world's population sustains an asymptomatic, life-long infection with EBV. The virus persists in the memory B-cell pool of normal healthy individuals, and any disruption of this interaction results in virus-associated B-cell tumors. The association of EBV with epithelial cell tumors, specifically nasopharyngeal carcinoma (NPC) and EBV-positive gastric carcinoma (EBV-GC), is less clear and is currently thought to be caused by the aberrant establishment of virus latency in epithelial cells that display premalignant genetic changes. Although the precise role of EBV in the carcinogenic process is currently poorly understood, the presence of the virus in all tumor cells provides opportunities for developing novel therapeutic and diagnostic approaches. The study of EBV and its role in carcinomas continues to provide insight into the carcinogenic process that is relevant to a broader understanding of tumor pathogenesis and to the development of targeted cancer therapies.
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Affiliation(s)
- Lawrence S Young
- Warwick Medical School, The University of Warwick, Coventry, CV4 7AL, UK.
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21
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Marrão G, Habib M, Paiva A, Bicout D, Fallecker C, Franco S, Fafi-Kremer S, Simões da Silva T, Morand P, Freire de Oliveira C, Drouet E. Epstein-Barr virus infection and clinical outcome in breast cancer patients correlate with immune cell TNF-α/IFN-γ response. BMC Cancer 2014; 14:665. [PMID: 25213133 PMCID: PMC4171567 DOI: 10.1186/1471-2407-14-665] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 09/08/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND For nearly two decades now, various studies have reported detecting the Epstein-Barr virus (EBV) in breast cancer (BC) cases. Yet the results are unconvincing, and their interpretation has remained a matter of debate. We have now presented prospective data on the effect of EBV infection combined with survival in patients enrolled in a prospective study. METHODS We assessed 85 BC patients over an 87-month follow-up period to determine whether EBV infection, evaluated by qPCR in both peripheral blood mononuclear cells (PBMCs) and tumor biopsies, interacted with host cell components that modulate the evolution parameters of BC. We also examined the EBV replicating form by the titration of serum anti-ZEBRA antibodies. Immunological studies were performed on a series of 35 patients randomly selected from the second half of the survey, involving IFN-γ and TNF-α intracellular immunostaining tests performed via flow cytometry analysis in peripheral NK and T cells, in parallel with EBV signature. The effect of the EBV load in the blood or tumor tissue on patient survival was analyzed using univariate and multivariate analyses, combined with an analysis of covariance. RESULTS Our study represents the first ever report of the impact of EBV on the clinical outcome of BC patients, regardless of tumor histology or treatment regimen. No correlation was found between: (i) EBV detection in tumor or PBMCs and tumor characteristics; (ii) EBV and other prognostic factors. Notably, patients exhibiting anti-ZEBRA antibodies at high titers experienced poorer overall survival (p = 0.002). Those who recovered from their disease were found to have a measurable EBV DNA load, together with a high frequency of IFN-γ and TNF-α producing PBMCs (p = 0.04), which indicates the existence of a Th1-type polarized immune response in both the tumor and its surrounding tissue. CONCLUSIONS The replicative form of EBV, as investigated using anti-ZEBRA titers, correlated with poorer outcomes, whereas the latent form of the virus that was measured and quantified using the EBV tumor DNA conferred a survival advantage to BC patients, which could occur through the activation of non-specific anti-tumoral immune responses.
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Affiliation(s)
- Gina Marrão
- Université de Grenoble-Alpes, Unit for Virus Host-Cell Interactions, UMI 3265 UJF-CNRS-EMBL, CIBB, 71 Avenue des Martyrs, F-38042 Grenoble, Cedex 9, France
- Portuguese Institute for Blood and Transplantation, University Hospital, Coimbra, Portugal
| | - Mohammed Habib
- Université de Grenoble-Alpes, Unit for Virus Host-Cell Interactions, UMI 3265 UJF-CNRS-EMBL, CIBB, 71 Avenue des Martyrs, F-38042 Grenoble, Cedex 9, France
| | - Artur Paiva
- Portuguese Institute for Blood and Transplantation, University Hospital, Coimbra, Portugal
| | - Dominique Bicout
- Team Environment and Health Prediction in Populations Unit – TIMC Laboratory, UMR CNRS 5525, Université Joseph Fourier, Grenoble, France
| | - Catherine Fallecker
- Université de Grenoble-Alpes, Unit for Virus Host-Cell Interactions, UMI 3265 UJF-CNRS-EMBL, CIBB, 71 Avenue des Martyrs, F-38042 Grenoble, Cedex 9, France
| | - Sofia Franco
- Department of Gynecology, University Hospital, Coimbra, & Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Samira Fafi-Kremer
- Unit of Virology, University Hospital, Grenoble, France
- Laboratoire de Virologie, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France
| | | | - Patrice Morand
- Université de Grenoble-Alpes, Unit for Virus Host-Cell Interactions, UMI 3265 UJF-CNRS-EMBL, CIBB, 71 Avenue des Martyrs, F-38042 Grenoble, Cedex 9, France
- Unit of Virology, University Hospital, Grenoble, France
| | - Carlos Freire de Oliveira
- Department of Gynecology, University Hospital, Coimbra, & Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Emmanuel Drouet
- Université de Grenoble-Alpes, Unit for Virus Host-Cell Interactions, UMI 3265 UJF-CNRS-EMBL, CIBB, 71 Avenue des Martyrs, F-38042 Grenoble, Cedex 9, France
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22
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Top ÖE, Vardar E, Yağcı A, Deniz S, Öztürk R, Zengel B. Lymphoepithelioma-like Carcinoma of the Breast: A Case Report. THE JOURNAL OF BREAST HEALTH 2014; 10:177-180. [PMID: 28331666 DOI: 10.5152/tjbh.2014.1675] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Accepted: 05/30/2013] [Indexed: 12/15/2022]
Abstract
Lymphoepithelioma-like carcinoma carries similar histopathological features with lymphoepithelioma typically located in the nasopharynx. Lymphoepithelioma-like carcinoma of the breast can be mistaken for breast lymphoma or medullary carcinoma due to the undifferentiated appearance of tumor cells and presence of prominent lymphoid component. Lymphoepithelioma-like carcinoma is rare, and the similarity between medullary carcinoma of the breast makes it difficult to distinguish these two tumors. In the presented case, neither lymph node nor distant metastases were detected. Breast lymphoepithelioma-like carcinoma is extremely rare with only 21 reported cases in the literature. Herein we present a 59-year-old woman with lymphoepithelioma-like carcinoma of the breast along with the cases previously published in the literature.
