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Primary pulmonary lymphoepithelioma-like carcinoma with positive expression of Epstein-Barr virus and PD-L1: A case report

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Title: Primary pulmonary lymphoepithelioma-like carcinoma with positive expression of Epstein-Barr virus and PD-L1: A case report
Authors: Sasaki, Akihiro Browse this author
Kato, Tatsuya Browse this author
Ujiie, Hideki Browse this author
Cho, Yasushi Browse this author
Sato, Masaaki Browse this author
Kaji, Mitsuhito Browse this author
Keywords: Lymphoepithelioma-like carcinoma (LELC)
Epstein-Barr virus (EBV)
EBV encoded small RNA (EBER)
In situ hybridization (ISH)
Programmed death-ligand 1 (PD-L1)
Case report
Issue Date: Feb-2021
Publisher: Elsevier
Journal Title: International journal of surgery case reports
Volume: 79
Start Page: 431
End Page: 435
Publisher DOI: 10.1016/j.ijscr.2021.01.066
Abstract: INTRODUCTION AND IMPORTANCE: Pulmonary lymphoepithelioma-like carcinoma (LELC) is a rare type of non-small cell lung cancer (NSCLC) that is classified as a subtype of unclassified carcinoma by the WHO. LELC is usually associated with Epstein-Barr virus (EBV) infection. LELC has often been observed in Southeast Asia; however, it is extremely rare in Japan. CASE PRESENTATION: A 60-year-old Japanese woman presented with an abnormal shadow in the left lung on chest radiography. Chest computed tomography showed a nodule located between the lingular and basal anteromedial segments. A blood test suggested an existing EBV infection, and LELC was suspected preoperatively in the transbronchial lung biopsy. She underwent a lingular and basal bi-segmentectomy. The EBV-encoded small ribonucleic acid in-situ hybridization (EBER-ISH) was positive, and she was diagnosed with LELC. Moreover, programmed death-ligand 1 (PD-L1) expression was moderately positive. No recurrence was observed for 30 months. CLINICAL DISCUSSION: Although LELC has been reported as a low-grade malignancy with a good prognosis, the frequency of PD-Ll expression in LELC seems to be higher than that in other NSCLCs. Moreover, it has been reported that LELC patients with high PD-Ll expression are likely to have early recurrence/metastasis and poor prognosis. CONCLUSION: An investigation of PD-Ll expression for LELC would be useful considering the benefit of PD-1/PD-L1 blockade in patients with pulmonary LELC with high PD-Ll expression. The present case is the first report of LELC with positive expression of EBER-ISH and PD-Ll in Japan. (C) 2021 The Authors. Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.
Type: article
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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