Korean J Gastroenterol.  2014 Oct;64(4):246-249. 10.4166/kjg.2014.64.4.246.

A Case of Gastric Lymphoepithelioma-like Carcinoma Presenting as a Subepithelial Tumor Diagnosed by Endoscopic Resection

• Hong SH
• Jeong ID

• KMID: 1979211
• DOI: http://doi.org/10.4166/kjg.2014.64.4.246

Abstract

No abstract available.

Figure

• 

  Fig. 1. Endoscopic finding. About 2.0 cm sized protruding lesion with surface erosion and bridging folds is seen on the less curvature of low body.

• 

  Fig. 2. EUS finding. EUS shows 2.0 cm sized hypoecohoic mass involving mainly the third layer and focal fourth layer of gastric wall.

• 

  Fig. 3. Endoscopic findings during endoscopic resection. (A) Whitish mass lesion is revealed after mucosa denudation. (B) The mass lesion is shown to have invaded the proper muscle layer.

• 

  Fig. 4. Histologic findings (H&E). (A) The submucosal tumor is well demarcated (×40). (B) Large sized atypical cells are seen with many lymphocytes on the background (×400).

• 

  Fig. 5. Immunohistochemical staining. Large sized atypical tumor cells show positive reaction for cytokeratin stain (×400).

• 

  Fig. 6. In situ hybridization for Epstein-Barr virus (EBV)-encoded RNAs. Large sized atypical tumor cells show positive reaction with strong nuclear staining while the surrounding lymphoid cells show no reaction (×200).

Reference

References

1. Sashiyama H, Nozawa A, Kimura M, et al. Case report: a case of lymphoepithelioma-like carcinoma of the oesophagus and review of the literature. J Gastroenterol Hepatol. 1999; 14:534–539.

2. MacCarty WC, Mahle AE. Relation of differentiation and lympho-cytic infiltration to postoperative longevity in gastric carcinoma. J Lab Clin Med. 1921; 6:473–480.

3. Watanabe H, Enjoji M, Imai T. Gastric carcinoma with lymphoid stroma. Its morphologic characteristics and prognostic correlations. Cancer. 1976; 38:232–243.

4. Oda K, Tamaru J, Takenouchi T, et al. Association of Epstein-Barr virus with gastric carcinoma with lymphoid stroma. Am J Pathol. 1993; 143:1063–1071.

5. Nakamura S, Ueki T, Yao T, Ueyama T, Tsuneyoshi M. Epstein-Barr virus in gastric carcinoma with lymphoid stroma. Special reference to its detection by the polymerase chain reaction and in situ hybridization in 99 tumors, including a morphologic analysis. Cancer. 1994; 73:2239–2249.

6. Kume T, Oshima K, Yamashita Y, Shirakusa T, Kikuchi M. Relationship between Fas-ligand expression on carcinoma cell and cytotoxic T-lymphocyte response in lymphoepithelioma-like cancer of the stomach. Int J Cancer. 1999; 84:339–343.

7. Hsu DH, de Waal Malefyt R, Fiorentino DF, et al. Expression of in-terleukin-10 activity by Epstein-Barr virus protein BCRF1. Science. 1990; 250:830–832.

8. Endo T, Okuda H, Arimura Y, et al. A case of early gastric carcinoma with lymphoid stroma: diagnostic usefulness of endosono-graphy. Dig Endosc. 1998; 10:240–243.

9. Lee JY, Kim KM, Min BH, Lee JH, Rhee PL, Kim JJ. Epstein-Barr virus-associated lymphoepithelioma-like early gastric carcinomas and endoscopic submucosal dissection: case series. World J Gastroenterol. 2014; 20:1365–1370.

10. Tak DH, Jeong HY, Seong JK, Moon HS, Kang SH. Comparison of clinical characteristics and prognostic factors between gastric lymphoepithelioma-like carcinoma and gastric adenocarcinoma. Korean J Gastroenterol. 2013; 62:272–277.