Breast malignant, males, children - Lymphoepithelioma-like carcinoma

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Breast malignant, males, children

Carcinoma subtypes

Lymphoepithelioma-like carcinoma

Reviewer: Monika Roychowdhury, M.D. (see Reviewers page)
Revised: 19 December 2012, last major update August 2012
Copyright: (c) 2001-2012, PathologyOutlines.com, Inc.

General
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● Rare in breast, more common in pharynx

Terminology
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● Not part of WHO breast classification

Epidemiology
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● Usually older patients

Case reports
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● 45 year old woman with possible HPV association (Anticancer Res 2012;32:1435)
● 47 year old woman (Virchows Arch 2005;447:653)
● 50 year old woman with coexisting lymphocytic mastitis (Arch Pathol Lab Med 2001;125:669)
● 53 year old woman with preoperative FNA (Acta Cytol 2012;56:85)
● 65 year old woman (Mod Pathol 1994;7:129)
● HPV18+/HPV33+ tumor (Hum Pathol 2008;39:298)

Gross description
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● Multiple nodules, without circumscription

Micro description
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● Dense inflammatory infiltrate of mature round lymphocytes and lymphoid follicles with occasional plasma cells, histiocytes and eosinophils
● Also single large cells with abundant pale cytoplasm, large vesicular nuclei, prominent nucleolus and infiltrative pattern at margin of tumor
● Occasional mitotic figures
● Lymphoid cells “cuff” large cells in rosette-like manner
● Tumor cells are occasionally pleomorphic and multinucleated with lymphophagocytosis
● Also lobulocentric lymphoid infiltrate in hyalinized, sclerotic stroma

Micro images
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Various images

Bladder: high grade tumor cells in sheets and nests; AE1/AE3

Lymphoepithelioma-like carcinoma

Strong cytoplasmic staining

Positive stains
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● Keratin (AE1/AE3, CAM5.2)
● EMA

Negative stains
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● EBV (Breast 2004;13:522)
● Usually ER, PR, HER2 and E-cadherin (Ann Diagn Pathol 2004;8:309)

Differential diagnosis
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● Medullary carcinoma: circumscribed, syncytial growth pattern

Additional references
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● Breast J 2009;15:658

End of Breast malignant, males, children > Carcinoma subtypes > Lymphoepithelioma-like carcinoma

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