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Affiliation(s)
- Ömer Erdinç Top
- Department of Pathology, İzmir Bozyaka Training and Research Hospital, İzmir, Turkey
| | - Enver Vardar
- Department of Pathology, İzmir Bozyaka Training and Research Hospital, İzmir, Turkey
| | - Ayşe Yağcı
- Department of Pathology, İzmir Bozyaka Training and Research Hospital, İzmir, Turkey
| | - Senem Deniz
- Department of Pathology, İzmir Bozyaka Training and Research Hospital, İzmir, Turkey
| | - Rafet Öztürk
- Department of Pathology, İzmir Bozyaka Training and Research Hospital, İzmir, Turkey
| | - Baha Zengel
- Department of General Surgery, İzmir Bozyaka Training and Research Hospital, İzmir, Turkey
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23
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Abdou AG, Asaad NY. Lymphoepithelioma-like carcinoma of the breast: cytological, histological, and immunohistochemical characteristics. Diagn Cytopathol 2014; 43:210-3. [PMID: 24610805 DOI: 10.1002/dc.23141] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Revised: 01/14/2014] [Accepted: 02/24/2014] [Indexed: 12/14/2022]
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24
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Khabaz MN. Association of Epstein-Barr virus infection and breast carcinoma. Arch Med Sci 2013; 9:745-51. [PMID: 24049539 PMCID: PMC3776191 DOI: 10.5114/aoms.2013.37274] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Revised: 08/14/2012] [Accepted: 10/23/2012] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION A controversy regarding the association of Epstein-Barr virus (EBV) with breast carcinomas has recently been reported in the literature. The present study was carried out in an attempt to determine whether there is a relationship between latent infection with EBV and breast carcinomas in Jordanian females. MATERIAL AND METHODS Extraction of DNA from the archive samples of breast carcinoma cases embedded in paraffin wax was performed and the extracted DNA was subjected to polymerase chain reaction amplification to detect the EBV genome using four sets of primers for EBER 2, BNLF-1, EBNA 2, and Gp220. Immunohistochemistry study was performed on sections of 4 µm which were cut from paraffin blocks of tumor and control groups. Monoclonal antibody against EBNA-1 was applied to all slides to identify the EBV-infected tumor cells. Detection was performed using the Dako envision dual link system. RESULTS DNA was successfully extracted from 92 paraffin embedded samples of breast carcinoma patients, and from 49 normal samples. The extracted DNA was confirmed by using glyceraldehyde-3-phosphate-dehydrogenase (GAPDH) primers. Twenty-four out of 92 breast carcinoma specimens was found to be infected with EBV as compared to 3 out of 49 control group specimens, which represented a statistically significant difference (p-value using χ(2) = 0.008). Immunohistochemically, 24 (26%) of the 92 studied samples were found to be positive, showing EBNA-1 granular nuclear staining in tumor epithelial cells. CONCLUSIONS These findings suggest an association between EBV infection and breast carcinoma development.
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Affiliation(s)
- Mohamad Nidal Khabaz
- Department of Pathology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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25
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Ambrosio MR, Mastrogiulio MG, Barone A, Rocca BJ, Gallo C, Lazzi S, Leoncini L, Bellan C. Lymphoepithelial-like carcinoma of the parotid gland: a case report and a brief review of the western literature. Diagn Pathol 2013; 8:115. [PMID: 23856064 PMCID: PMC3751049 DOI: 10.1186/1746-1596-8-115] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Accepted: 06/25/2013] [Indexed: 01/14/2023] Open
Abstract
Background Primary lymphoepithelial-like carcinoma of the parotid gland is a rare tumour with an increased incidence among Eskimos and Orientals. In these populations, it is usually associated with Epstein-Barr virus. In Western countries, salivary gland lymphoepithelial-like carcinomas are uncommon and only 14 cases have been described so far; among these, only five cases showed Epstein-Barr virus positivity. Case report A 45-year-old woman was admitted to Siena Hospital for evaluation of a pre-existent (2 years) painless and tender submandibular mass, rapidly enlarging since two months. On physical examination, a 2.5-cm mass was found in the right parotid. It was firm, mobile and non-tender. Laboratory data were within reference range. Nuclear magnetic resonance detected a 2,5×1,5×1-cm well-circumscribed mass in the deep lobe of the right parotid. A total right paroditectomy with dissection of a satellite lymph node was performed. On the basis of morphological, immunohistochemical and molecular biology findings, a diagnosis of stage II (according to TNM7) Epstein Barr-virus positive, undifferentiated lymphoepithelial-like carcinoma of the parotid gland was made. Twenty months after surgery the patient was free of disease. Conclusions Further studies seem to be necessary to completely elucidate the oncogenic role of Epstein Barr-virus in these tumors, which have identical morphology but different prognosis and variable presence of the virus. Virtual Slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1260381551000616
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26
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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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27
