Lymphoepithelioma-like carcinoma in liver not associated with Epstein-Barr virus: a report of 3 cases and literature review

Abstract

Background Lymphoepithelioma-like carcinoma is a rare distinctive variant of liver cancer with unique epidemiological and pathological characteristics, characterized by dense lymphocyte infiltration. It can be divided into lymphoepithelioma-like hepatocellular carcinoma and lymphoepithelioma-like intrahepatic cholangiocarcinoma. Existing research shows that the prognosis of this tumor is good. To date, only 101 cases have been reported. Case presentation The first patient was a 62-year-old Chinese man with hepatitis B virus infection who presented with a single lesion in the liver. The patient underwent surgical treatment and was discharged on the 4th day. The patient was diagnosed with combined lymphoepithelioma-like hepatocellular carcinoma and cholangiocarcinoma; he has been alive for 15 months. The second patient was a 63-year-old Chinese woman with right upper abdominal pain and hepatitis B virus infection. The imaging examination revealed a single lesion in the liver. The patient underwent surgical treatment and was discharged 1 week later. The patient was diagnosed with lymphoepithelioma-like hepatocellular carcinoma and was considered to have recurrence in the lymph nodes approximately 2 years after the operation. The patient underwent local radiotherapy; she has been alive for 60 months. The third patient was a 50-year-old Chinese man with hepatitis B virus infection who presented with a single lesion in the liver and two enlarged lymph nodes. The patient received liver puncture before surgery to indicate lymph node metastasis and experienced local recurrence after liver resection. The patient underwent chemotherapy and radiotherapy. The patient was diagnosed with lymphoepithelioma-like hepatocellular carcinoma. The patient was deceased at 24-month follow-up. Conclusions This article reports 3 cases without Epstein-Barr virus and reviews the current literature, which suggests even mixed pathological type or locally advanced cases of LELC with lymph node metastasis and postoperative recurrence should be actively treated for a longer survival period.

A Case of Lymphocyte-Rich Hepatocellular Carcinoma in a Patient Who Was Treated for Colon Cancer

“…7,10 To date, 67 cases of lymphocyte-rich HCC have been reported. 11 It has also been referred to as lymphoepithelioma-like HCC. 5,9,10 Histologic findings of this subtype are characterized by massive intratumoral infiltration of lymphocytes.…”

Pathologic and molecular features of hepatocellular carcinoma: An update

“…WHO defines LEL-HCC subtype as the condition in which lymphocytes outnumber pleomorphic neoplastic cells in most microscopic fields, but no clear cutoffs for lymphocyte number has been provided[ 10 ]. In contrast to LEL cholangiocarcinoma, which are frequently associated with EBV infection and are well described in literature, LEL-HCC are not associated with EBV infection and are not well characterized in literature[ 52 , 54 , 55 ]. Grossly, these are well circumscribed tumors with variable encapsulation.…”

Thymic Lymphoepithelial Carcinoma Associated with Epstein-Barr Virus: Experiences and Literature Review

“…Thymic LEC has the capacity to metastasize to other organs, including liver, lung, and bone, so that the prognosis is generally poor [ 5 , 6 ]. LEC has been reported in many other organs, including the oral, oropharyngeal, nasal, and paranasal sinus LECs [ 7 ], and LEC involving the lung, skin, cervix, gallbladder, bladder, mammary gland, gastric mucosa, breast, lungs, liver, skin, urinary bladder, and cervix has also been reported [ 8 , 9 , 10 , 11 , 12 , 13 , 14 ]. EBV has been detected in some of these LECs, indicating that EBV may be involved in carcinogenesis, even in LELC of many organs [ 3 , 4 , 10 , 11 , 12 , 13 , 14 ].…”

“…LEC has been reported in many other organs, including the oral, oropharyngeal, nasal, and paranasal sinus LECs [ 7 ], and LEC involving the lung, skin, cervix, gallbladder, bladder, mammary gland, gastric mucosa, breast, lungs, liver, skin, urinary bladder, and cervix has also been reported [ 8 , 9 , 10 , 11 , 12 , 13 , 14 ]. EBV has been detected in some of these LECs, indicating that EBV may be involved in carcinogenesis, even in LELC of many organs [ 3 , 4 , 10 , 11 , 12 , 13 , 14 ]. Other researchers have argued that EBV may also be associated with the metastasis of TLEC to these organs [ 3 , 4 ].…”