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Miyama Y, Kato T, Sato M, Yabuno A, Hasegawa K, Yasuda M. Cervical lymphoepithelioma-like carcinoma with deficient mismatch repair and loss of SMARCA4/BRG1: a case report and five related cases. Diagn Pathol 2024; 19:6. [PMID: 38178127 PMCID: PMC10765828 DOI: 10.1186/s13000-023-01429-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 12/13/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND We encountered a cervical lymphoepithelial carcinoma (LEC) possessing a predominantly solid architecture with deficient mismatch repair (dMMR) and loss of expression of the SWI/SNF (SWItch/Sucrose Non-Fermentable) chromatin remodeling complex subunit. This is the first case report of LEC with dMMR and loss of SWI/SNF complex subunit. CASE PRESENTATION A 34-year-old woman presented at our hospital with menstrual irregularities and abnormal vaginal bleeding. Magnetic resonance imaging revealed an exophytic mass in the posterior uterine cervix. Biopsy specimens confirmed squamous cell carcinoma with a 2018 International Federation of Gynecology and Obstetrics (FIGO) uterine cervical cancer stage of IB2. In a subsequent conization specimen, the tumor appeared exophytic. Microscopically, the tumor cells formed a predominant solid architecture. Abundant lymphocytic infiltration was observed. The pathological diagnosis indicated human papillomavirus (HPV)-associated squamous cell carcinoma with LEC pattern and pT1b2. Immunohistochemically, high programmed death-ligand 1 (PD-L1) expression, dMMR, and loss of the switch/sucrose non-fermentable family-related, matrix-associated, actin-dependent regulator of chromatin subfamily member 4 (SMARCA4)/BRG1, an SWI/SNF complex subunit, were observed. The patient underwent a radical hysterectomy and is alive without disease one year and five months later. Our analysis of five additional LEC cases revealed a consistent association with high-risk HPV and elevated PD-L1 expression. In addition to the present case, another patient exhibited dMMR. The SWI/SNF complex was retained except in the present case. The prognosis was favorable in all cases. CONCLUSIONS This unique case of LEC with dMMR suggests a distinct clinical entity with potential immunotherapy implications. Analysis of the other five LEC cases revealed that LEC was immune hot, and immune checkpoint inhibitors may be effective. The two dMMR cases showed loss of MLH1 and PMS2 expressions, and prominently high tumor PD-L1 expression. In those cases, dMMR might have contributed to the morphological characteristics of LEC.
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Affiliation(s)
- Yu Miyama
- Department of Pathology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama, 350-1298, Japan.
| | - Tomomi Kato
- Department of Pathology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama, 350-1298, Japan
| | - Masayasu Sato
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama, 350-1298, Japan
| | - Akira Yabuno
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama, 350-1298, Japan
| | - Kosei Hasegawa
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama, 350-1298, Japan
| | - Masanori Yasuda
- Department of Pathology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama, 350-1298, Japan
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Kim SH, Yoon HJ, Lee NK, Choi KU, Kim KH, Suh DS. A fertility-sparing surgery in lymphoepithelioma-like carcinomas of the uterine cervix: A case report. Medicine (Baltimore) 2022; 101:e31579. [PMID: 36397341 PMCID: PMC9666136 DOI: 10.1097/md.0000000000031579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION A poorly differentiated lymphoepithelioma-like carcinoma (LELC) of the cervix is an extremely rare presentation. We herein present an unusual case of LELC of the cervix, which was treated with radical trachelectomy for fertility preservation. PATIENT CONCERNS A 28-year-old female patient presented with a 1-month-history of post-coital vaginal bleeding, and a 2 cm tumor was found on gynecological sonography and magnetic resonance imaging. DIAGNOSIS The final pathological examination established a conclusive diagnosis of LELC of the cervix. After surgery, the patient was finally diagnosed as The International Federation of Gynecology and Obstetrics (FIGO) stage IB1 with no vaginal wall or parametrium infiltration. INTERVENTIONS Subsequently, a surgery was scheduled, and intraoperatively, we performed resection twice because of a frozen biopsy result that was resection margin-positive initially. As a result, further resection was performed, which was a 5mm thickness for each. Cisplatin adjuvant chemotherapy was administered 3 weeks after the operation to prevent recurrence. OUTCOMES The patient has been followed for 1 year postoperatively, with an adjuvant treatment, with no evidence of tumor recurrence or metastasis. CONCLUSION Based on this case, we highly recommend that operators should consider a deeper resection margin range than that visible on magnetic resonance imaging. More attention is needed to better understand the treatment method for LELC of the cervix. We also plan to closely monitor the patient's prognosis and fertility, and to conduct additional studies.