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Zekri ARN, Bahnassy AA, Mohamed WS, El-Kassem FA, El-Khalidi SJ, Hafez MM, Hassan ZK. Epstein-Barr virus and breast cancer: epidemiological and molecular study on Egyptian and Iraqi women. J Egypt Natl Canc Inst 2012; 24:123-31. [PMID: 22929918 DOI: 10.1016/j.jnci.2012.06.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Revised: 05/30/2012] [Accepted: 06/03/2012] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND AND PURPOSE The role of Epstein-Barr virus (EBV) in breast carcinogenesis is still controversial. Unraveling this relationship is potentially important for better understanding of breast cancer etiology, early detection and possibly prevention of breast cancer. The aim of the current study is to unravel the association between EBV and primary invasive breast cancer (PIBC) in two different Arab populations (Egyptian and Iraqi women). PATIENTS AND METHODS The study was done on paraffin-embedded tissues of 40 Egyptian and 50 Iraqi patients with PIBC in addition to 20 normal breast tissues as controls for each group. Both controls and neoplastic tissues were assessed for the expression of EBV genes and proteins (EBNA-1, LMP-1, and EBER) as well as CD21 marker by immunohistochemistry (IHC), in situ hybridization (ISH) and PCR techniques. RESULTS Our gold standard for EBV reactivity in breast cancer cases was positivity of both EBNA1 by PCR and EBER by in situ hybridization. EBV was detected in 18/40 (45%) and 14/50 (28%) of Egyptian and Iraqi women; respectively where p=0.073, compared to 0/20 (0%) of their control groups (p<0.05). Regarding the association between EBV positivity and tumor grade, there was not any statistical significant difference between EBV presence and tumor grade in both populations where p=0.860 and p=0.976 and the calculated rank biserial correlation coefficient was 0.114 and 0.269 for Egyptian and Iraqi women respectively. CONCLUSION Our findings show that EBV might act as a promoter for the development of PIBC and it might contribute to increased tumor aggressiveness in Egyptian and Iraqi patients.
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MESH Headings
- Adult
- Aged
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/metabolism
- Breast Neoplasms/epidemiology
- Breast Neoplasms/metabolism
- Breast Neoplasms/virology
- Carcinoma, Ductal, Breast/epidemiology
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/virology
- Carcinoma, Lobular/epidemiology
- Carcinoma, Lobular/metabolism
- Carcinoma, Lobular/virology
- Egypt/epidemiology
- Epstein-Barr Virus Infections/complications
- Epstein-Barr Virus Infections/epidemiology
- Epstein-Barr Virus Infections/metabolism
- Female
- Gene Expression
- Herpesvirus 4, Human/genetics
- Herpesvirus 4, Human/metabolism
- Humans
- Iraq/epidemiology
- Middle Aged
- Molecular Epidemiology
- Receptors, Complement 3d/metabolism
- Viral Proteins/genetics
- Viral Proteins/metabolism
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Affiliation(s)
- Abdel-Rahman N Zekri
- Virology and Immunology Unit, Cancer Biology Department, National Cancer Institute, Cairo University, Cairo 11976, Egypt.
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28
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Dinniwell R, Hanna WM, Mashhour M, Saad RS, Czarnota GJ. Lymphoepithelioma-like carcinoma of the breast: a diagnostic and therapeutic challenge. ACTA ACUST UNITED AC 2012; 19:e177-83. [PMID: 22670107 DOI: 10.3747/co.19.926] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
We present a patient with lymphoepithelioma-like carcinoma (LELC) of the breast whose diagnosis is illustrative of the pathology nuances that must be taken into account to successfully reach correct identification of the disease. We also present an overview of our patient's proposed treatment in the context of 16 other reported LELC cases. Although LELC cases are rare, a sufficient number have been reported to discern the natural history of this pathologic entity and to undertake a review of those cases and of the application of oncologic first principles in their management. Given the potential for locoregional spread and distant metastases in LELC, adjuvant therapy has a role in the treatment of this entity.
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Affiliation(s)
- R Dinniwell
- Department of Radiation Oncology, Princess Margaret Hospital, Toronto, ON.
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29
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Huo Q, Zhang N, Yang Q. Epstein-Barr virus infection and sporadic breast cancer risk: a meta-analysis. PLoS One 2012; 7:e31656. [PMID: 22363698 PMCID: PMC3283657 DOI: 10.1371/journal.pone.0031656] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2011] [Accepted: 01/17/2012] [Indexed: 12/15/2022] Open
Abstract
Background A large number of epidemiological studies have evaluated the association between Epstein-Barr virus infection and breast carcinoma risk but results have been inconsistent. Methodology Research using the polymerase chain reaction technique for detecting the Epstein-Barr virus was selected; 24 studies and 1535 cases were reviewed. Information on the study populations, sample types, publication calendar period and histological types of breast carcinoma were collected. An unconditional logistic regression model was used to analyze potential parameters related to the Epstein-Barr virus prevalence. A Kappa test was used to evaluate the consistency in detecting different Epstein-Barr virus DNA regions. Nine studies that included control groups and 1045 breast cancer cases were adopted in this meta-analysis. Conclusions We found that 29.32% of the patients with breast carcinoma were infected with the Epstein-Barr virus. The prevalence of Epstein-Barr was highest in Asia (35.25%) and lowest in the USA (18.27%). Statistical analysis revealed a trend that showed lobular breast carcinoma might have the strongest association with Epstein-Barr virus infection. This meta-analysis showed a significant increase in breast malignancy risk in patients testing positive for the Epstein-Barr virus (OR = 6.29, 95% CI = 2.13–18.59). This result suggests that an Epstein-Barr virus infection is statistically associated with increased breast carcinoma risk.
