Lymphoepithelioma-Like Carcinoma of the Colon

Abstract

A 70-year-old female underwent follow-up colonoscopy after colonic polypectomy. The colonoscopy revealed the presence of a 7-mm submucosal tumor in the sigmoid colon. The tumor surface was smooth and covered with normal mucosa. It was diagnosed as a submucosal tumor, and polypectomy was performed. Histopathological examination of the resected specimen revealed moderately to poorly differentiated adenocarcinoma measuring 2 × 5 × 3 mm with marked peritumoral lymphocytic infiltration and lymphoid follicle formation. It was diagnosed as carcinoma with lymphoid stroma (lymphoepithelioma-like carcinoma), SM (1,800 μm), ly2, v0, budding; grade 1. We confirmed the indication for noncurative additional surgical resection and performed laparoscopic sigmoid colectomy. No metastases were observed in the dissected lymph nodes.

<p>A Rare Case of Moderately Differentiated Adenocarcinoma With PD-L1 Overexpression and a Heterogeneous LELC Component in the Ascending Colon</p>

“…prominent nucleoli; however, the findings of a syncytial growth pattern of undifferentiated malignant epithelial cells and ill-defined borders were obscure and suggested that the tumor was strictly but slightly different from typical UNPC findings. However, some cases of LELC being reported for CRC have shown findings similar to those observed in our case, 2,8 and diagnostic criteria regarding CRC may broaden. Chetty 16 reported that gastric medullary carcinoma demonstrates a syncytial growth pattern, bears robust peritumoral inflammation, and has a well-defined border, while lymphoepithelioma-like carcinoma is formed by small clusters of cells that "do not correspond to the syncytial growth patterns seen in medullary carcinoma" and has more prominent intratumoral inflammation and an infiltrative border.…”

“…19 However, to our knowledge, regarding CRC, only eight cases of LELC have been sporadically reported in the English literature. [1][2][3][4][5][6][7][8] Colorectal LELCs as well as LELCs of other organs have been reported to be clinically less aggressive. To date, all colorectal LELCs have been reported to have homogenous histological features.…”

“…1 However, reports of LELCs derived from the colorectum are extremely rare, and we found only eight reports to date, all of which were consistent with LELC findings for the whole lesion. [1][2][3][4][5][6][7][8] LELCs are also known to be relatively weakly aggressive in the clinic and have a high survival rate despite their poorly differentiated features, 9,10 and similar characteristics have also been reported in previous colorectal cancers (CRCs) with LELC. The interaction between programmed death 1 (PD-1) and programmed death ligand-1 (PD-L1) is one of the most important costimulatory signals; its mediated immunosuppression is an important part of the dynamic immune system balance because it limits the immune response and prevents autoimmune disease.…”

A case of poorly differentiated adenocarcinoma with lymphoid stroma originated in the ascending colon diagnosed as lymphoepithelioma-like carcinoma

“…EBV is associated with 5-20% of gastric carcinomas worldwide [7][8][9]; however, more than 80% of LELCs of the stomach have been found to be related to EBV infection [10] in comparison to only approximately 6-7% of non-LELC [11]. With regards to colorectal LELC, thus far only 10 cases have been reported, including our case [12][13][14][15][16][17][18][19][20] (Table 1). According to previous case reports, LELC of the large intestine is diagnosed based on the pathological similarity to LELC of other organ.…”

A Rare Submucosal Tumor of The Colon

“…1 More than 80% of gastric LELC were associated with an EBV infection, but the association between EBV and colorectal LELC was obscure, with only 1 EBV-positive case reported. 1 The tumors with microsatellite instability could also recruit tumor-infiltrating lymphocytes, and a colorectal LELC in a patient with Lynch syndrome had been reported before. 2 However, submucosal tumor-like colorectal carcinoma associated with Lynch syndrome was indeed a rare presentation.…”