Abstract
BackgroundPrimary pulmonary lymphoepithelioma-like carcinoma (LELC) is a rare tumor and often misdiagnosed as squamous carcinoma. In the current study, clinical characteristics and outcome of primary pulmonary LELC were systematically compared with pulmonary squamous carcinoma.MethodsForty-two cases of primary pulmonary LELC and 134 squamous carcinomas were enrolled retrospectively. Characteristic and prognosis difference between the two groups was compared, and the independent prognostic factor for pulmonary LELC was identified as well.ResultsIn comparison to squamous carcinoma, pulmonary LELC was more common in women with a younger median age and less smokers. LELC seemed to be smaller in diameter on computed tomography (CT) scans than squamous carcinoma, with scarce spiculation and vascular convergence signs. Epstein-Bar virus-encoded RNA (EBER) by in-situ hybridization was detected in 33 LELC cases, among whom 27 ones were positive in serum EBV-DNA examination. LELC patients presented a much longer median progression-free survival (PFS) than squamous carcinoma. Positive serum EBV-DNA, distant lymph node invasion, advanced clinical stage and receiving radiotherapy were correlated with the shorter PFS in LELC patients. However, only positive serum EBV-DNA was the independent PFS predictor.ConclusionPulmonary LELC looks like distinct from squamous carcinoma. Middle-aged women and nonsmokers are comparatively predominated. CT features of pulmonary LELC are relatively less-malignant. Correspondently, the progression of pulmonary LELC is seemingly favorable than squamous carcinoma and the positive serum EBV-DNA appears to be the predictor of PFS.
Highlights
Primary pulmonary lymphoepithelioma-like carcinoma (LELC) is a rare tumor and often misdiagnosed as squamous carcinoma
Because of one nasopharyngeal and one mandibular LELC being excluded, 42 cases of primary pulmonary LELC were enrolled. Another group of 134 pulmonary squamous carcinomas with full clinical and prognostic information were collected as control
We focused on the primary pulmonary LELC and compared its clinical and prognostic characteristics with primary pulmonary squamous carcinoma
Summary
Primary pulmonary lymphoepithelioma-like carcinoma (LELC) is a rare tumor and often misdiagnosed as squamous carcinoma. Clinical characteristics and outcome of primary pulmonary LELC were systematically compared with pulmonary squamous carcinoma. Lymphoepithelioma-like carcinoma (LELC) is a special pathological tumor. Chen et al Respiratory Research (2019) 20:262 primary pulmonary LELC is morphologically similar to poorly differentiated squamous carcinoma. This resemblance increases the diagnostic difficulties apparently. Characteristics of primary pulmonary LELC were systematically investigated, compared with pulmonary squamous carcinoma, including the predispositions, clinical and radiographic findings, disease progression and essential risk factors
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