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Frittoli B, Castaldo A, Santarsiere M, Ascione R, Tanzi G, Ponsiglione A, Baiocchi GL, Grazioli L. A unique case of lymphoepithelioma-like HCC with osteoclast-like giant cells: CT imaging features with pathologic correlations. Clin J Gastroenterol 2024; 17:112-117. [PMID: 37864655 PMCID: PMC10830663 DOI: 10.1007/s12328-023-01871-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 09/26/2023] [Indexed: 10/23/2023]
Abstract
Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver, with several histological variants being reported in literature. Hereby, we describe a case of a 77-year-old man with chronic liver disease referred to our department for performing a computed tomography (CT) due to a liver mass discovered at an abdominal ultrasound follow-up. At CT, a large, ill-defined lesion in the third hepatic segment was detected, characterized by progressive and delayed enhancement with minimal retraction of the hepatic capsule, associated with perihepatic adipose tissue inhomogeneity, mimicking a cholangiocarcinoma. At histopathological evaluation, the lesion turned out to be an HCC with lymphoepithelioma-like component and osteoclastic-like giant cells. This report focuses on the clinicopathological and radiological features of this unique case.
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Affiliation(s)
| | - Anna Castaldo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Marika Santarsiere
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Raffaele Ascione
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Giulia Tanzi
- Department of Pathology, ASST Cremona, Cremona, Italy
| | - Andrea Ponsiglione
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy.
| | - Gian Luca Baiocchi
- Department of Clinical and Experimental Sciences, Surgical Clinic, University of Brescia, Brescia, Italy
- Department of Surgery, ASST Cremona, Cremona, Italy
| | - Luigi Grazioli
- Department of Radiology, ASST Spedali Civili, Brescia, Italy
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2
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Renzulli M, Braccischi L, D'Errico A, Pecorelli A, Brandi N, Golfieri R, Albertini E, Vasuri F. State-of-the-art review on the correlations between pathological and magnetic resonance features of cirrhotic nodules. Histol Histopathol 2022; 37:1151-1165. [PMID: 35770721 DOI: 10.14670/hh-18-487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Hepatocellular carcinoma (HCC) has become the second greatest cause of cancer-related mortality worldwide and the newest advancements in liver imaging have improved the diagnosis of both overt malignancies and premalignant lesions, such as cirrhotic or dysplastic nodules, which is crucial to improve overall patient survival rate and to choose the best treatment options. The role of Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) has grown in the last 20 years. In particular, the introduction of hepatospecific contrast agents has strongly increased the definition of precursor nodules and detection of high-grade dysplastic nodules and early HCCs. Nevertheless, the diagnosis of liver tumours in cirrhotic patients sometimes remains challenging for radiologists, thus, in doubtful cases, biopsy and histological analysis become critical in clinical practice. This current review briefly summarizes the history of imaging and histology for HCC, covering the newest techniques and their limits. Then, the article discusses the links between radiological and pathological characteristics of liver lesions in cirrhotic patients, by describing the multistep process of hepatocarcinogenesis. Explaining the evolution of pathologic change from cirrhotic nodules to malignancy, the list of analyzed lesions provides regenerative nodules, low-grade and high-grade dysplastic nodules, small HCC and progressed HCC, including common subtypes (steatohepatitic HCC, scirrhous HCC, macrotrabecular massive HCC) and more rare forms (clear cell HCC, chromophobe HCC, neutrophil-rich HCC, lymphocyte-rich HCC, fibrolamellar HCC). The last chapter covers the importance of the new integrated morphological-molecular classification and its association with radiological features.
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Affiliation(s)
- Matteo Renzulli
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italia
| | - Lorenzo Braccischi
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italia
| | - Antonietta D'Errico
- Pathology Unit, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Anna Pecorelli
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italia
| | - Nicolò Brandi
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italia
| | - Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italia
| | - Elisa Albertini
- Pathology Unit, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Francesco Vasuri
- Pathology Unit, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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Zhu Y, Dang Z, Xu H, Yuan Y, Chen Y, Li Z. High PD-L1 Level of Advanced Hepatic Lymphoepithelioma-like Carcinoma Response Favorably to Lenvatinib plus Toripalimab. Cancer Sci 2022; 113:1880-1884. [PMID: 35298067 PMCID: PMC9128174 DOI: 10.1111/cas.15339] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 03/07/2022] [Accepted: 03/12/2022] [Indexed: 02/05/2023] Open
Abstract
Lymphoepithelioma‐like carcinoma (LELC) is an uncommon subtype of primary liver cancer with predominant lymphocyte infiltration and a relatively favorable outcome. However, no standard treatment for advanced hepatic LELC has been established. Here, we give a first report of a 60‐year‐old man with advanced hepatic LELC who had a high expression of PD‐L1 in tumor cells and a high level of tumor‐infiltrating leukocytes (TILs) in the tumor microenvironment (TME). After receiving six cycles of multiple receptor tyrosine kinase inhibitor (rTKI) with lenvatinib plus PD‐1 inhibitor toripalimab treatment, the patient achieved persistent partial response (PR). Our report indicates that advanced hepatic LELC with high expression of PD‐L1 may benefit from the combination of rTKI and PD‐L1/PD‐1 blockade. Therefore, this potential strategy should be considered when treating those rare liver cancers.
