Kidney tumor - Adult malignancies
Adult renal cell carcinoma
Urothelial carcinoma of renal pelvis - Lymphoepithelioma-like

Author: Nicole K. Andeen, M.D. (see Authors page)
Editor: Maria Tretiakova, M.D.

Revised: 7 February 2017, last major update December 2015

Copyright: (c) 2003-2017, PathologyOutlines.com, Inc.

PubMed Search: Urothelial carcinoma lymphoepithelioma-like

Related Topic: Urothelial carcinoma of renal pelvis
Cite this page: Urothelial carcinoma of renal pelvis - Lymphoepithelioma-like. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/kidneytumormalignanturothelialcarcinomasubtypeslympholike.html. Accessed October 19th, 2017.
Definition / general
  • Resembles undifferentiated nasopharyngeal carcinoma
  • Large pleomorphic cells with vesicular nuclei and prominent nucleoli arranged in syncytia with a prominent inflammatory infiltrate
  • Given overall rarity and similarities with lymphoepithelioma-like urothelial carcinoma of the bladder, some information and pictures are extracted from bladder, where appropriate
Essential features
  • Very rare
  • Resembles undifferentiated nasopharyngeal carcinoma but EBV negative
Terminology
  • Lymphoepithelioma-like carcinoma (LELC)
Epidemiology
  • Very rare in renal pelvis (~ 10 cases reported)
  • Ages 68 - 79, M = F
Sites
  • Renal pelvis, ureter, bladder
Pathophysiology
Clinical features
  • Most common presenting symptom is gross hematuria
  • Majority presents at stage T2 or higher (Mod Pathol 2007;20:828)
Prognostic factors
  • In bladder, quantity of lymphoepithelioma-like features impacts prognosis:
    • Pure or predominant (< 50%) form appears to have more favorable outcome, potentially due to host response or timing of presentation (Adv Anat Pathol 2008;15:218)
    • If focal (< 50%), has similar outcome to stage matched high grade urothelial carcinoma (Adv Anat Pathol 2008;15:218)
Case reports
Treatment
  • Combination of surgery and chemotherapy has better clinical response (Arch Pathol Lab Med 2007;131:1244)
  • Resection, +/- radiotherapy, but too few cases to establish optimal treatment
Gross description
  • Solid, white mass
Gross images

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Solid tumor (fig. 2)

Microscopic (histologic) description
Microscopic (histologic) images

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Lymphoepithelioma-like urothelial carcinoma, contributed by Dr. Maria Tretiakova and Dr. Nicole Andeen

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Lymphocytes and plasma cells (fig. 3)

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EBNA2 (fig. 4)

Positive stains
Negative stains
Differential diagnosis