Lymphoepitelioma-like hepatocellular carcinoma: A case report and a review of the literature

Nemolato, Sonia; Fanni, Daniela; Naccarato, Antonio Giuseppe; Ravarino, Alberto; Bevilacqua, Generoso; Faa, Gavino

doi:10.3748/wjg.14.4694

Cited by 47 publications

(48 citation statements)

References 21 publications

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“…The mean tumor size was stated as 22.2 mm by Wada et al 34 in their series of 11 cases. For the remaining 9 cases, the tumor size ranged from 1 to 5 cm, 32,35,[37][38][39] whereas it was 1.3 to 10.5 cm in our study. The underlying liver disease was hepatitis C virus (HCV)-related cirrhosis in 6 of 20 cases reported so far, 32,34,35,37 hepatitis B virus (HBV)-related cirrhosis in 3 cases, 35,39 and familial hemochromatosisrelated cirrhosis in 1 case, 35 and the remaining 2 cases had no underlying liver disease.…”

Section: Discussionmentioning

confidence: 87%

“…The underlying liver disease was hepatitis C virus (HCV)-related cirrhosis in 6 of 20 cases reported so far, 32,34,35,37 hepatitis B virus (HBV)-related cirrhosis in 3 cases, 35,39 and familial hemochromatosisrelated cirrhosis in 1 case, 35 and the remaining 2 cases had no underlying liver disease. 35,38 A total of 5 of 11 patients reported on by Wada et al 34 showed HCV seropositivity but no evidence of cirrhosis on histopathologic examination, and 2 of 5 patients reported on by Emile et al 35 showed both HBV and HCV cirrhosis. Our series was striking in its absence of viral markers, cirrhosis, or any other underlying liver disease in all 8 patients.…”

Section: Discussionmentioning

confidence: 99%

“…35 Our study involves 8 North American patients and is the first to comprehensively review the histopathologic, immunophenotypic, viral, and clinicopathologic characteristics of this tumor. Combining the 20 cases of LEL-HCC from different parts of the world reported so far in the literature, the age of the patients has ranged from 39 to 77 years, and there is a male predominance, with a male to female ratio of 17:3, 32,34,35,[37][38][39] as there is in all other forms of HCC. Interestingly, our study population was older, with an age range of 57 to 78 years, and the male to female ratio was distinctly reversed at 1:3.…”

Section: Discussionmentioning

confidence: 99%

“…Among the cases reported so far, the race was unknown in 14 cases, 5 patients were white, and 1 was Hispanic. 32,34,35,[37][38][39] All of the patients in our study were white. The mean tumor size was stated as 22.2 mm by Wada et al 34 in their series of 11 cases.…”

Section: Discussionmentioning

confidence: 99%

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Characterization of Inflammatory (Lymphoepithelioma-like) Hepatocellular Carcinoma: A Study of 8 Cases

Patel

Liu

Vaccharajani

et al. 2014

Archives of Pathology &Amp; Laboratory Medicine

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Context.-The World Health Organization has recently recognized lymphoepithelioma-like carcinoma, or inflammatory hepatocellular carcinoma, as a variant of hepatocellular carcinoma.Objective.-To identify and characterize the inflammatory hepatocellular carcinomas in our institution from 1988 to the present.Design.-All cases of hepatocellular carcinoma in our institution from 1988 to the present were reviewed and reclassified as lymphoepithelioma-like carcinoma and were studied in comparison to appropriately matched controls.Results.-Among the 8 cases of lymphoepithelioma-like carcinoma identified, the male to female ratio was 1:3, the mean age was 68.5 years (range, 57-78 years), and all of the cases were seen in noncirrhotic livers. The average numbers of lymphocytes were significantly higher in the cases than in the controls. T cells were predominant, with a uniform distribution of CD4 and CD8 positive cells. Cholangiolar differentiation was seen by K19 positivity as focal in 1 case and diffuse in 2 cases. In situ hybridization for Epstein-Barr virus was negative in all of the cases. Diffuse overexpression of p16 (.75% of cells) was seen in 2 cases, both of which were negative for the presence of transcriptionally active human papilloma virus by in situ hybridization. In our series, 3 of 8 cases (37.5%) showed local recurrence, which was similar to the controls (6 of 18; 33%), P . .99. Although the rate of distant metastases was lower among the cases (12.5%) than the controls (22.2%), the difference was not statistically significant (P . .99).Conclusion.-We present the first series of 8 cases of lymphoepithelioma-like carcinoma of the liver occurring in patients without cirrhosis and with a female preponderance and the absence of Epstein-Barr virus. Although clinical outcomes were similar to those of controls in our small series, additional data may be required for confirmation.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Characterization of Inflammatory (Lymphoepithelioma-like) Hepatocellular Carcinoma: A Study of 8 Cases