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Affiliation(s)
- Yueting Zhu
- Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Zhuyi Dang
- Department of Radiotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Hang Xu
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Yunlong Yuan
- West China Medical School, Sichuan University, Chengdu, China
| | - Ye Chen
- Department of Abdominal Cancer, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Zhiping Li
- Department of Radiotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.,Department of Abdominal Cancer, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
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Sweed D, Sultan MM, Mosbeh A, Fayed YA, Abdelsameea E, Ehsan NA, Abdel-Rahman MH, Waked I. Lymphoepithelioma-like Hepatocellular Carcinoma: a Case Report and Review of Literature. J Gastrointest Cancer 2021; 54:275-281. [PMID: 34813031 DOI: 10.1007/s12029-021-00757-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2021] [Indexed: 01/07/2023]
Abstract
We report a case of hepatic lymphoepithelioma-like carcinoma-hepatocellular carcinoma subtype (LEL-HCC) in a 41-year-old man with chronic hepatitis C virus (HCV) infection. The patient presented with abdominal pain and further assessment revealed a hypoechoic mass on ultrasonography. Serum alpha-fetoprotein (AFP) was 13·6 ng/dl. The patient was diagnosed as hepatocellular carcinoma based on the established triphasic computed tomography (TCT) diagnostic criteria and he underwent a surgical resection of the mass. Microscopic examination showed sheets and cords of malignant epithelial cells intermixed with heavy lymphoid infiltrate, with more than 100 tumor-infiltrating lymphocytes (TILs) per 10 high-power-field (HPF). Based on immunohistochemical studies, the malignant cells were positive for Hep Par 1 and glypican 3, focally positive for cytokeratin 7 (CK7), and negative for cytokeratin 20 (CK20). TILs were diffusely positive for cluster of differentiation 3 CD3 with an approximately equal CD4/CD8 ratio. The patient was recurrence free at 25 months after surgery, as evident by CT and serum alpha-fetoprotein level. LEL-HCC is a rare variant of HCC with a relatively better prognosis. Exploring the potential for immune modulator-based therapy in this subset of tumors is highly recommended.
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Affiliation(s)
- Dina Sweed
- Pathology Department, National Liver Institute, Menoufia University, Shibin Al Kawm, Egypt
| | - Mervat M Sultan
- Pathology Department, National Liver Institute, Menoufia University, Shibin Al Kawm, Egypt
| | - Asmaa Mosbeh
- Pathology Department, National Liver Institute, Menoufia University, Shibin Al Kawm, Egypt.
| | - Yahya A Fayed
- Hepatopancreatobiliary Surgery Department, National Liver Institute, Menoufia University, Shibin Al Kawm, Egypt
| | - Eman Abdelsameea
- Hepatology and Gastroenterology Department, National Liver Institute, Menoufia University, Shibin Al Kawm, Egypt
| | - Nermine A Ehsan
- Pathology Department, National Liver Institute, Menoufia University, Shibin Al Kawm, Egypt
| | - Mohamed H Abdel-Rahman
- Pathology Department, National Liver Institute, Menoufia University, Shibin Al Kawm, Egypt
| | - Imam Waked
- Hepatology and Gastroenterology Department, National Liver Institute, Menoufia University, Shibin Al Kawm, Egypt
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Omori G, Osuga T, Miyanishi K, Hamaguchi K, Tanaka S, Ohnuma H, Murase K, Takada K, Nagayama M, Kimura Y, Takemasa I, Kikuchi Y, Torigoe T, Kato J. Programmed cell death ligand 1 expression in a case of poorly differentiated lymphocyte-rich hepatocellular carcinoma. Clin Case Rep 2021; 9:e04764. [PMID: 34522383 PMCID: PMC8428809 DOI: 10.1002/ccr3.4764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/12/2021] [Accepted: 08/15/2021] [Indexed: 12/27/2022] Open
Abstract
Our pathological study of a case of poorly differentiated lymphocyte-rich hepatocellular carcinoma suggested that immune checkpoint inhibitor may be an effective therapy. The histological type is an important factor in determining treatment choices.
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Affiliation(s)
- Ginji Omori
- Department of Medical OncologySapporo Medical University School of MedicineSapporoJapan
| | - Takahiro Osuga
- Department of Medical OncologySapporo Medical University School of MedicineSapporoJapan
| | - Koji Miyanishi
- Department of Medical OncologySapporo Medical University School of MedicineSapporoJapan
| | - Kota Hamaguchi
- Department of Medical OncologySapporo Medical University School of MedicineSapporoJapan
| | - Shingo Tanaka
- Department of Medical OncologySapporo Medical University School of MedicineSapporoJapan
- Department of Infection Control and Laboratory MedicineSapporo Medical University School of MedicineSapporoJapan
| | - Hiroyuki Ohnuma
- Department of Medical OncologySapporo Medical University School of MedicineSapporoJapan
| | - Kazuyuki Murase
- Department of Medical OncologySapporo Medical University School of MedicineSapporoJapan
| | - Kohichi Takada
- Department of Medical OncologySapporo Medical University School of MedicineSapporoJapan
| | - Minoru Nagayama
- Department of Surgery, Surgical Oncology and ScienceSapporo Medical University School of MedicineSapporoJapan
| | - Yasutoshi Kimura
- Department of Surgery, Surgical Oncology and ScienceSapporo Medical University School of MedicineSapporoJapan
| | - Ichiro Takemasa
- Department of Surgery, Surgical Oncology and ScienceSapporo Medical University School of MedicineSapporoJapan
| | - Yasuhiro Kikuchi
- Department of PathologySapporo Medical University School of MedicineSapporoJapan
| | - Toshihiko Torigoe
- Department of PathologySapporo Medical University School of MedicineSapporoJapan
| | - Junji Kato
- Department of Medical OncologySapporo Medical University School of MedicineSapporoJapan
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Chaparro Mirete M, López-López V, Robles Campos R. Lymphoepithelioma-like carcinoma of the duodenum: a very infrequent tumor. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2021; 112:239. [PMID: 32022569 DOI: 10.17235/reed.2020.6503/2019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Lymphoepithelioma-like carcinoma (LELC) is a type of tumor that is histologically characterized by wide lymphoplasmacytic infiltration in the stroma. This type of carcinoma is usually found in the airway and is extremely infrequent in the gastrointestinal tract. We present the case of a 77-year-old male, under follow-up for refractory anemia, who was diagnosed with a cavum type lymphoepithelioma-like carcinoma in the third duodenal portion. After diagnosis, he was treated surgically via a duodenal resection, without adjuvant oncological treatment due to the early diagnosis and surgical pathology features. Today, 12 months after surgery, the patient is free of disease. Cases of LELC have been described in other organs of the gastrointestinal tract. However, after an extensive review of the literature, this is the first case of LELC in the duodenum. A review of the available literature about LELC in the digestive tract and its management was also included.
