Abstract
: Primary hepatic lymphoepithelioma-like carcinoma (LELC) is rare. Here we report a case of a 39-year-old woman who presented with abdominal pain and weight loss for one month. A space-occupying lesion was demonstrated in the left liver lobe by MRI. Further laboratory studies showed abnormal liver function tests. A partial hepatectomy including the lesion was performed, with clear margin. A well demarcated gray-white nodule was found, measuring 15 mm × 12 mm × 10 mm, with no satellite nodules. Microscopically, the tumor consisted of neoplastic cells arranged in nest and sheets, surrounded and infiltrated by abundant lymphoid tissue. Immunohistochemical analyses showed the tumor to be positive for CEA, CK7, CK19, and villin. The Ki-67 index was about 30%. In situ hybridization for EBER was positive. A comprehensive examination including EGD with extensive biopsies of the stomach did not reveal another lesion. Therefore, this represented a primary Epstein-Barr virus (EBV)-associated hepatic LELC. No recurrence was found followed up one year. Liver is a common target for metastasis, when a liver tumor with abundant lymphocytes infiltrated is found in adults with EBV positive, the possibility of metastatic carcinoma must be excluded before the tumor can be categorized as primary, and the possibility of EBV-related LELC should be considered.
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