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Affiliation(s)
- Qiang Huo
- Department of Breast Surgery, School of Medicine, Shandong University, Qilu Hospital, Ji'nan, Shandong, People's Republic of China
| | - Ning Zhang
- Department of Breast Surgery, School of Medicine, Shandong University, Qilu Hospital, Ji'nan, Shandong, People's Republic of China
| | - Qifeng Yang
- Department of Breast Surgery, School of Medicine, Shandong University, Qilu Hospital, Ji'nan, Shandong, People's Republic of China
- * E-mail:
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30
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Baltzell K, Buehring GC, Krishnamurthy S, Kuerer H, Shen HM, Sison JD. Epstein-Barr virus is seldom found in mammary epithelium of breast cancer tissue using in situ molecular methods. Breast Cancer Res Treat 2012; 132:267-74. [PMID: 22042367 DOI: 10.1007/s10549-011-1841-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2011] [Accepted: 10/14/2011] [Indexed: 10/16/2022]
Abstract
Epstein-Barr virus (EBV) has been proposed as a possible etiological agent of breast cancer based on 21 reports of EBV in malignant breast tissues. Most of these studies used standard and nested solution polymerase chain reaction (PCR) techniques, both disadvantaged by susceptibility to contamination from laboratory EBV, and the inability to localize the signal to a specific cell type. To avoid these issues, we used in situ molecular methods of viral detection to reassess the frequency of EBV in malignant breast tissue. We used a commercial in situ hybridization (ISH) system with an EBER genome target, and a non-commercial in situ PCR (IS-PCR) method using primers specific for the BamH1 region. The assays were performed on malignant breast tissue sections from 70 breast cancer patients at the M. D. Anderson Cancer Center, Houston, TX. EBV was found in mammary epithelial cells, the cell type from which most breast cancers arise, in 2/70 (2.9%) of specimens using IS-PCR and in none of the specimens using ISH. Based on these findings that EBV was present in human mammary epithelial cells so infrequently, it is unlikely to play a causative role in most types of breast cancer.
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MESH Headings
- Adult
- Aged
- Breast Neoplasms/pathology
- Breast Neoplasms/virology
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/virology
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Carcinoma, Intraductal, Noninfiltrating/virology
- Carcinoma, Lobular/pathology
- Carcinoma, Lobular/virology
- Epithelium/virology
- Epstein-Barr Virus Infections/virology
- Female
- Herpesvirus 4, Human
- Humans
- In Situ Hybridization
- Leukocytes/virology
- Middle Aged
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Affiliation(s)
- Kimberly Baltzell
- Department of Family Health Care Nursing, University of California San Francisco, 2 Koret Way, N431-M, San Francisco, CA 94143, USA.
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Joshi D, Buehring GC. Are viruses associated with human breast cancer? Scrutinizing the molecular evidence. Breast Cancer Res Treat 2012; 135:1-15. [PMID: 22274134 DOI: 10.1007/s10549-011-1921-4] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2011] [Accepted: 12/09/2011] [Indexed: 01/29/2023]
Abstract
The three viruses most studied as possible causes of human breast cancer are mouse mammary tumor virus-like sequences (MMTV-LS), Epstein-Barr virus (EBV), and oncogenic (high risk) types of human papilloma virus (HPV). The first step in fulfilling traditional criteria for inferring that a cancer is caused by a virus is to demonstrate the virus in the affected tissue. Molecular techniques, compared to host antibody assessment and immunohistochemistry, are the most definitive in establishing viral presence. Results of 85 original molecular research investigations to detect one or more of the three viruses have been extremely divergent with no consensus reached. We evaluated the methodology of these studies for the following: type of molecular assay, DNA/RNA quality control, positive and negative assay controls, type of fixation, genome targets, methods for preventing and detecting molecular contamination, pathology of specimens processed, sample size, and proportion of specimens positive for the viral genome region targeted. Only seven of the studies convincingly demonstrated the presence of an oncogenic virus biomarker (EBV: 4/30 studies (13%); HPV 3/29 studies (10%), whereas 25 convincingly demonstrated absence of the virus studied (MMTV-LS: 4/25 (16%); EBV: 15/30 (50%); 6/29 (21%). The remainder of the studies suffered shortcomings, which, in our opinion, prevented a definitive conclusion. Only one of the studies compared frequency of the virus in breast tissue of breast cancer patients versus appropriate normal control subjects with no history of breast cancer. None of the studies were designed as epidemiologic studies to determine if the presence of the virus was significantly associated with breast cancer. Based on our evaluation, the data in the publications reviewed here remain preliminary, and do not justify a conclusion that MMTV-LS, HPV, or EBV are causally associated with breast cancer. However, they form a valuable basis for redirecting future studies.
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Affiliation(s)
- Deepti Joshi
- Department of Pathology, Mahatma Gandhi Institute of Medical Sciences, Sevagram, District Wardha, Maharashtra, India.