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Affiliation(s)
- Marta Chaparro Mirete
- Cirugía General y del Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca
| | - Víctor López-López
- Cirugía General y del Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, España
| | - Ricardo Robles Campos
- Department of Gastrointestinal Surgery, Hospital Clínico Universitario Virgen de la Arrixaca
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Hermel DJ, Du EZ, Lin R, Frenette CT, Sigal DS. Checkpoint Inhibition in the Treatment of Unresectable, Advanced Lymphoepithelioma-like Hepatocellular Carcinoma. J Clin Transl Hepatol 2021; 9:265-268. [PMID: 34007809 PMCID: PMC8111110 DOI: 10.14218/jcth.2020.00094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 12/13/2020] [Accepted: 01/05/2021] [Indexed: 12/13/2022] Open
Abstract
Lymphoepithelioma-like hepatocellular carcinoma (LEL-HCC) is a very rare neoplasm, with distinct epidemiologic, morphologic and clinical characteristics. Molecular mechanistic insight into the pathogenesis of this carcinoma suggests a pivotal role for the host immune system in the proliferation and progression of this tumor. However, while detailed genomic profiling of these hepatic tumors have revealed an intra-tumoral inflammatory mutational signature that may predispose to immune checkpoint inhibitor efficacy, no published report has described their use in this tumor type. Unfortunately, with near 100 cases of LEL-HCC reported in the literature to date and the majority of cases confined to localized and resectable disease, current evidence-based practices in the unresectable setting are lacking, with unknown benefit of chemotherapy or immunotherapy. We report on the case of a 68 year-old man with unresectable, advanced LEL-HCC who had evidence of disease stability after starting on the immune checkpoint inhibitor nivolumab. His disease response persisted off therapy for over a year and was potentially augmented by radiotherapy at the site of local progression. For this extremely rare tumor subtype, this case highlights the potential efficacy and safety of immune checkpoint blockade in LEL-HCC and reinforces the need for more robust, large-scale analysis of patients with these rare tumors to better evaluate treatment strategies and outcomes.
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Affiliation(s)
- David J. Hermel
- Division of Hematology and Oncology, Scripps Clinic and Scripps MD Anderson Cancer Center, La Jolla, CA, USA
- Correspondence to: David J. Hermel, Division of Hematology and Oncology, Scripps Clinic, 10666 N Torrey Pines Rd, MS 312, La Jolla, CA 92037, USA. Tel: +1-858-537-7617, Fax: +1-858-554-9100, E-mail:
| | - Emma Z. Du
- Division of Pathology, Scripps Clinic and Scripps MD Anderson Cancer Center, La Jolla, CA, USA
| | - Ray Lin
- Division of Radiation Oncology, Scripps Clinic and Scripps MD Anderson Cancer Center, La Jolla, CA, USA
| | - Catherine T. Frenette
- Division of Gastroenterology, Scripps Clinic and Scripps MD Anderson Cancer Center, La Jolla, CA, USA
| | - Darren S. Sigal
- Division of Hematology and Oncology, Scripps Clinic and Scripps MD Anderson Cancer Center, La Jolla, CA, USA
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The CT and MRI Features of Primary Intrahepatic Lymphoepithelioma-Like Cholangiocarcinoma. AJR Am J Roentgenol 2020; 216:393-402. [PMID: 33325732 DOI: 10.2214/ajr.20.22937] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE. The purpose of our study was to retrospectively characterize the CT and MRI features of primary intrahepatic lymphoepithelioma-like cholangiocarcinoma (LELCC). MATERIALS AND METHODS. Eleven patients (10 women and one man; age range, 30-63 years) with 11 pathologically proven LELCCs were enrolled retrospectively from April 2016 to December 2018. Triphasic enhanced images were obtained of all patients: MR images of five patients, CT images of five patients, and both CT and MR images of one patient. The clinical data and CT and MRI findings were reviewed. RESULTS. All LELCC cases were associated with Epstein-Barr virus (EBV) infection. Eight of the 11 patients had hepatitis B virus (HBV) infection. The tumor diameter ranged from 1.1 to 8.7 cm. All tumors were well defined with a smooth or lobulated margin. A cystic area was noted in two of the 11 tumors. After the administration of contrast material, the tumors showed homogeneous (n = 7) or heterogeneous (n = 4) hypervascular arterial enhancement and gradual washout, delayed central scar or irregular enhancement (n = 9), delayed circular thin or incomplete pseudocapsule enhancement (n = 7), and homogeneous hypointensity in the hepatobiliary phase (n = 2). No cirrhosis, focal dilatation of intrahepatic ducts, or satellite nodules were detected. Lymphadenopathy were detected in four patients, appearing as hypervascular enhancement and no necrosis (even in multiple nodes > 3 cm) or as moderate peripheral enhancement and necrosis. CONCLUSION. A liver mass in a middle-aged woman with EBV and HBV infection that appears on CT and MRI to have a well-defined boundary and a combination of hypervascularity, washout, delayed intratumoral enhancement, or pseudocapsule enhancement may suggest an imaging diagnosis of primary LELCC. More cases are needed to better understand this disease.