Patel

Liu

Vaccharajani

et al. 2014

Archives of Pathology &Amp; Laboratory Medicine

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“…Lymphoepithelioma-like carcinoma has been reported in a variety of anatomic sites that include skin [13][14][15][16] , lacrimal and salivary glands 17,18 , thyroid gland 19 , thymus 20 , breast 3 , lung 21 , esophagus 22 , stomach 23 , colon 24 , hepatobiliary system 25,26 , renal pelvis [27][28][29][30] , ureter 28 , kidney 27 , bladder 31 , prostate 27 , uterine cervix 32 , vulva 33,34 , and vagina 35 . The foregoing sites typically have better outcomes than are seen with aggressive nasopharyngeal tumours; however, they do demonstrate the potential for local spread, angioinvasion, and metastasis to lymph nodes.…”

Section: Discussionmentioning

confidence: 99%

Lymphoepithelioma-Like Carcinoma of the Breast: A Diagnostic and Therapeutic Challenge

et al. 2012

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also present an overview of our patient's proposed treatment in the context of the 16 other reported lelc cases. CASE PRESENTATIONA 55-year-old postmenopausal woman originally from Ghana presented with a 4-week history of left breast tenderness and an upper outer quadrant mobile breast mass. She had been mammographically screened, with the most recent mammogram (performed 1 year before her presentation) having demonstrated no abnormalities. Her past medical history was unremarkable, with a surgical history of Cesarean section, tubal ligation, and hernia repair. She was gravida 2, para 2, with menopause having occurred at age 53. On systems review, she denied fevers, chills, or night sweats. No weight loss was reported, and she was asymptomatic but for left breast tenderness.Physical examination revealed no cervical or axillary adenopathy, but was significant for a diffusely swollen left breast with a discrete, mobile 4-cm mass. The exam was otherwise noncontributory.Mammography revealed a 3-to 4-cm upper outer quadrant density with spot compression views showing lobulated margins. No evidence of calcifications was noted. Breast ultrasonography showed a 4.3×3.5×2.6-cm lobulated, poorly marginated, hypoechoic solid mass. Computed tomography of the thorax, abdomen, and pelvis showed no evidence of distant metastases and the presence of an 8-cm left breast mass with a uniform low-density component (Figure 1).Fine-needle aspirate yielded a cellular specimen noteworthy for single and groups of abnormal elongated cells with visible nucleoli presenting together with lymphocytes and plasma cells. A bone marrow biopsy revealed normocellular marrow with no evidence of lymphoproliferative disorder.An excisional biopsy was followed by 3 successive pathology reviews. The initial consultant ABSTRACTWe present a patient with lymphoepithelioma-like carcinoma (lelc) of the breast whose diagnosis is illustrative of the pathology nuances that must be taken into account to successfully reach correct identification of the disease. We also present an overview of our patient's proposed treatment in the context of 16 other reported lelc cases. Although lelc cases are rare, a sufficient number have been reported to discern the natural history of this pathologic entity and to undertake a review of those cases and of the application of oncologic first principles in their management. Given the potential for locoregional spread and distant metastases in lelc, adjuvant therapy has a role in the treatment of this entity.

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Programmed cell death ligand 1 expression in a case of poorly differentiated lymphocyte‐rich hepatocellular carcinoma

Omori

Osuga

Miyanishi

et al. 2021

Clinical Case Reports

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Lymphoepitelioma-like hepatocellular carcinoma: A case report and a review of the literature

Cited by 47 publications

References 21 publications

Characterization of Inflammatory (Lymphoepithelioma-like) Hepatocellular Carcinoma: A Study of 8 Cases

Characterization of Inflammatory (Lymphoepithelioma-like) Hepatocellular Carcinoma: A Study of 8 Cases

Lymphoepithelioma-Like Carcinoma of the Breast: A Diagnostic and Therapeutic Challenge

Programmed cell death ligand 1 expression in a case of poorly differentiated lymphocyte‐rich hepatocellular carcinoma

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