Colon tumor - Lymphoepithelioma-like carcinoma

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Colon tumor

Carcinoma

Lymphoepithelioma-like carcinoma

Reviewers: Charanjeet Singh, M.D. (see Reviewers page)
Revised: 16 October 2011, last major update September 2011
Copyright: (c) 2003-2011, PathologyOutlines.com, Inc.

Definition
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● Very rare in colon
● Associated with EBV

Case reports
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● Rectal tumor associated with EBV (Pathol Res Pract 2001;197:577)
● In Lynch syndrome with colonic mucinous and well-differentiated adenocarcinomas (Arch Pathol Lab Med 1999;123:720)
● With tumors at other sites (Dis Colon Rectum 1998;41:925)
● Associated with ulcerative colitis (J Gastroenterol 2007;42:181)

Micro description
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● Syncytial growth pattern of undifferentiated pleomorphic malignant epithelial cells with ill-defined borders, prominent nucleoli, brisk mitotic activity, prominent stromal and intratumoral lymphoid infiltrate
● Focal necrosis
● Infiltrative margins

Micro images
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Bladder tumor

Lung tumors:

Pale islands of tumor cells surrounded by lymphocytes

Tumor cells and infiltrating lymphocytes

Tumor cells have pale, vesicular nuclei

Positive stains
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● Cytokeratin (AE1/AE3, CAM 5.2), EBV (often) and p53 (10% of tumor cells)

Negative stains
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● Mucin (may be focal), neuroendocrine markers and S100

Differential diagnosis
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● Medullary carcinoma: lymphocytic infiltrates are peritumoral, not intratumoral; pushing not infiltrative margins, monomorphic tumor cells

End of Colon tumor > Carcinoma > Lymphoepithelioma-like carcinoma

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