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Zhang K, Tao C, Tao Z, Wu F, An S, Wu J, Rong W. Lymphoepithelioma-like carcinoma in liver not associated with Epstein-Barr virus: a report of 3 cases and literature review. Diagn Pathol 2020; 15:115. [PMID: 32967689 PMCID: PMC7513497 DOI: 10.1186/s13000-020-01035-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 09/15/2020] [Indexed: 12/13/2022] Open
Abstract
Background Lymphoepithelioma-like carcinoma is a rare distinctive variant of liver cancer with unique epidemiological and pathological characteristics, characterized by dense lymphocyte infiltration. It can be divided into lymphoepithelioma-like hepatocellular carcinoma and lymphoepithelioma-like intrahepatic cholangiocarcinoma. Existing research shows that the prognosis of this tumor is good. To date, only 101 cases have been reported. Case presentation The first patient was a 62-year-old Chinese man with hepatitis B virus infection who presented with a single lesion in the liver. The patient underwent surgical treatment and was discharged on the 4th day. The patient was diagnosed with combined lymphoepithelioma-like hepatocellular carcinoma and cholangiocarcinoma; he has been alive for 15 months. The second patient was a 63-year-old Chinese woman with right upper abdominal pain and hepatitis B virus infection. The imaging examination revealed a single lesion in the liver. The patient underwent surgical treatment and was discharged 1 week later. The patient was diagnosed with lymphoepithelioma-like hepatocellular carcinoma and was considered to have recurrence in the lymph nodes approximately 2 years after the operation. The patient underwent local radiotherapy; she has been alive for 60 months. The third patient was a 50-year-old Chinese man with hepatitis B virus infection who presented with a single lesion in the liver and two enlarged lymph nodes. The patient received liver puncture before surgery to indicate lymph node metastasis and experienced local recurrence after liver resection. The patient underwent chemotherapy and radiotherapy. The patient was diagnosed with lymphoepithelioma-like hepatocellular carcinoma. The patient was deceased at 24-month follow-up. Conclusions This article reports 3 cases without Epstein-Barr virus and reviews the current literature, which suggests even mixed pathological type or locally advanced cases of LELC with lymph node metastasis and postoperative recurrence should be actively treated for a longer survival period.
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Affiliation(s)
- Kai Zhang
- Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Changcheng Tao
- Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Zonggui Tao
- Department of Imaging, Jinan city people's hospital, Shandong First Medical University, Jinan, 271199, China
| | - Fan Wu
- Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Songlin An
- Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
| | - Jianxiong Wu
- Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
| | - Weiqi Rong
- Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
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Noguchi H, Noguchi N, Idichi T, Kawasaki Y, Kirishima M, Tasaki T, Kitazono I, Horinouchi M, Hiraki T, Higashi M, Tanimoto A. Case report of a lymphoepithelioma-like hepatocellular carcinoma with prominent lymphoplasmacytic infiltration. HUMAN PATHOLOGY: CASE REPORTS 2020. [DOI: 10.1016/j.ehpc.2020.200402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Iwasaki T, Kubota A, Suzuki M, Terada T. A case of small well-differentiated hepatocellular carcinoma with marked lymphocytic infiltrate. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2020; 13:624-633. [PMID: 32269704 PMCID: PMC7137018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 02/07/2020] [Indexed: 06/11/2023]
Abstract
We herein report a case of well-differentiated small hepatocellular carcinoma (HCC) with severe lymphocytic infiltrate (SLI) in a 55-year-old male patient with HCV-related cirrhosis. The patient had been followed-up because of HCV-related cirrhosis. He was found to have two small nodules in S8 by imaging techniques, and he underwent S8 segmentectomy. The resected liver showed two small nodules. Both were encapsulated, well-defined, solid, reddish and expansive nodules with fibrous septa. They measured 8 × 8 mm and 15 × 10 mm, respectively. Histologically, both tumours were pure HCC; the smaller showed SLI with lymphocytes/HCC cells ratio over 20, while the larger showed mild lymphocytic infiltration with lymphocytes/HCC cells ratio of 0.8. The smaller HCC was well-differentiated (trabecular thickness <3) HCC-SLI with Edmondson II = I cytologic atypia, while the larger was moderately-differentiated (trabeculae >3) HCC (Edmondson II>III>I). Extremely well-differentiated Edmondson I HCC or adenomatous hyperplasia areas were seen in the periphery of both HCCs. The patterns of SLI could be classified into the following three: sinusoids (S) type, portal tract (PT) type, lymph follicle (LF) type. In S-type, lymphocytes were infiltrated between the trabeculae. In PT-type, SLI was found to arise from extension from already inflamed PT within HCC or neighboring PT. The HCC cells frequently exhibited moth-eaten or piece meal necrosis in PT-type. In LF-type, lymphocytes were activated, and nuclear dusts were noted. It appeared that LF-type has arisen from preexisting S-type and/or PT-type. We speculated that the entry of SLI was from S in S-type, from incorporated inflamed PT in PT-type, and from both in LF-type. The approximate overall positive ratios of lymphoid cells among inflammatory cells were as follows: CD20 50%, CD3 70%, CD4 50%, CD8 30%, CD138 3%, CD163 40%, granzyme B 2%, smooth muscle actin (SMA) 30%, CD31 30%, CD21 2%, S100 3%, bcl-2 10%, CK19 1%, CD10 1%, CD30 0%, CD56 0% and Ki67 labeling index = 5%. EBV-ISH and HPV IHC were negative. Interestingly, Kupffer cells had myofibroblastic antigen in addition to macrophage antigens, and stellate cells expressed macrophage antigens aside from myofibroblastic antigens. These data suggest that, in the present case, pan-B-cells, pan-T-cells, helper T-cells, cytotoxic T-cells, plasma cells, macrophages, Kupffer cells, stellate cells, myofibroblasts, fibroblasts, endothelial cells, dendritic cells, Langerhans cells, and toxic molecules may play roles in tumour immunology.
