Lymphoepithelioma-Like Hepatocellular Carcinoma: Report of Three Cases and Review of Literature

Abstract

Lymphoepithelioma-like carcinomas (LELCs) are carcinomas which show histologic similarities to lymphoepithelioma (AKA nasopharyngeal carcinoma) and prominently feature a lymphoid-rich stroma with tumor-infiltrating lymphocytes. LELCs have been described in a number of different organ systems, are often associated with Epstein-Barr virus (EBV) infection, and have been reported to carry favorable prognoses when compared to classic carcinomas of these organ systems. LELCs of the liver are exceedingly rare. Here, we report three cases of lymphoepithelioma-like hepatocellular carcinoma (HCC) in one female and two male patients. All three carcinomas were composed of a population of malignant cells with focal to diffuse positivity for HepPar-1, as well as a prominent lymphoplasmacytic infiltrate intimately associated with the malignant cells. In two cases investigated by immunohistochemistry, the lymphoid population contained a prominent CD3 + T-cell population which consisted of CD4 + lymphocytes and CD8 + cytotoxic T cells, which also showed staining for T-cell intracellular antigen-1 (TIA-1). Chromogenic in situ hybridization for EBV-encoded RNA (EBER CISH) was negative in both the malignant cells and the lymphoid population in all three cases. Two patients who underwent surgical resection are alive without recurrence at 38 and 26 months after surgery. The third patient treated by chemoembolization died 31 months after the diagnosis. J Med Cases. 2015;6(7):297-303 doi: http://dx.doi.org/10.14740/jmc2106w