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Table of Contents
Definition / general | Essential features | Terminology | Clinical features | Case reports | Clinical images | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Negative stains | Differential diagnosisCite this page: Lymphoepithelioma-like carcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/colontumorLEL.html. Accessed July 14th, 2017.
Definition / general
- Extremely rare subtype of colonic adenocarcinoma (< 10 reported cases) associated with Epstein-Barr virus infection
- Only case reports exist, though some may actually be medullary carcinoma (see differential diagnosis section)
Essential features
- Rare colonic carcinoma with fewer than 10 reported cases
- Linked to infection with Epstein-Barr virus, similar to gastric lymphoepithelioma-like carcinoma
Terminology
- May also be called "poorly differentiated adenocarcinoma with lymphoid stroma"
Clinical features
- No particular age, sex or site predilection
Case reports
- 25 year old man with lymphoepithelioma-like carcinoma of the colon with ulcerative colitis (J Gastroenterol 2007;42:181)
- 44 year old man with lymphoepithelioma-like carcinoma of the colon and hereditary nonpolyposis colorectal cancer (Arch Pathol Lab Med 1999;123:720)
- Lymphoepithelioma-like carcinoma of rectum (Pathol Res Pract 2001;197:577)
Clinical images
Images hosted on other servers:
Colonoscopy findings
Microscopic (histologic) description
- Syncytial growth pattern of undifferentiated pleomorphic malignant epithelial cells with ill defined borders, prominent nucleoli and brisk mitotic activity
- Prominent stromal and intratumoral lymphoid infiltrate
- Focal necrosis
- Infiltrative margins
Microscopic (histologic) images
Images hosted on other servers:
Lymphoid follicle formation
Polypoid nature
Cords and clusters
Pleomorphic with large nuclei
Bladder tumor
Positive stains
Negative stains
- Neuroendocrine markers, S100
Differential diagnosis
- Medullary carcinoma: lymphocytic infiltrates are more prominent peritumorally than intratumorally; pushing, not infiltrative, margins; distinction not always perfect on H&E
- In the stomach, "medullary gastric cancer" should be used for mismatch repair deficient tumors and "lymphoepithelioma-like gastric cancer" should be used for EBER+ cases
- Such a distinction may carry over to the colon, but the morphologic overlap and rarity of EBV+ colon cancers makes this difficult to determine
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