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Affiliation(s)
- Tomohiro Iwasaki
- Department of Pathology, Shizuoka General Hospital No. 4-27-1, Kita-Ando, Aoi-ku, Shizuoka, Shizuoka 420-8527, Japan
| | - Aki Kubota
- Department of Pathology, Shizuoka General Hospital No. 4-27-1, Kita-Ando, Aoi-ku, Shizuoka, Shizuoka 420-8527, Japan
| | - Makoto Suzuki
- Department of Pathology, Shizuoka General Hospital No. 4-27-1, Kita-Ando, Aoi-ku, Shizuoka, Shizuoka 420-8527, Japan
| | - Tadashi Terada
- Department of Pathology, Shizuoka General Hospital No. 4-27-1, Kita-Ando, Aoi-ku, Shizuoka, Shizuoka 420-8527, Japan
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Inflammatory Stroma of Lymphoepithelioma-like Carcinoma of the Cervix: Immunohistochemical Study of 3 Cases and Review of the Literature. Int J Gynecol Pathol 2018; 37:482-487. [PMID: 28985196 DOI: 10.1097/pgp.0000000000000446] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The aim of this study was to characterize the inflammatory infiltrate of the lymphoepithelioma-like carcinoma, a variant of squamous cell carcinoma clinically associated with a good prognosis. Immunohistochemistry was used to characterize 3 cases of lymphoepithelioma-like carcinoma in the uterine cervix, diagnosed over a period of 3 yr. The patients were between 30 and 50 yr old. Their cervical smears had shown atypical squamous cells of unknown significance or high-grade squamous intraepithelial lesions, and the initial cervical biopsy showed high-grade cervical intraepithelial neoplasia (CIN3) or squamous cell carcinoma. All patients underwent a Wertheim operation, 2 of which were preceded by a cervicectomy. Microscopically, all tumors were characterized by poorly defined sheets of undifferentiated squamous cells with a syncytial pattern and a dense background of infiltrating lymphocytes. Immunohistochemical analysis revealed that the lymphocytes were predominantly CD3 and CD8 T cells. The tumor lobules contained isolated CD8 T cells, whereas CD4 T cells and CD20 B cells surrounded the tumor lobules. CD56 NK cells and CD79 B cells were scattered in the tumor tissue. An in situ hybridization staining for Epstein-Barr encoding region was negative but all cases were immunohistochemically positive for P16. Follow-up varied between 2 mo and 2.7 yr. All 3 patients were disease free. Lymphoepithelioma-like carcinoma of the uterine cervix is a variant of squamous cell carcinoma, known for its better prognosis. The good prognosis of this tumor is potentially explained by the high levels of infiltrating CD8 T cells.
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Shih EJ, Chau IY, Yeh YC, Chau GY. Synchronous hepatocellular carcinoma and lymphoepithelioma-like carcinoma arising from 2 different sites of the liver: A case report. Medicine (Baltimore) 2018; 97:e12548. [PMID: 30290612 PMCID: PMC6200470 DOI: 10.1097/md.0000000000012548] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Most cases of primary liver cancer involve hepatocellular carcinoma (HCC). Lymphoepithelioma-like carcinoma (LELC) is defined as a tumor composed of undifferentiated epithelial cells with a prominent lymphoid infiltrate, which is rarely reported. Lymphoepithelioma-like HCC (LEL-HCC) is an uncommon variant of HCC, having an unclear process of development. Here, we report the first case involving simultaneous HCC and LEL-HCC. PATIENT CONCERNS A 77-year-old female was accidentally found to have a hypoechoic hepatic nodule via an abdominal ultrasound during a health examination. Abdominal computed tomography scan revealed 2 hepatic nodules with arterial phase enhancement and washout in the late phase. DIAGNOSES We diagnosed the case with 2 distinct liver nodules, HCC and LEL-HCC. INTERVENTIONS With suspicion of HCC, tumor resection (liver segments 4 and 5) was then performed. Histopathological examination of tumor 1 showed a moderately differentiated HCC and tumor 2 demonstrated a LEL-HCC. Immunohistochemically, the cells of tumor 2 were immunoreactive for cytokeratin (CK), CK7, and CK19. Epstein-Barr virus encoding small RNA (EBER) in situ hybridization results were negative. OUTCOMES Six months after resection, intrahepatic tumor recurrence was noted. Radiofrequency ablation was conducted. LESSONS This is an interesting case providing circumstantial evidence of simultaneous development of HCC and LEL-HCC in distinct nodules of the liver with a background of chronic hepatitis B virus infection.
