Tuberc Respir Dis.  2013 Oct;75(4):170-173.

A Case of Primary Pulmonary Lymphoepithelioma-like Carcinoma Misdiagnosed as Adenocarcinoma

• Jeong JS
• Kim SR
• Park SY
• Chung MJ
• Lee YC

Abstract

Primary pulmonary lymphoepithelioma-like carcinoma (LELC) is rare, with a more favorable prognosis compared with that of other types of non-small cell lung cancers. Herein, we describe an interesting case of primary pulmonary LELC confirmed postoperatively, which had been initially diagnosed as poorly differentiated adenocarcinoma. We suggest that despite the rarity of pulmonary LELC, it should be included as one of the differential diagnoses for lung malignancies. Physicians should consider taking a larger biopsy, especially when histologic examination shows undifferentiated nature.

Keyword

Carcinoma, Non-Small-Cell Lung; Lung Neoplasms; Adenocarcinoma

MeSH Terms

Adenocarcinoma*
Biopsy
Carcinoma, Non-Small-Cell Lung
Diagnosis, Differential
Lung
Lung Neoplasms
Prognosis

Figure

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  Figure 1 (A) Initial chest radiograph reveals approximately 2.5 cm-sized nodular opacity in the right middle lung field. (B.D) Chest computed tomography (CT) at admission. Coronal image (post-enhancement) (B), lung setting (C), and axial image (post-enhancement) (D), show a 3 cm-sized mass with spiculated margin, heterogeneous enhancement with ground glass opacities posterioly. (E) Positron emission tomography-CT shows hypermetabolic nodule (standardized uptake value, 9.32) of irregular shape in the right lower lobe.

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  Figure 2 (A) There are many undifferentiated, large epithelioid malignant cells with indistinct cell borders (syncytial growth). A striking influx of lymphocytes around malignant cells is evident (H&E stain, ×200). (B) Some of the malignant cells are positive for in situ hybridization of Ebstein-Barr virus (EBV)-coded small RNA (×200). The right lower corner box (twice enlarged photo from the original image) shows the magnification view of positive reaction with EBV.

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