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32
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Hachana M, Amara K, Ziadi S, Romdhane E, Gacem RB, Trimeche M. Investigation of Epstein–Barr virus in breast carcinomas in Tunisia. Pathol Res Pract 2011; 207:695-700. [DOI: 10.1016/j.prp.2011.09.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Revised: 07/28/2011] [Accepted: 09/05/2011] [Indexed: 10/15/2022]
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33
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Aguayo F, Khan N, Koriyama C, González C, Ampuero S, Padilla O, Solís L, Eizuru Y, Corvalán A, Akiba S. Human papillomavirus and Epstein-Barr virus infections in breast cancer from chile. Infect Agent Cancer 2011; 6:7. [PMID: 21699721 PMCID: PMC3141534 DOI: 10.1186/1750-9378-6-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2011] [Accepted: 06/23/2011] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Human papillomavirus (HPV) and Epstein Barr virus (EBV) have been found in breast carcinomas (BCs) around the world. In this study, fifty-five BCs from Chile were analyzed for HPV and EBV presence. In addition, HPV-16 viral load/physical status and E6/E7 expressions were determined. RESULTS The amplification of a housekeeping gene showed that 46/55 samples (84%) had amplifiable DNA. HPV-16 was detected in 4/46 BCs (8.7%) and EBV was detected in 3/46 (6.5%) BCs. The analysis of HPV-16 physical status showed that this virus was integrated in all of the tumors with a relatively low viral load (range: 0.14 to 33.8 copies/cell). E6 and E7 transcripts, however, were not detected in any HPV-16 positive specimens. Using a Cox-regression model, we found a statistically significant association between EBV presence and poor survival (p = 0.013). CONCLUSIONS The findings in this study suggest that it is unlikely that HPV and/or EBV play a direct role in the etiology of BC.
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Affiliation(s)
- Francisco Aguayo
- Virology Program, I.C.B.M., Faculty of Medicine, University of Chile, Independencia 1027, Santiago 838-9100, Chile
| | - Noureen Khan
- Department of Public Health, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
| | - Chihaya Koriyama
- Department of Public Health, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
| | - Carolina González
- Virology Program, I.C.B.M., Faculty of Medicine, University of Chile, Independencia 1027, Santiago 838-9100, Chile
| | - Sandra Ampuero
- Virology Program, I.C.B.M., Faculty of Medicine, University of Chile, Independencia 1027, Santiago 838-9100, Chile
| | - Oslando Padilla
- Department of Public Heath, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Luisa Solís
- Pathology Department, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Yoshito Eizuru
- Division of Oncogenic and Persistent Viruses, Center for Chronic Viral Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
| | - Alejandro Corvalán
- Department of Hematology and Oncology, Pontificia Universidad Catolica, 85 Lira Street, Santiago 133-202, Santiago, Chile
| | - Suminori Akiba
- Department of Public Health, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
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34
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Mazouni C, Fina F, Romain S, Ouafik L, Bonnier P, Brandone JM, Martin PM. Epstein-Barr virus as a marker of biological aggressiveness in breast cancer. Br J Cancer 2010; 104:332-7. [PMID: 21179039 PMCID: PMC3031896 DOI: 10.1038/sj.bjc.6606048] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Purpose: Although a potential role of the Epstein-Barr virus (EBV) in the pathogenesis of breast cancer (BC) has been underlined, results remain conflicting. Particularly, the impact of EBV infection on biological markers of BC has received little investigation. Methods: In this study, we established the frequency of EBV-infected BC using real-time quantitative PCR (RT–PCR) in 196 BC specimens. Biological and pathological characteristics according to EBV status were evaluated. Results: EBV DNA was present in 65 of the 196 (33.2%) cases studied. EBV-positive BCs tended to be tumours with a more aggressive phenotype, more frequently oestrogen receptor negative (P=0.05) and with high histological grade (P=0.01). Overexpression of thymidine kinase activity was higher in EBV-infected BC (P=0.007). The presence of EBV was weakly associated with HER2 gene amplification (P=0.08). Conclusion: Our study provides evidence for EBV-associated BC undergoing distinct carcinogenic processes, with more aggressive features.
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Affiliation(s)
- C Mazouni
- Laboratoire de transfert d'oncologie biologique, Assistance Publique - Hôpitaux de Marseille, Faculté de Médecine Nord, Marseille, France.
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35
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Ambrosio MR, Rocca BJ, Onorati M, Mourmouras V, Mastrogiulio MG, Crispino S, Liberatore C, Santopietro R. Lymphoepithelioma-like carcinoma of the ovary. Int J Surg Pathol 2010; 19:514-7. [PMID: 20444729 DOI: 10.1177/1066896909354336] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Only one case of lymphoepithelioma-like carcinoma of the ovary has been reported so far. A new case is herein illustrated in a 69-year-old woman: an ovarian mass adherent to urinary bladder dome with peritoneal carcinomatosis. Histologically, undifferentiated carcinomatous areas were intermingled with abundant lymphoid tissue. Epstein-Barr virus has not been detected either in neoplastic or in lymphoid cells.
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36
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Jeong AK, Park SB, Kim YM, Ko BK, Yang MJ, Kwon WJ, Lee JH, Weon YC. Lymphoepithelioma-like carcinoma of the breast. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2010; 29:485-488. [PMID: 20194945 DOI: 10.7863/jum.2010.29.3.485] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- Ae Kyung Jeong
- Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
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37
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Joshi D, Quadri M, Gangane N, Joshi R, Gangane N. Association of Epstein Barr virus infection (EBV) with breast cancer in rural Indian women. PLoS One 2009; 4:e8180. [PMID: 19997605 PMCID: PMC2782138 DOI: 10.1371/journal.pone.0008180] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2009] [Accepted: 11/11/2009] [Indexed: 11/22/2022] Open
Abstract
Introduction Breast cancer is the most common malignancy affecting females worldwide but conventional risk factors are able to explain only a small proportion of these cases. A possible viral etiology for breast cancer has been proposed and Epstein-Barr Virus (EBV) is a widely researched candidate virus. The aim of the present study, first one of its kind from India, was to determine if there is a greater association of EBV infection with breast cancer patients as compared to patients with benign breast diseases. Methods We looked for expression of Epstein-Barr Virus Nuclear Antigen-1 (EBNA-1) in breast cancer tissue specimens by employing immunohistochemistry (IHC). We also measured levels of anti-EBNA-1 Immunoglobulin (IgG) antibodies in stored sera of these patients using commercial Enzyme linked Immunosorbent Assay (ELISA) kit. Patients with benign breast diseases were used as a comparison group for both immunohistochemical and serological analysis. Results 58 cases of malignant breast disease and 63 of benign breast disease (controls) were included in the study. Using manufacturer determined cut-off of 3 IU/ml, 50/55 tested (90.9%) cases and 27/33 tested (81.8%) controls were seropositive for anti-EBNA-1 IgG. Mean antibody levels were significantly higher for cases (54.22 IU/ml) as compared to controls (18.68 IU/ml). IHC for EBNA-1 was positive in 28/51 cases (54.9%). No IHC positivity was noted in the tested 30 controls. Our results show that EBNA-1 expression is seen in a significant proportion of breast cancer tissue specimens from rural India and as compared to patients with benign breast diseases these patients also have a higher immunological response against EBNA-1.