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Affiliation(s)
- En-Jie Shih
- Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ivy Yenwen Chau
- Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital
| | - Yi-Chen Yeh
- Department of Pathology, Taipei Veterans General Hospital
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Gar-Yang Chau
- Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
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Wang JK, Jin YW, Hu HJ, Regmi P, Ma WJ, Yang Q, Liu F, Ran CD, Su F, Zheng EL, Li FY. Lymphoepithelioma-like hepatocellular carcinoma: A case report and brief review of literature. Medicine (Baltimore) 2017; 96:e9416. [PMID: 29390565 PMCID: PMC5758267 DOI: 10.1097/md.0000000000009416] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
RATIONAL Lymphoepithelioma-like hepatocellular carcinoma (LEL-HCC) is a rare variant of hepatocellular carcinoma (HCC). To date, few cases have been reported in the literature, and almost no report in analyzing the different features of LEL-HCC. PATIENT CONCERNS We describe a 37-year-old female patient with a 32 × 30 mm mass in the right liver. INTERVENTIONS Complete surgical resection of the lesion was performed. DIAGNOSES Histopathological examination of the resected tumor revealed undifferentiated HCC cells with significant lymphocytes infiltration. Immunohistochemically, the tumor cells were positive for AFP (alpha fetoprotein), hepatocyte, CK8, and glypican-3. The patient was diagnosed with LEL-HCC. OUTCOMES The patient had a favorable clinical outcome, and was free from tumor recurrence after a 52-months follow-up. LESSONS Our case was the youngest patient of all the reported cases, and the third case who was infected with both hepatitis B virus (HBV) and hepatitis C virus (HCV). LEL-HCC is a rare variant of HCC, with a relatively favorable prognosis. Further research recruiting more patients is required to determine the accurate causes and mechanism of LEL-HCC.
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Affiliation(s)
| | | | | | | | | | | | - Fei Liu
- Department of Biliary Surgery
| | | | | | - Er-Liang Zheng
- Department of Gastrointestinal Surgery, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
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Labgaa I, Stueck A, Ward SC. Lymphoepithelioma-Like Carcinoma in Liver. THE AMERICAN JOURNAL OF PATHOLOGY 2017; 187:1438-1444. [PMID: 28500863 DOI: 10.1016/j.ajpath.2017.02.022] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Accepted: 02/27/2017] [Indexed: 02/07/2023]
Abstract
Liver cancer, primarily encompassing hepatocellular carcinoma and intrahepatic cholangiocarcinoma, has become the second leading cause of worldwide cancer-related death during the past two decades. Lymphoepithelioma-like carcinomas (LELCs) are defined as tumors composed of undifferentiated epithelial cells with a prominent lymphoid infiltrate, and can arise in the liver as hepatocellular or cholangiocarcinoma forms. Patients with liver LELC display distinctive demographics and tumor characteristics. LELCs also appear to be associated with strikingly better outcomes compared to typical liver cancers, with 5-year survival rates of 57% to 100% versus 12% to 68%, respectively. Liver LELCs represent a unique model of immune response in liver cancer. Data on LELCs of the liver remain limited, and future comprehensive studies are needed to further elucidate this disease, which could ultimately offer precious insights for immunotherapeutic strategies in liver cancer.
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Affiliation(s)
- Ismail Labgaa
- Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Visceral Surgery, Lausanne University Hospital CHUV, Lausanne, Switzerland
| | - Ashley Stueck
- Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Stephen C Ward
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York.
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Insilla AC, Faviana P, Pollina LE, Simone PD, Coletti L, Filipponi F, Campani D. Lymphoepithelioma-like hepatocellular carcinoma: Case report and review of the literature. World J Gastroenterol 2015; 21:10468-10474. [PMID: 26420974 PMCID: PMC4579894 DOI: 10.3748/wjg.v21.i36.10468] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 05/29/2015] [Accepted: 07/03/2015] [Indexed: 02/06/2023] Open
Abstract
Lymphoepithelioma-like hepatocellular carcinoma (LEL-HCC) is a rare form of undifferentiated carcinoma of the liver characterized by the presence of an abundant lymphoid infiltrate. Here, a case of LEL-HCC is described. An 81-year-old woman with a chronic hepatitis C infection was referred to the general surgery department of our hospital in August 2013 with a diagnosis of HCC. A past ultrasound examination had revealed a 60 mm-diameter nodular lesion in the third segment of the liver. After a needle biopsy, the lesion was diagnosed as HCC. The patient underwent surgery with a liver segmentectomy. Two additional nodes on the gastric wall were detected during the surgical operation. The histology of the removed specimen showed a poorly differentiated HCC with significant lymphoid stroma. Immunohistochemical studies revealed that the epithelial component was reactive for CK CAM5.2, CK8, CK18, CEA (polyclonal) and was focally positive for hepar-1 and that the lymphoid infiltrate was positive for CD3, CD4 and CD8. The tumor cells were negative for Epstein-Barr virus. The gastric nodes were ultimately determined to be two small gastrointestinal stromal tumors (GISTs). The synchronous occurrence of HCC and GIST is another very uncommon finding rarely described in the literature. Here, we report the clinicopathological features of our case, along with a review of the few cases present in the literature.
