Lymphoepithelioma-Like Carcinoma of the Breast: Cytological and Histological Features and Review of the Literature

Abstract

Objective: We present, for the first time, the cytological features of lymphoepithelioma-like carcinoma (LELC) of the breast in preoperative fine-needle aspiration (FNA) and touch imprints from secondary deposits in the sentinel lymph node (SLN). Study Design: We report a case of a 53-year-old woman who was diagnosed with breast carcinoma on preoperative FNA and was subjected to SLN biopsy, partial mastectomy and axillary lymph node dissection. The final diagnosis was LELC of the breast. Cytological and histological features were analyzed. Results: The smears from preoperative FNA contained cohesive clusters and isolated tumour cells in a haemorrhagic background with scattered lymphocytes. Some of the clusters were infiltrated by the inflammatory cells. The cells had large, pleomorphic nuclei and scanty, ill-defined cytoplasm. The intraoperative touch imprints from the SLN were highly cellular, comprising abundant scattered lymphoid cells, among which were tight clusters of indistinct cells, about 3 times larger than the lymphocyte population. Conclusion: In our case, LELC shares many cytological features with LELC described in other organs. Immunostains with epithelial markers play an important role in establishing the epithelial nature of the neoplastic cells. LELC should be borne in mind in the evaluation of breast lesions with prominent lymphoid cell infiltration. Its cytological features, as presented, could contribute to its preoperative evaluation on cytological grounds.

Loss of Cellular Cohesion in Cytology Composes a Special Subgroup of Breast Tumors - Analysis of 37 Cases

“…These 3 cases had tumors <2 cm in diameter and may have been in the early phase of medullary carcinoma. For differential diagnosis, lymphoepithelioma-like carcinoma, permeated by many lymphocytes, may be considered, but in the case of lymphoepithelioma-like carcinoma, the tumor cells exhibit loose clusters and maintain cohesion [7]. …”

Lymphoepithelioma-like Carcinoma of the Breast: A Case Report

“…In 5 of the 21 cases reported in the literature, axillary lymph node metastasis was identified, in our patient metastases was not observed in 23 lymph nodes dissected from the axilla (1,(11)(12)(13)(14). Immunohistochemical staining results of 19 patients out of 21 reported cases in the literature are given in Table 2.…”

Lymphoepithelioma-like carcinoma of the breast

“…While LELC can occur in many organ systems, this entity rarely occurs in the breast. Kumar and Kumar ( 1 ) published the first instance of LELC of the breast in 1994, and since then fewer than 20 cases of this tumor have been documented in the literature ( 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 ). The age of initial presentation of the previous cases ranged from 37 to 69 years ( 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 ).…”

“…At this time, the etiology of LELC of the breast remains unknown. LELC tumor cells in other organ systems have been associated with varying degrees of Epstein-Barr virus (EBV) genome expression; however, there have been no documented cases of EBV detected in LELC of the breast ( 2 ).…”