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Affiliation(s)
- Deepti Joshi
- Department of Pathology, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India
| | - Munira Quadri
- Department of Pathology, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India
| | - Neha Gangane
- Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India
| | - Rajnish Joshi
- Department of Medicine, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India
| | - Nitin Gangane
- Department of Pathology, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India
- * E-mail:
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38
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Abstract
Rare tumours are a heterogeneous group of conditions that encompass benign to malignant lesions both of stromal and epithelial origin. Here some of these tumours are described, in which the authors have most familiarity. An outline of medullary carcinoma is also presented.
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Affiliation(s)
- Maria P Foschini
- Department of Haematology and Oncology, Bellaria Hospital, University of Bologna, Italy
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39
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Dendritic cell sarcomas/tumours of the breast: report of two cases. Virchows Arch 2009; 454:333-9. [DOI: 10.1007/s00428-009-0729-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2008] [Revised: 11/28/2008] [Accepted: 01/05/2009] [Indexed: 10/21/2022]
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40
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Amarante MK, Watanabe MAE. The possible involvement of virus in breast cancer. J Cancer Res Clin Oncol 2008; 135:329-37. [PMID: 19009309 DOI: 10.1007/s00432-008-0511-2] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2008] [Accepted: 10/28/2008] [Indexed: 12/25/2022]
Abstract
It is well known that the etiology of human breast cancer is significantly affected by environmental factors. Virus-associated cancer refers to a cancer where viral infection results in the malignant transformation of the host's infected cells. Human papillomaviruses (HPV), mouse mammary tumor virus (MMTV) and Epstein-Barr (EBV) virus are prime candidate viruses as agents of human breast cancer. The precise role that viruses play in tumorigenesis is not clear, but it seems that they are responsible for causing only one in a series of steps required for cancer development. The idea that a virus could cause breast cancer has been investigated for quite some time, even though breast cancer could be a hereditary disease; however, hereditary breast cancer is estimated to account for a small percentage of all breast cancer cases. Based on current research, this review present at moment, substantial, but not conclusive, evidence that HPV, EBV and MMTV may be involved in breast cancer.
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Affiliation(s)
- Marla Karine Amarante
- Department of Pathological Sciences, Biological Sciences Center, State University of Londrina, Londrina, PR, Brazil
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41
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Chuang HC, Wang JM, Hsieh WC, Chang Y, Su IJ. Up-regulation of activating transcription factor-5 suppresses SAP expression to activate T cells in hemophagocytic syndrome associated with Epstein-Barr virus infection and immune disorders. THE AMERICAN JOURNAL OF PATHOLOGY 2008; 173:1397-405. [PMID: 18832568 DOI: 10.2353/ajpath.2008.080440] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Hemophagocytic syndrome (HPS) is a fatal, pro-inflammatory cytokine disorder that is associated with viral infections and immune disorders. Previously, we demonstrated that Epstein-Barr virus latent membrane protein-1 (LMP-1) could down-regulate the SAP gene, enhancing Th1 cytokine secretion in T cells and leading to HPS. The exact mechanism of SAP gene regulation by LMP-1 remains to be clarified. In this study, using cDNA microarray analysis, we identified ATF5 as the candidate transcriptional repressor for SAP expression in LMP-1-expressing T cells. LMP-1 up-regulated ATF5 via TRAF2,5/NF-kappaB signals to suppress SAP gene expression. Reporter assays and electrophoretic mobility shift assays revealed that ATF5 bound differentially to two sites of the SAP promoter. In resting T cells, ATF5 bound predominantly to the high-affinity site in the -81 to -74 region while additionally binding to the low-affinity site at -305 to -296 in LMP-1-expressing T cells. Such binding subsequently disrupted the transcription of the SAP gene. At the same time, Th1 cytokine secretion was enhanced. This phenomenon was also observed in conditions such as ATF5 overexpression, phytohemagglutinin stimulation of primary T cells, and ligand engagement of T-cell lines. Therefore, the down-regulation of the SAP gene by ATF5 may represent a common mechanism for the pathogenesis of HPS that is associated with either Epstein-Barr virus infection or immune disorders with dysregulated T-cell activation.
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Affiliation(s)
- Huai-Chia Chuang
- Division of Clinical Research, National Health Research Institutes, Tainan, Taiwan
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42
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Fawzy S, Sallam M, Mohammad Awad N. Detection of Epstein–Barr virus in breast carcinoma in Egyptian women. Clin Biochem 2008; 41:486-92. [DOI: 10.1016/j.clinbiochem.2007.12.017] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2007] [Revised: 11/29/2007] [Accepted: 12/11/2007] [Indexed: 10/22/2022]
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43
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Kulka J, Kovalszky I, Svastics E, Berta M, Füle T. Lymphoepithelioma-like carcinoma of the breast: not Epstein-Barr virus-, but human papilloma virus-positive. Hum Pathol 2008; 39:298-301. [PMID: 18206498 DOI: 10.1016/j.humpath.2007.08.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2006] [Revised: 08/07/2007] [Accepted: 08/10/2007] [Indexed: 12/17/2022]
Abstract
Lymphoepithelioma-like carcinoma of the breast is a rare tumor, with fewer than 20 cases documented in the literature. None of the published cases was Epstein-Barr virus positive, and our case was also Epstein-Barr virus negative. However, in our case, human papilloma virus (HPV) types 18 and 33 DNA could be demonstrated within the tumor tissue. Many years previously, the patient underwent hysterectomy for cervical carcinoma in situ which showed the presence of HPV-33. To the best of our knowledge, this is the first report on lymphoepithelioma-like carcinoma of the breast where high-risk HPV infection may be suggested as an etiological factor in a patient with a previous history of cervical carcinoma in situ.
