Lymphoepithelioma-like esophageal carcinoma with macroscopic reduction

Abstract

Esophageal lymphoepithelioma-like carcinoma (LELC) is extremely rare. We report the first case of esophageal LELC showing macroscopic reduction. A 67-year-old male presented with dysphagia and, by endoscopic examination, was found to have a significantly raised tumor of 10 mm in diameter in the thoracic esophagus. The biopsied material showed esophageal cancer. We performed endoscopic submucosal dissection. However, the tumor became flattened, similar to a scar, in only 2 mo. Histologically, the carcinoma cells had infiltrated the submucosal layer. Prominent infiltration of T lymphoid cells that stained positive for CD8 was observed around the carcinoma cells. Therefore, this lesion was considered to be an LELC with poorly differentiated squamous cells. Because the margin was positive, an esophagectomy was performed. Carcinoma cells were detected in the neck in one lymph node. The staging was T1N0M1b. However, the patient has been well, without adjuvant therapy or recurrence, for more than 5 years.

A case study of rare lympho-epithelioma like esophageal carcinoma

“…While the histologic features are similar, clinical presentation, age, sex, stage at presentation, size, and overall survival vary dramat ically between sites. LELC has a better prognosis compared to conventional gastrointestinal adenocarcinoma [9].…”

“…The stomach is the most common site for gastrointestinal LELC; however, esophageal involvement is occasionally observed [8]. In the stomach and breast, undifferentiated medullary carcinoma with lymphoid infiltration has been shown to have a good prognosis [9]. Esophageal LELC are primarily submucosal lesions with nor mal-appearing epithelial coverage and rarely can have polyp oid, ulcerative, or reddish mucosal irregularity [8].…”

Therapeutic applications of the selective high affinity ligand drug SH7139 extend beyond non-Hodgkin’s lymphoma to many other types of solid cancers

“…While there have been numerous reports of HLA-DR expression by melanomas [21,[55][56][57][58], cervical [59][60][61][62], ovarian [63][64][65][66][67][68] prostate [19,[69][70][71][72][73], liver [74][75][76][77], kidney [18,78], bone [79], breast [80][81][82][83][84][85], esophageal [86][87][88][89], head and neck [90][91][92], bladder [93][94][95][96], colorectal [97][98][99][100][101], lung [102][103]…”

“…While there have been numerous reports of HLA-DR expression by melanomas [ 21 , 55 – 58 ], cervical [ 59 – 62 ], ovarian [ 63 – 68 ] prostate [ 19 , 69 – 73 ], liver [ 74 – 77 ], kidney [ 18 , 78 ], bone [ 79 ], breast [ 80 – 85 ], esophageal [ 86 – 89 ], head and neck [ 90 – 92 ], bladder [ 93 – 96 ], colorectal [ 97 – 101 ], lung [ 102 – 105 ], pancreatic [ 106 ], larynx [ 107 – 109 ], gastric [ 110 – 113 ], glioma [ 114 – 116 ], and thyroid [ 117 – 120 ] cancers, these MHC class II proteins have not been adequately evaluated as potential targets in the treatment of non-hematological cancers. Although it is not entirely clear why tumors derived from tissues of non-lymphoid origin express HLA-DR, the predominant theory for which there is a great deal of experimental support suggests this expression can be initiated in response to tumor infiltration by lymphocytes, macrophages or dendritic cells [ 84 , 96 ] and the release of cytokines [ 84 , 121 ] during the inflammation that often accompanies tumor growth and the progression of the disease.…”