Korean J Radiol.  2010 Dec;11(6):697-700. 10.3348/kjr.2010.11.6.697.

Epstein-Barr Virus-Associated Lymphoepithelioma-Like Gastric Carcinoma Presenting as a Submucosal Mass: CT Findings with Pathologic Correlation

• Kim SW
• Shin HC
• Kim IY
• Kim CJ
• Lee JH
• Lee CK
• Jeong DJ

• KMID: 1119235
• DOI: http://doi.org/10.3348/kjr.2010.11.6.697

Abstract

A lymphoepithelioma-like carcinoma, characterized by a carcinoma with heavy lymphocyte infiltration, is one of the histological patterns observed in patients with Epstein-Barr virus (EBV)-associated gastric carcinoma. Less than half of invasive carcinomas with lymphoepithelioma-like histology can grow to make a submucosal mass. These tumors generally have a better prognosis than conventional adenocarcinomas. We report a case of an EBV-associated lymphoepithelioma-like gastric carcinoma that presented as a submucosal mass on multi-detector (MD) CT and correlate them with the pathology.

Keyword

Epstein-Barr virus infections; Stomach neoplasms; Tomography, X-ray computed

MeSH Terms

Carcinoma/*radiography/surgery/*virology
Contrast Media
Diagnosis, Differential
Epstein-Barr Virus Infections/*radiography/surgery
Gastroscopy
Humans
In Situ Hybridization
Male
Middle Aged
Stomach Neoplasms/*radiography/surgery/*virology
*Tomography, X-Ray Computed

Figure

• 

  Fig. 1 46-year-old man with Epstein-Barr virus-associated lymphoepithelioma-like gastric carcinoma. A. Gastroscopy revealed submucosal mass with two mucosal ulcerations (arrows) in gastric high body near cardia. B. Contrast-enhanced axial CT scan shows ovoid enhancing mass (arrows) in submucosal layer of gastric high body. Note overlying mucosa with contrast enhancement (arrowheads). C. Coronal reformatted image shows submucosal mass with contrast enhancement near cardia (arrows). Also note overlying mucosa (arrowheads). D. Low-power photomicrograph (Hematoxylin & Eosin stain, ×4) shows tumor infiltration in mucosa (arrows), mucosal ulcerations (U) and well-demarcated submucosal mass of lymphoid stroma (arrowheads). E. High-power photomicrograph (Hematoxylin & Eosin stain, ×200) shows multifocal small nests of poorly differentiated adenocarcinomas (arrows) that are uniformly distributed throughout lymphoid stroma. These findings of pathology were observed in all of mucosal and submucosal layers.

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