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Affiliation(s)
- Janina Kulka
- 2nd Department of Pathology, Semmelweis University, Budapest 1091, Hungary.
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44
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Lee S, Park SY, Hong EK, Ro JY. Lymphoepithelioma-like Carcinoma of the Ovary: A Case Report and Review of the Literature. Arch Pathol Lab Med 2007; 131:1715-8. [DOI: 10.5858/2007-131-1715-lcotoa] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2007] [Indexed: 11/06/2022]
Abstract
Abstract
Lymphoepithelioma-like carcinoma is an undifferentiated carcinoma morphologically characterized by sheets of pleomorphic epithelioid cells with an intense lymphoid infiltrate. A 51-year-old woman presenting with low abdominal pain was found to have a right ovarian mass and enlarged pelvic, left para-aortic, and left supraclavicular lymph nodes. Based on a clinical diagnosis of right ovarian carcinoma with lymph node metastases, she received 9 cycles of chemotherapy, resulting in a reduction of her ovarian tumor, disappearance of the enlarged pelvic and para-aortic lymph nodes, and normalization of serum CA 125 level. The residual mass was removed surgically. The histology of the multinodular tumor resembled that of lymphoepithelioma of the nasopharynx and was observed in the right ovary. However, there was no viable tumor in either supraclavicular or para-aortic lymph nodes. Seven months after surgery, the patient has no evidence of disease. Lymphoepithelioma-like carcinoma appears to be rare in the female genital tract.
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Affiliation(s)
- Sun Lee
- From the Department of Pathology, College of Medicine, Kyung Hee University, Seoul, South Korea (Dr Lee); the Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, South Korea (Drs Park and Hong); and the Department of Pathology, Cornell University, The Methodist Hospital, Houston, Tex (Dr Ro)
| | - Sang Yoon Park
- From the Department of Pathology, College of Medicine, Kyung Hee University, Seoul, South Korea (Dr Lee); the Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, South Korea (Drs Park and Hong); and the Department of Pathology, Cornell University, The Methodist Hospital, Houston, Tex (Dr Ro)
| | - Eun Kyung Hong
- From the Department of Pathology, College of Medicine, Kyung Hee University, Seoul, South Korea (Dr Lee); the Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, South Korea (Drs Park and Hong); and the Department of Pathology, Cornell University, The Methodist Hospital, Houston, Tex (Dr Ro)
| | - Jae Yoon Ro
- From the Department of Pathology, College of Medicine, Kyung Hee University, Seoul, South Korea (Dr Lee); the Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, South Korea (Drs Park and Hong); and the Department of Pathology, Cornell University, The Methodist Hospital, Houston, Tex (Dr Ro)
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45
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Abstract
There are well-established risk factors for breast cancer, most of which relate to estrogens and growth hormones in females. These include early-age menarche, late-age menopause, postmenopausal obesity and use of hormone therapy. However, these factors do not account for the sixfold difference in breast cancer incidence and mortality between countries and the fact that these differences dramatically lessen after migration; nor do they account for male breast cancer. Accordingly, hormone-responsive viruses have become major suspects as etiological agents for human breast cancer. Human papillomaviruses, mouse mammary tumor virus and Epstein-Barr virus are the prime candidate viruses as causes of human breast cancer. Human papillomaviruses and the mouse mammary tumor virus have hormone responsive elements that appear to be associated with enhanced replication of these viruses in the presence of corticosteroid and other hormones. This biological phenomenon is particularly relevant because of the hormone dependence of breast cancer. Viral genetic material for each of these candidate viruses has been identified by polymerase chain reaction in breast tumors but rarely in normal breast tissue controls. Pooled data from controlled studies show substantial odds ratios for the presence of viral genetic material in breast tumors compared with normal controls. These and additional data provide substantial, but not conclusive, evidence that human papillomavirus, the mouse mammary tumor virus and Epstein-Barr virus may have a role in the etiology of human breast cancer. If conclusive evidence for a role of these viruses in breast carcinogenesis can be developed, there is a practical possibility of primary prevention.
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Affiliation(s)
- James S Lawson
- School of Public Health, University of New South Wales, Sydney, Australia.