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Affiliation(s)
- So Hee Kim
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Hyung Joon Yoon
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Nam Kyung Lee
- Department of Radiology, Pusan National University School of Medicine, Busan, South Korea
| | - Kyung Un Choi
- Department of Pathology, Pusan National University School of Medicine, Busan, South Korea
| | - Ki Hyung Kim
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Dong Soo Suh
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Pusan National University School of Medicine, Busan, Republic of Korea
- *Correspondence: Dong Soo Suh, Department of Obstetrics and Gynecology, Pusan National University School of Medicine, 49241 Busan, South Korea (e-mail: )
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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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Vranic S, Cyprian FS, Akhtar S, Al Moustafa AE. The Role of Epstein-Barr Virus in Cervical Cancer: A Brief Update. Front Oncol 2018; 8:113. [PMID: 29719817 PMCID: PMC5913353 DOI: 10.3389/fonc.2018.00113] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 03/29/2018] [Indexed: 12/19/2022] Open
Abstract
Epstein–Barr virus (EBV) belongs to the group of gamma-herpes viruses and was the first recognized human oncovirus. EBV is responsible for infectious mononucleosis and multiple lymphoid and epithelial malignancies including B-cell lymphomas (Burkitt lymphoma, Hodgkin lymphoma, and post-transplant lymphoproliferative disorder), various T-cell/NK lymphoproliferative disorders, nasopharyngeal carcinoma, and gastric carcinoma, respectively. In addition, the presence of EBV has been documented in other cancers including breast, prostate, oral, and salivary gland carcinomas. The presence and role of EBV in cervical cancer and its precursor lesions (CIN) have also been described, but the results from the literature are inconsistent, and the causal role of EBV in cervical cancer pathogenesis has not been established yet. In the present review, we briefly surveyed and critically appraised the current literature on EBV in cervical cancer and its variants (lymphoepithelioma-like carcinoma) as well as its precursor lesions (CIN). In addition, we discussed the possible interactions between EBV and human papilloma virus as well as between EBV and immune checkpoint regulators (PD-L1). Though further studies are needed, the available data suggest a possible causal relationship between EBV and cervical cancer pathogenesis.
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Affiliation(s)
- Semir Vranic
- College of Medicine, Qatar University, Doha, Qatar
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Lymphoepithelioma-like carcinoma of the uterine cervix. Obstet Gynecol Sci 2017; 60:118-123. [PMID: 28217683 PMCID: PMC5313355 DOI: 10.5468/ogs.2017.60.1.118] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 07/20/2016] [Accepted: 07/21/2016] [Indexed: 11/23/2022] Open
Abstract
Lymphoepithelioma-like carcinoma (LELC) of the uterine cervix is exceedingly uncommon. We herein report a rare case of cervical LELC. A 45-year-old woman was admitted to gynecology department with vaginal bleeding for one month. Liquid-based cytology revealed atypical endometrial cells, not otherwise specified on her cervix. On a hysteroscopy, an endocervical mass was identified and the pathologic result was consistent with poorly differentiated squamous cell carcinoma. Magnetic resonance imaging and positron emission tomography with 2-deoxy-2-[fluorine-18] fluoro-D-glucose integrated with computed tomography revealed a 3.1-cm endocervical mass without distant metastasis or enlarged lymph nodes. The International Federation of Gynecology and Obstetrics stage was IB1. A radical hysterectomy and bilateral pelvic lymph node dissection were performed. The pathologic diagnosis was a poorly differentiated carcinoma, showing features of LELC. She has been followed for 8 months without adjuvant treatment since the surgery, during which time there has been no evidence of tumor recurrence or metastasis.
