Liver and intrahepatic bile ducts - tumor
Hepatocellular carcinoma
Lymphoepithelioma-like variant

Topic Completed: 28 May 2019

Revised: 30 May 2019

Copyright: 2019,, Inc.

PubMed Search: Lymphoepithelioma-like hepatocellular carcinoma

Daffolyn Rachael Fels Elliott, M.D., Ph.D.
Ryan M. Gill, M.D., Ph.D.
Page views in 2019 to date: 227
Cite this page: Fels Elliott DR, Gill RM. Lymphoepithelioma-like variant of hepatocellular carcinoma. website. Accessed August 24th, 2019.
Definition / general
  • Rare variant characterized by pleomorphic tumor cells in a dense lymphoid stroma
Essential features
  • Cords of pleomorphic epithelial cells in a dense lymphoid stroma
  • Very rare variant of hepatocellular carcinoma (HCC)
  • Most cases negative for Epstein-Barr virus (EBV)
ICD coding
  • ICD-10: C22.7 - Other specified carcinomas of liver
Clinical features
Radiology images

Images hosted on other servers:

CT scan

Prognostic factors
Case reports
Gross description
Microscopic (histologic) description
  • Cords and trabecula of pleomorphic epithelial cells in a dense lymphoid stroma
  • May have focal syncytial growth
Microscopic (histologic) images

Contributed by Ryan M. Gill, M.D., Ph.D.

Dense lymphoid infiltrate

Inconspicuous tumor cells


Positive stains
Negative stains
Molecular / cytogenetics description
Sample pathology report
  • Liver, mass, core biopsy:
    • Lymphoepithelioma-like hepatocellular carcinoma (see comment)
    • Comment: The tumor shows histologic features of lymphoepithelioma-like carcinoma with pleomorphic tumor cells arranged in nests and cords within a dense lymphoid stroma. The tumor cells are positive for pancytokeratin, HepPar1 and glypican 3, and negative for CK7, CK19 and mucicarmine. EBV in situ hybridization is negative.
Differential diagnosis
Board review question #1
Which variant of hepatocellular carcinoma is shown in the image?

  1. Fibrolamellar
  2. Lymphoepithelioma-like
  3. Sarcomatoid
  4. Scirrhous
  5. Undifferentiated
Board review answer #1
Board review question #2
Which of the following features is characteristic of the lymphoepithelioma-like variant of hepatocellular carcinoma (HCC)?

  1. Composed of pleomorphic epithelial cells in a dense lymphoid stroma
  2. Cytokeratin is usually negative
  3. Has a worse prognosis in comparison to classic HCC
  4. It is one of the more common variants of HCC
  5. Most cases are positive for Epstein-Barr virus in situ hybridization
Board review answer #2
A. Composed of pleomorphic epithelial cells in a dense lymphoid stroma

Reference: Lymphoepithelioma-like hepatocellular carcinoma

Comment Here
Back to top