A case of pulmonary lymphoepithelioma-like carcinoma with epstein-barr virus infection

Abstract

Background. Pulmonary lymphoepithelioma-like carcinoma (LELC) is a rare tumor and development of the disease is thought to be involved with Epstein-Barr virus {EBV) infection. The majority of LELC is reported mostly in Asia, however, it is rarely seen in Japan. Case. A 73-year-old man presented with cold-like symptom and an abnormal shadow was found in the left lung. A computed tomography scan of the chest revealed an ill-defined round mass 2.5 cm in diameter, in left S8 or S9. Lung cancer was suspected from the result of preoperative bronchial lavage. Therefore, left lower lobectomy with partial removal of a lymph node (ND2a) was performed. Pathologically, the tumor was composed of nests of large malignant cells with marked lymphocyte and plasma cell infiltration. The histopathological diagnosis was LELC, pTINOMO {stage IA). The EBV antibody titer in serum obtained preoperatively was positive and quantitative analysis of EBV by real-time PCR was also positive. Conclusion. Involvement of EBV infection in this case of LELC was confirmed using ISH method and realtime PCR. A review of the literature showed that only 9 cases of LELC, including the present case, have been reported so far in Japan and 7 of them were positive for EBV infection. © 2009 The Japan Lung Cancer Society.