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Morteza Abedi S, Salama S, Alowami S. Lymphoepithelioma-like carcinoma of the skin: case report and approach to surgical pathology sign out. Rare Tumors 2013; 5:e47. [PMID: 24179659 PMCID: PMC3804822 DOI: 10.4081/rt.2013.e47] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 05/13/2013] [Accepted: 05/15/2013] [Indexed: 02/08/2023] Open
Abstract
Lymphoepithelioma-like carcinoma of the skin (LELCS) is a rare and poorly differentiated variant of squamous cell carcinoma. The lesion is histologically identical to undifferentiated nasopharyngeal carcinoma (lymphoepithelioma), but with Epstein-Barr virus involvement documented rarely. The first case of LELCS was described in 1988 by Swanson et al. and since there has been less than a total of 60 cases documented. This case review discusses a 87 year old man who presented to his primary care physician with a 2.5 cm solitary ulcerated nodular lesion on his right chest for two weeks. The patient ultimately had the lesion excised and sent for histological examination. The microscopic examination, ancillary studies used and differential diagnosis considered are discussed in detail in the following report. This case review aims to provide insight and approach to a rare cutaneous neoplasm, with the conclusions supporting a theory that LELCS is a separate entity from lymphoepithelioma.
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Affiliation(s)
- Syed Morteza Abedi
- Department of Pathology and Molecular Medicine, McMaster University , Hamilton, Ontario, Canada
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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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8
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Saroha V, Gupta P, Singh M, Dhingra K, Khurana N. Lymphoepithelioma-like carcinoma of the cervix. J OBSTET GYNAECOL 2010; 30:659-61. [DOI: 10.3109/01443615.2010.500421] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Does Epstein-Barr Virus Play a Role in Lymphoepithelioma-like Carcinoma of the Uterine Cervix? Int J Gynecol Pathol 2009; 28:279-85. [DOI: 10.1097/pgp.0b013e31818fb0a9] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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10
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Takai N, Nakamura S, Goto K, Hayashita C, Kira N, Urabe S, Narahara H, Matsumoto H. Lymphoepithelioma-like carcinoma of the uterine cervix. Arch Gynecol Obstet 2009; 280:725-7. [DOI: 10.1007/s00404-009-0993-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2008] [Accepted: 02/05/2009] [Indexed: 10/21/2022]
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Kohrenhagen N, Eck M, Höller S, Dietl J. Lymphoepithelioma-like carcinoma of the uterine cervix: absence of Epstein-Barr virus and high-risk human papilloma virus infection. Arch Gynecol Obstet 2007; 277:175-8. [PMID: 17674013 DOI: 10.1007/s00404-007-0427-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2007] [Accepted: 07/05/2007] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Lymphoepithelioma-like carcinoma (LELC) is a rare variant of squamous cell carcinoma of the uterine cervix. In contrast to Asian women, Caucasian women have a low prevalence of cervical LELC with no infection of the Epstein-Barr virus (EBV) and sporadic appearances of human papilloma viruses (HPV) in Caucasian women. CASE We report a 36-year-old female Caucasian patient with LELC of the cervix. RESULT In contrast to the present studies, our case of LELC of the cervix is not associated with EBV or high-risk HPV appearances. CONCLUSION This is the first study, that showed no relationship between LELC of the uterine cervix with EBV and high-risk HPV infections in a Caucasian woman.
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Affiliation(s)
- N Kohrenhagen
- Department of Obstetrics and Gynecology, University of Wuerzburg, Josef-Schneider-Str. 4, 97080, Wuerzburg, Germany.
