CT findings and clinical features of Epstein–Barr virus-associated lymphoepithelioma-like gastric carcinoma

Abstract

Epstein–Barr virus (EBV)-associated lymphoepithelioma-like gastric carcinoma (LELGC) is a rare primary stomach tumor, which has overlapping imaging features with mass forming gastric carcinoma (GC). The aim of our study was to present the computed tomography (CT) findings and clinical features of EBV-associated LELGC to increase awareness of this entity. The CT findings and clinical features of 4 patients with pathologically documented EBV-associated LELGC were retrospectively analyzed. Among the 4 patients, 3 were male, and 1 was female. The medium age was 51 years old. All cases were single lesions including 1 was in the gastric cardia, 1 was in the gastric body, and 2 were in the gastric antrum. A focal thickening of the gastric wall was conducted, with a large thickness-to-length ratio. The low-density stripe of the normal gastric wall abruptly terminated at the edge of the lesion. The CT images of 4 cases showed inhomogeneous density with the radiodensity values ranging from 25 to 48 HU. In addition, an ulcer was demonstrated with an irregular base and slightly raised borders in all cases. Enhancement after injection of contrast material was heterogeneous enhancement (n = 3) or homogeneous (n = 1). After enhancement, obvious enhancement was seen in 1 case, moderate enhancement was seen in 3 cases, with the peak value of the tumor in the portal phase. No evidence of lymph node involvement and distant invasion was observed. Although LELGC is quite rare, it should be considered in differential diagnosis of early GC, advanced GC, and lymphoma. The relatively typical CT appearance, combined the age and sex of patients, can suggest the diagnosis of LELGC.

A computed tomography-based preoperative risk scoring system to distinguish lymphoepithelioma-like gastric carcinoma from non-lymphoepithelioma-like gastric carcinoma

“…CT features included location, enhancement pattern (gradual, continuous, and washed out), enhancement grade (mild, moderate, and obvious), homogeneous enhancement, ulcer appearance, circum wall involvement, and CT-defined lymph node status. The enhancement grade was evaluated based on CT attenuation ( 13 ). Thickness of tumor and CT attenuations at the non-contrast, arterial, and venous phases (CT non , CT artery , and CT venous ) were measured.…”

“…To the best of our knowledge, most previous related studies focused only on clinicopathological characteristics and few studies focused on CT characteristics. A previous study ( 13 ) in our medical center analyzed the CT features of four patients with LELGC, without control group with non-LELGC. Thus, we compared CT characteristics between patients with LELGC and non-LELGC, aiming to develop a preoperative risk scoring system to distinguish them.…”

Clinical value of miR-135 and miR-20a combined with multi-detector computed tomography in the diagnosis of gastric cancer

“…This study wants to further demonstrate from the facts [ 18 , 19 ]. Meanwhile, general CT scan has some limitations in detecting preoperative staging of GC, while multi-phase can by using MDCT that exhibits better effect in evaluating tumor size, depth of invasion, and extent of lymph node metastasis, which has been concerned about gradually by clinicians [ 20 ]. However, it still has disadvantage in the display of gastric wall structures [ 21 ].…”