EBV-associated lymphoepithelioma-like thyroid carcinoma with favorable outcome: case report with cytopathologic and histopathologic study

Abstract

BackgroundLymphoepithelioma-like carcinoma (LELC) is a rare entity among thyroid tumors. Based on the limited number of case reports that exist, the association of Epstein–Barr virus (EBV) with primary thyroid LELCs seems inconsistent.Case presentationWe present a confusing cytological case of lymphoepithelioma-like thyroid carcinoma with expression of EBV. The patient presented with a central neck mass and bilateral lymphadenopathy. Fine-needle aspiration cytology revealed three-dimensional and syncytial fragments of epithelioid cells accompanied by small lymphocytes. The surgical specimen of resected thyroid tumor disclosed typical histopathological features of LELC. Metastatic papillary carcinoma was also discovered in the metastatic lymph nodes. In situ hybridization for EBV-encoded RNA (EBER-ISH) was positive in the tumor cells. Negative immunoreactivity for TTF-1, Pax-8, and CD5 was observed. The patient is currently undergoing regular follow-up and is 1 year and 10 months postresection with no evidence of recurrence.ConclusionsLong-term survival is discussed in relation to this variant of thyroid carcinoma, which might differ in behavior from anaplastic carcinoma. Further investigation is required to elucidate the clinical significance of EBV expression and progression of this unique variant of thyroid carcinoma.

Primary pulmonary lymphoepithelioma-like carcinoma: a rare type of lung cancer with a favorable outcome in comparison to squamous carcinoma

“…Furthermore, in light of the major role of EBV in LELC, positive results of EBV infection by EBV detection was another evidence to support the diagnosis of LELC [21, 30]. Several studies revealed that all LELC tissues harbored EBER in-situ hybridization without exception [9, 31], but literature review by Dr. Luo demonstrated 73.98% positive rate of EBV infection (145/196), 21.43% negative rate and 4.59% unknown [12].…”

“…In contrary, the positive EBV detection in tumor tissues was removed either in univariate or multivariate analysis. EBV has been regarded as essential in LELC tumorigenesis, even though the underlying mechanism remains unknown [21, 22, 28, 30]. Circulating serum EBV DNA or EBV antibody has been proved to be found in nasopharyngeal, gastric LELC patients [3, 38].…”

Human Papillomaviruses and Epstein–Barr Virus Interactions in Colorectal Cancer: A Brief Review

“…EBV has also been associated with nasopharyngeal carcinomas, a distinct subtype of head and neck carcinoma with a prominent lymphoid component. Also, a particular type of primary colorectal cancer [119], lymphoepithelioma-like carcinoma (LEC) is morphologically similar to nasopharyngeal carcinoma [120] and is often associated with EBV infection [121][122][123]. Moreover, although rare, non-epithelial colorectal malignancies are also associated with EBV infection.…”

Papillary Thyroid Carcinoma With Lymphoepithelial Features and Lacking Association With Epstein-Barr Virus (EBV): A Rare Case

“…It has been previously termed intrathyroidal epithelial thymoma, primary thyroid thymoma or carcinoma of the thyroid showing thymuslike differentiation [10]. LELC is a subtype of thyroid carcinoma and shows morphology similar to undifferentiated carcinoma of nasopharynx and LELC of other sites [11].…”