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12
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Rettenmaier MA, Goldstein BH, Stallman JM, Brown JV, Micha JP. Lymphoepithelial Carcinoma of the Cervix: Review and Treatment Course. J Gynecol Surg 2005. [DOI: 10.1089/gyn.2005.21.185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Mark A. Rettenmaier
- Gynecologic Oncology Associates, Hoag Memorial Hospital Cancer Center, Newport Beach, CA
| | - Bram H. Goldstein
- Gynecologic Oncology Associates, Hoag Memorial Hospital Cancer Center, Newport Beach, CA
| | - Janet M. Stallman
- Hoag Memorial Hospital Presbyterian, Department of Pathology, Newport Beach, CA
| | - John V. Brown
- Gynecologic Oncology Associates, Hoag Memorial Hospital Cancer Center, Newport Beach, CA
| | - John P. Micha
- Gynecologic Oncology Associates, Hoag Memorial Hospital Cancer Center, Newport Beach, CA
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Bais AG, Kooi S, Teune TM, Ewing PC, Ansink AC. Lymphoepithelioma-like carcinoma of the uterine cervix: absence of Epstein–Barr virus, but presence of a multiple human papillomavirus infection. Gynecol Oncol 2005; 97:716-8. [PMID: 15863191 DOI: 10.1016/j.ygyno.2005.01.016] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2004] [Revised: 01/09/2005] [Accepted: 01/13/2005] [Indexed: 11/27/2022]
Abstract
BACKGROUND Cervical lymphoepithelioma-like carcinoma (LELC) is a rare variant of squamous cell carcinoma of the cervix. Association with Epstein-Barr virus (EBV) is still controversial. EBV has been demonstrated in Asian women with cervical LELC. In Western women, human papillomavirus (HPV) might play a role in the etiology. CASE We describe a 44-year-old Caucasian woman with a lymphoepithelioma-like carcinoma of the cervix without EBV, but in the presence of multiple HPV infection. CONCLUSION Our case supports a possible different pathway of development of cervical LELC in Western women as compared to Asian women.
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Affiliation(s)
- Aagje G Bais
- Department of Obstetrics and Gynaecology, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
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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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Martorell MA, Julian JM, Calabuig C, García-García JA, Pérez-Vallés A. Lymphoepithelioma-like carcinoma of the uterine cervix. Arch Pathol Lab Med 2002; 126:1501-5. [PMID: 12456211 DOI: 10.5858/2002-126-1501-llcotu] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT It has been proposed that Epstein-Barr virus (EBV) plays a role in the etiology of lymphoepithelioma-like carcinoma (LELC) in diverse anatomic locations. In contrast to Asian women, Western women have a low prevalence of LELC of the uterine cervix, and EBV genomes have not been identified. OBJECTIVE To assess the presence of EBV in LELC of the uterine cervix in 4 white Western women. DESIGN We collected 4 cases of LELC of the uterine cervix between 1990 and 2000. We performed histologic and immunohistochemical analyses of formalin-fixed, paraffin-embedded tumor samples. We amplified tumor DNA with polymerase chain reaction to detect EBV, human papillomavirus, and simian virus 40 DNAs. RESULTS Immunohistochemically, tumor cells were positive for cytokeratins and showed strong expression of p53 and MIB-1. Staining for the oncoprotein c-Erb-B2 was focally positive, and staining for Bcl-2 and progesterone receptors was negative. Only one case showed focal nuclear staining for estrogen receptors. All cases had a dense infiltrate of mature lymphocytes expressing T-cell antigens CD45RO, CD3, and CD8. Polymerase chain reaction analysis did not detect EBV, human papillomavirus, or simian virus 40 DNA sequences in any of the 4 cases. One case had positive serologic results for anti-EBV antibodies, indicating a mild or chronic infection. CONCLUSIONS LELC of the uterine cervix shows the immunohistochemical profile of an aggressive tumor in spite of its good prognosis, in which CD8 cytotoxic suppressor lymphocytes could play an important role. Based on our results, the role of EBV, human papillomavirus, or simian virus 40 in the pathogenesis of LELC of the uterine cervix in Western women remains unclear.
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Affiliation(s)
- Miguel A Martorell
- Servicio Anatomía Patológica, Hospital General Universitario, Valencia, Spain.
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