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MESH Headings
- Aged, 80 and over
- Biomarkers, Tumor/analysis
- Biopsy, Needle
- Carcinoma, Hepatocellular/chemistry
- Carcinoma, Hepatocellular/pathology
- Carcinoma, Hepatocellular/surgery
- Carcinoma, Hepatocellular/virology
- Epithelial Cells/chemistry
- Epithelial Cells/pathology
- Female
- Gastrointestinal Stromal Tumors/pathology
- Hepatectomy
- Hepatitis C, Chronic/complications
- Hepatitis C, Chronic/diagnosis
- Humans
- Immunohistochemistry
- Liver Neoplasms/chemistry
- Liver Neoplasms/pathology
- Liver Neoplasms/surgery
- Liver Neoplasms/virology
- Lymphocytes/chemistry
- Lymphocytes/pathology
- Neoplasms, Multiple Primary
- Stomach Neoplasms/pathology
- Tomography, X-Ray Computed
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Xue J, Yu H, Yan J, Ren N, Yang Y, Wang X, Wang Y. Non-Epstein-Barr virus-associated double primary lymphoepithelioma-like carcinoma of the esophagus and stomach: a case report and literature review. Int J Clin Exp Med 2015; 8:10051-10057. [PMID: 26309699 PMCID: PMC4538029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 06/03/2015] [Indexed: 06/04/2023]
Abstract
A 55-year-old Chinese male was admitted to the hospital for epigastralgia and dysphagia with a two month history, and hematemesis and melena with a two-day history. Two lesions were found in the esophagus and stomach by esophago--gastroduodenoscopy and computed tomography. The patient underwent subtotal esophagectomy and gastrectomy, esophagogastric anastomosis above the aortic arch, and thoracic-abdominal two-field lymph node dissection. Pathological and immumohistochemical studies showed that both lesions had the same form of poorly differentiated carcinoma with dense lymphoid stroma, which was diagnosed as lymphoepithelioma-like carcinoma (LELC). No metastatic relationship was found between the two tumors. Therefore, the case was double primary lymphoepithelioma-like carcinoma of the esophagus and stomach. Epstein-Barr virus (EBV) in the two tumors were negative by EBV-encoded small RNA1 (EBER-1) in situ hybridization. No adjuvant therapy was performed due to his poor physical condition post-operatively, and no evidence of tumor recurrence or metastasis was found during the next 14 months of follow-up. Esophageal and gastric LELC are rare, especially the former, which has a specific geographical distribution. Literature reported cases showed upper gastrointestinal LELC were highly malignant with good prognosis, and EBV was detected less in esophageal LELC cases but more commonly in gastric LELC cases. Upper gastrointestinal LELC lesions are usually singular, and no synchronous lesions were reported in the literature. Our case is the first LELC to present as double primary lymphoepithelioma- like carcinoma of both esophagus and stomach simultaneously, which demonstrates that LELC can be multifocal in the upper gastrointestinal tract.
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Affiliation(s)
- Jinru Xue
- Department of Thoracic Surgery, China-Japan Union Hospital of Jilin UniversityChangchun 130033, China
| | - Haixin Yu
- Department of Thoracic Surgery, China-Japan Union Hospital of Jilin UniversityChangchun 130033, China
| | - Jidong Yan
- Department of Thoracic Surgery, China-Japan Union Hospital of Jilin UniversityChangchun 130033, China
| | - Na Ren
- Department of Thoracic Surgery, China-Japan Union Hospital of Jilin UniversityChangchun 130033, China
| | - Yi Yang
- Department of Rheumatology and Immunology, China-Japan Union Hospital of Jilin UniversityChangchun 130033, China
| | - Xueju Wang
- Department of Pathology, China-Japan Union Hospital of Jilin UniversityChangchun 130033, China
| | - Yan Wang
- Department of Thoracic Surgery, China-Japan Union Hospital of Jilin UniversityChangchun 130033, China
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Lymphoepithelioma-like hepatocellular carcinoma: an uncommon variant of hepatocellular carcinoma with favorable outcome. Am J Surg Pathol 2015; 39:304-12. [PMID: 25675010 DOI: 10.1097/pas.0000000000000376] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Lymphoepithelioma-like hepatocellular carcinoma (LEL-HCC) is an uncommon variant of HCC with only 22 cases reported in the literature. To better determine the incidence, clinicopathologic features, prognostic significance, and molecular pathogenesis of LEL-HCC, we presented the largest series of LEL-HCC from a 9-year retrospective cohort of patients with HCC undergoing surgical resection. LEL-HCC was identified in 20 patients (4.9%). Compared with patients having HCC without significant tumor-infiltrating lymphocyte (TIL), patients with LEL-HCC had a relatively lower frequency of male sex (P=0.022), tended to present at early-stage disease (80.0% vs. 56.3% as AJCC stage I, P=0.037; 100% vs. 77.3% as BCLC stage 0/A, P=0.010), and all harbored a solitary tumor only (P=0.006). There was no significant difference in the age at presentation, underlying chronic liver disease, cirrhotic background, serum α-fetoprotein level, tumor size, histologic grade, and frequencies of vascular invasion. Most of the TILs in LEL-HCC were cytotoxic T lymphocytes. None of the LEL-HCCs was associated with Epstein-Barr virus. LEL-HCC was associated with better overall (5-y survival: 94.1% vs. 63.9%; P=0.007) and progression-free (5-y survival: 87.8% vs. 46.6%; P=0.002) survivals compared with HCC without significant TIL. The multivariate analysis revealed that LEL-HCC was an independent prognostic factor for overall and progression-free survivals. The adjusted hazard ratio of cancer death and tumor progression for LEL-HCC was 0.12 (P=0.037) and 0.14 (P=0.002), respectively. LEL-HCC did not differ in frequencies of microsatellite instability, BRAF mutation, and DNA hypermethylation. In brief, LEL-HCC is a distinct uncommon variant of HCC characterized by dense cytotoxic T-cell infiltration and favorable prognosis.
