Colon tumor
Lymphoepithelioma-like carcinoma

Author: Raul Gonzalez M.D. (see Authors page)

Revised: 25 November 2015, last major update November 2015

Copyright: (c) 2002-2015,, Inc.

PubMed Search: Lymphoepithelioma-like carcinoma [title] colon
Cite this page: Lymphoepithelioma-like carcinoma. website. Accessed December 3rd, 2016.
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
  • May also be called "poorly differentiated adenocarcinoma with lymphoid stroma"
Clinical Features
  • No particular age, sex or site predilection
Case Reports
Clinical Images
Missing Image

Colonoscopy findings

Micro 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
Micro Images
Missing Image

Lymphoid follicle formation

Missing Image

Polypoid nature

Missing Image

Cords and clusters

Missing Image

Pleomorphic with large nuclei

Missing Image Missing Image

Bladder tumor

Positive Stains
  • EBV / EBER positivity in tumor cells reported in some but not all cases
    • Other times, only surrounding lymphocytes are positive
  • Cytokeratin AE1/AE3
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