3例EBV相关性淋巴上皮瘤样癌临床病理学分析

EBV-associated lymphoepithelioma-like carcinoma: a clinicopathological analysis of three cases

目的 探讨胃部、肺部及鼻咽部的淋巴上皮瘤样癌的临床病理特征、治疗方法及预后情况。方法 回顾性分析南方医科大学附属小榄医院病理科2016-04—2020-10诊断的3例淋巴上皮瘤样癌,对其临床资料及病理学特征进行分析,以深入理解这种类型的恶性肿瘤。结果 3例淋巴上皮瘤样癌患者中,1例为女性,2例为男性,年龄分别为51、56、72岁。3例淋巴上皮瘤样癌分别发生在胃部、肺部、鼻咽部。免疫组织化学染色广谱角蛋白(CK-P)、细胞角蛋白5/6(CK5/6)、P63、P40、P53均阳性,细胞角蛋白7(CK7)、细胞角蛋白20(CK20)均阴性,甲状腺转录因子-1(TTF-1)及尾型同源盒转录因子2(CDX-2)阴性,间质反应性淋巴细胞表达CD4、CD8、CD20。EB病毒编码的小RNA(EBER)原位杂交检测3例阳性。结论 淋巴上皮瘤样癌是一种罕见但特殊的肿瘤,与EB病毒的感染有有关,具有独特的临床病理学特征,预后相对较好,但由于其发病率低,为明确其生物学特性及最佳治疗方法,须进一步研究。

Objective Lymphoepithelioma-like carcinoma is a rare type of epithelioid tumor, most of which originates in the nasopharynx. Lymphoepithelioma-like carcinoma of the stomach and lung is rare. The purpose of this study was to investigate the clinicopathological features, treatment and prognosis of lymphoepitheliomatoid carcinoma of the stomach, lung and nasopharynx. Methods Three cases of lymphoepithelioma-like carcinoma diagnosed in the Department of Pathology, Xiaolan Hospital Affiliated to Southern Medical University from April 2016 to October 2020 were retrospectively analyzed, and their clinical data and pathological characteristics were analyzed to further understand this type of malignant tumor. Results Among three cases, one case was female and two cases were male, aged 51, 56, and 72 years, respectively. Three cases of lymphoepithelioma-like carcinoma occurred in stomach, lung and nasopharynx. Immunohistochemical staining was positive for CK-P, CK5/6, P63, P40 and P53;negative for CK7 and CK20, negative for TTF-1 and CDX-2;CD4, CD8 and CD20 were expressed in interstitial reactive lymphocytes. In situ hybridization of small RNA encoded by Epstein-Barr virus was positive for three cases. Conclusion Lymphoepithelioma-like carcinoma is rare but specific tumor associated with Epstein-Barr virus infection. It has unique clinicopathological features and a relatively good prognosis. However, due to its low incidence, further studies are needed to determine its biological characteristics and the optimal treatment.