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Solinas A, Calvisi DF. Lessons from rare tumors: Hepatic lymphoepithelioma-like carcinomas. World J Gastroenterol 2015; 21:3472-3479. [PMID: 25834311 PMCID: PMC4375568 DOI: 10.3748/wjg.v21.i12.3472] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 12/11/2014] [Accepted: 02/05/2015] [Indexed: 02/06/2023] Open
Abstract
In this review we focus on lymphoepithelioma-like hepatocellular carcinomas (LEL-HCC) and lymphoepithelioma-like cholangiocarcinomas (LEL-ICC). Despite their rarity, these tumors are of general interest because of their epidemiological and clinical features, and because they represent a distinct model of interaction between the immune system and neoplastic cells. Approximately half of LEL-HCC arise in the context of chronic hepatitis C virus (HCV) infection and have been described both in Eastern and Western patients. By contrast, LEL-ICC is associated in almost all cases with Epstein-Barr virus (EBV) infection and exhibits the same epidemiological features of EBV related malignancies. Compared with classical hepatocellular carcinoma and intrahepatic cholangiocarcinoma of corresponding stage, both LEL-HCC and LEL-ICC are characterized by lower rates of recurrence after surgery and better overall survival. How this behavior is related to distinct genetic alterations and tumor microenvironment is unclear. The pathophysiological mechanisms of lymphoid infiltrations seem to be different among the two groups of tumors. In fact, LEL-HCC frequently arises in the context of inflammatory changes driven by HCV infection, and has been recognized as a variant of classical hepatocellular carcinoma. At variance, lymphocyte recruitment of LEL-ICC is similar to that described in nasopharyngeal carcinoma and gastric LEL, and possibly depends on the expression pattern of latent EBV infection.
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An SL, Liu LG, Zheng YL, Rong WQ, Wu F, Wang LM, Feng L, Liu FQ, Tian F, Wu JX. Primary lymphoepithelioma-like hepatocellular carcinoma: report of a locally advanced case and review of literature. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2015; 8:3282-3287. [PMID: 26045853 PMCID: PMC4440162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/25/2014] [Accepted: 01/10/2015] [Indexed: 06/04/2023]
Abstract
Lymphoepithelioma-like hepatocellular carcinoma is rare, which has been recognized as a variant of hepatocellular carcinoma. Here we report a locally advanced case of lymphoepithelioma-like hepatocellular carcinoma. A 50-year-old man with chronic hepatitis B virus infection presented with a single mass in the liver and two enlarged lymph nodes in retroperitoneum suspected to be hepatocellular carcinoma with lymph node metastasis. After discussion by multidisciplinary team, the patient underwent hepatectomy of VIII segment and dissection of two enlarged lymph nodes. One month after the operation, pre-chemotherapy abdominal computed tomography (CT) showed retroperitoneal enlarged lymph nodes, considered as local recurrence. Therefore, 3 cycles of oxaliplatin and tegafur gimeracil oteracil potassium capsule and 3 cycles of paclitaxel and cisplatin were offered, and post-chemotherapy abdominal CT revealed disease remained stable. The patient has been alive for 6 months since performance of surgery. Our report suggests that even locally advanced lymphoepithelioma-like hepatocellular carcinoma may have a good prognosis and operation and postoperative chemotherapy may benefit the patient.
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Affiliation(s)
- Song-Lin An
- Department of Surgical Oncology, Beijing Shijitan Hospital, The 9th Clinical Medical College of Peking University and Clinical Cancer Center of Capital Medical UniversityChina
| | - Li-Guo Liu
- Department of Hepatobiliary Surgery, China-Japan Friendship HospitalChina
| | - Yi-Ling Zheng
- Department of Abdominal Surgery, Cancer Hospital Chinese Academy of Medical SciencesChina
| | - Wei-Qi Rong
- Department of Abdominal Surgery, Cancer Hospital Chinese Academy of Medical SciencesChina
| | - Fan Wu
- Department of Abdominal Surgery, Cancer Hospital Chinese Academy of Medical SciencesChina
| | - Li-Ming Wang
- Department of Abdominal Surgery, Cancer Hospital Chinese Academy of Medical SciencesChina
| | - Li Feng
- Department of Abdominal Surgery, Cancer Hospital Chinese Academy of Medical SciencesChina
| | - Fa-Qiang Liu
- Department of Abdominal Surgery, Cancer Hospital Chinese Academy of Medical SciencesChina
| | - Fei Tian
- Department of Abdominal Surgery, Cancer Hospital Chinese Academy of Medical SciencesChina
| | - Jian-Xiong Wu
- Department of Abdominal Surgery, Cancer Hospital Chinese Academy of Medical SciencesChina
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Wei J, Liu Q, Wang C, Yu S. Lymphoepithelioma-like hepatocellular carcinoma without Epstein-Barr virus infection: A case report and a review of the literature. INDIAN J PATHOL MICR 2015; 58:550-3. [DOI: 10.4103/0377-4929.168857] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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23
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Primary biliary tract malignancies: MRI spectrum and mimics with histopathological correlation. ACTA ACUST UNITED AC 2014; 40:1520-57. [DOI: 10.1007/s00261-014-0300-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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