Korean J Hepatobiliary Pancreat Surg.  2016 Aug;20(3):148-151. 10.14701/kjhbps.2016.20.3.148.

Mixed lymphoepithelioma-like carcinoma and adenocarcinoma of the gallbladder

• Choi NK
• Lim SC

• KMID: 2351304
• DOI: http://doi.org/10.14701/kjhbps.2016.20.3.148

Abstract

Lymphoepithelioma-like carcinoma (LELC), an undifferentiated carcinoma with intense lymphoplasmacytic infiltrates, is commonly reported in the nasopharynx and occasionally in other organs. Pure type of LELC has previously been reported in the gallbladder. Mixed type could be reportable in comparison with other organs. Here we present a case of an 83-year-old man with mixed LELC and adenocarcinoma in the gallbladder. To the best of our knowledge, this is the first case of mixed LELC and adenocarcinoma in the gallbladder.

Keyword

Lymphoepithelioma-like carcinoma; Adenocarcinoma; Gallbladder

MeSH Terms

Adenocarcinoma*
Aged, 80 and over
Carcinoma
Gallbladder*
Humans
Nasopharynx

Figure

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  Fig. 1 PET-CT findings showing a hypermetabolic lesion in the gallbladder suggestive of malignancy.

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  Fig. 2 Microscopic findings. Transmural infiltration of neoplastic cells with lymphoid stroma is identified in the gallbladder wall. Scale bar: 1 mm (A). Well differentiated adenocarcinoma confined to the mucosa is partially overlying lymphoepithelioma-like carcinoma. Scale bar: 500 µm (B). Higher magnification of the boxed area in Figure 2B shows transition from adenocarcinoma to undifferentiated carcinoma. Scale bar: 100 µm (C). Large vesicular oval-shaped nuclei with occasional large prominent nucleoli and lymphocytic infiltration are found. Scale bar: 50 µm (D).

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  Fig. 3 Immunohistochemical findings. Immunostaining for cytokeratin 7 shows diffuse infiltration of the undifferentiated carcinoma cells in the gallbladder wall. Scale bar: 200 µm (A). Higher magnification shows scattered neoplastic infiltration with lymphoid stroma. Scale bar: 200 µm (B). The same area shows abundant CD3-positive T lymphocytes (C) and CD20-positive B lymphocytes (D) around the tumor cell nests. Scale bar: 200 µm.

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