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46
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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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47
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Fonseca R, Tomás AR, André S. Absence of Epstein-Barr virus EBER transcripts in male breast cancer. Virchows Arch 2005; 447:113-4. [PMID: 15926072 DOI: 10.1007/s00428-005-1230-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2004] [Accepted: 02/10/2005] [Indexed: 10/25/2022]
MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Breast Neoplasms, Male/genetics
- Breast Neoplasms, Male/pathology
- Breast Neoplasms, Male/virology
- Carcinoma, Ductal, Breast/genetics
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/virology
- Epstein-Barr Virus Infections/complications
- Herpesvirus 4, Human/genetics
- Herpesvirus 4, Human/isolation & purification
- Humans
- Male
- Middle Aged
- RNA, Viral/analysis
- RNA, Viral/genetics
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48
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Ilvan S, Celik V, Ulker Akyildiz E, Senel Bese N, Ramazanoglu R, Calay Z. Lymphoepithelioma-like carcinoma of the breast: is it a distinct entity? Clinicopathological evaluation of two cases and review of the literature. Breast 2005; 13:522-6. [PMID: 15563863 DOI: 10.1016/j.breast.2004.06.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2004] [Revised: 06/16/2004] [Accepted: 06/17/2004] [Indexed: 12/17/2022] Open
Abstract
Lymphoepithelioma-like carcinomas (LELCs) are tumors with morphologic features identical to those of undifferentiated nasopharyngeal carcinoma. They are characterized by a pronounced lymphocytic infiltrate, often obscuring the neoplastic epithelial component. LELCs have been described in several organs, but are extremely rare in the breast. In this report, two cases of LELC of the breast are presented with their histological and immunohistochemical features. In situ hybridization for Epstein-Barr viral genome was negative in both cases. We discuss the differential diagnosis of LELC of the breast and review the reports of this entity that have appeared in the literature.
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Affiliation(s)
- Sennur Ilvan
- Department of Pathology, Istanbul University, Cerrahpasa School of Medicine, Istanbul, Turkey.
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49
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Si MW, Thorson JA, Lauwers GY, DalCin P, Furman J. Hepatocellular lymphoepithelioma-like carcinoma associated with epstein barr virus: a hitherto unrecognized entity. ACTA ACUST UNITED AC 2005; 13:183-9. [PMID: 15322431 DOI: 10.1097/01.pas.0000124336.90615.8d] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Lymphoepithelioma-like carcinoma (LELC) is an undifferentiated carcinoma with a dense lymphoid stroma. It has been reported in diverse organs and shows variable association with Epstein-Barr virus (EBV). Only a few EBV positive cases have been observed in the hepatobiliary system, all of which were considered to be cholangiocarcinomas. We report a unique case of hepatocellular LELC arising in a cirrhotic liver with EBV demonstrated in the tumor cells. METHODS AND RESULTS A 39-year-old Hispanic female underwent an orthotopic liver transplant for end stage liver disease secondary to chronic hepatitis C. A high-grade hepatocellular carcinoma with a dense lymphocytic infiltrate was found in the explant as well as in a portal lymph node. Three months posttransplant, the patient developed numerous hepatic nodules with enlarged periaortic and portacaval lymph nodes. Biopsy of the hepatic nodules showed a recurrent hepatocellular carcinoma devoid of a dense lymphocytic infiltrate. Both the primary and recurrent tumors were positive for EBV by molecular studies. The patient eventually expired from liver failure over a 6-week period. CONCLUSION This case represents the first report of EBV-positive hepatocellular LELC. It is particularly interesting given the precipitous clinical outcome, which was possibly related to immunosuppresive therapy.
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MESH Headings
- Adult
- Carcinoma, Hepatocellular/genetics
- Carcinoma, Hepatocellular/pathology
- Carcinoma, Hepatocellular/virology
- Carcinoma, Squamous Cell/genetics
- Carcinoma, Squamous Cell/pathology
- Carcinoma, Squamous Cell/virology
- Chromosomes, Human, Pair 11/genetics
- Epstein-Barr Virus Infections/complications
- Epstein-Barr Virus Infections/pathology
- Female
- Gene Dosage
- Herpesvirus 4, Human/isolation & purification
- Humans
- Immunohistochemistry
- In Situ Hybridization, Fluorescence
- Liver Cirrhosis/virology
- Liver Neoplasms/genetics
- Liver Neoplasms/pathology
- Liver Neoplasms/virology
- Liver Transplantation
- Lymphatic Metastasis/pathology
- Polymerase Chain Reaction
- Tumor Virus Infections/complications
- Tumor Virus Infections/pathology
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Affiliation(s)
- Michael W Si
- Department of Pathology, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229-3900, USA
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Sanati S, Ayala AG, Middleton LP. Lymphoepithelioma-like carcinoma of the breast: Report of a case mimicking lymphoma. Ann Diagn Pathol 2004; 8:309-15. [PMID: 15494940 DOI: 10.1016/j.anndiagpath.2004.07.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Only 10 cases of lymphoepithelioma-like carcinoma of the breast have been reported in the literature. This report adds one more case to the published literature. A 62-year-old woman presented with a mass in her left breast on physical examination. The mammographic images showed a 3.0 cm, poorly defined mass in the upper outer quadrant. A biopsy was recommended. The gross specimen consisted of a 5 cm portion of breast parenchyma with no discrete tumor. On microscopic examination, the tumor was composed of sheets of epithelioid cells arranged as single cells or in cords partially obscured by a dense lymphocytic infiltrate. The epitheliod cells extensively expressed cytokeratin stain, but did not express E-cadherin. The lymphoid cells expressed L26 stain in the germinal centers, and CD3 stain in the T lymphocytes surrounding the germinal centers and in between tumor cells. In situ hybridization showed no evidence of Epstein-Barr virus infection in the tumor cells. An overall review of 11 cases shows that the disease is usually seen in older patients. In situ and invasive lobular component was reported in 36% of the cases. Eight of 11 were negative for E-cadherin, 36% were estrogen receptor-positive, 18% were progesterone receptor-positive, and all of them were HER2/neu negative. None of the reported cases have been associated with Epstein-Barr virus infection. Only two of the cases showed lymph node metastasis, and long-term follow-up in one of them showed good prognosis. In summary, lymphoepithelioma-like carcinoma of the breast is a tumor with a good prognosis that should be considered as a possible diagnosis in breast tumors with an intense lymphocytic infiltrate.
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Affiliation(s)
- Souzan Sanati
- The University of Texas Medical Branch, Galveston, TX 77030-4009, USA
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