Manonukul Jane, Chotirat Chanokpan, Boonchai Waranya, Chomanee Nusara, Choosrichom Naree
Department of Pathology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2011 Dec;94(12):1547-52.
Cutaneous lymphoepithelioma-like carcinoma (cutaneous LELC) is an extremely rare malignant neoplasm with unclear histogenesis. Its histopathologic features are like those of lymphoepithelioma-like carcinoma occurring in the nasopharynx and in visceral organs especially salivary glands.
The authors reported on one male and two female patients of cutaneous LELC with immunohistochemical and electron microscopic study. All patients were of old age. All cutaneous LELCs in this report occurred on the patient's face, one of each on the eyelid, conjunctiva, and cheek.
All resection specimens showed the typical histopathologic features of those of LELC, i.e. well-defined tumor lobules mainly located in the dermis and extending into the panniculus. These tumor lobules typically displayed ill-defined clusters/nests of large epitheloid cells with pale eosinophilic cytoplasm, atypical vesicular nuclei possessing prominent nucleoli and were surrounded by dense lymphoplasmacytic infiltration. Immunocytohistochemically, these epitheloid cells showed epithelial differentiation by the expression of epithelial membrane antigen (EMA), P63, CK5/6 and CAM5.2 but were negative to CK20, CEA and Ebstein-Barr virus (EBV). Squamous cell differentiation by the presence of desmosomes by electron microscopic study was also noted in two patients (case 1 and 3).
The findings described above indicated that cutaneous LELC was a malignant neoplasm exhibiting squamous cell differentiation.
皮肤淋巴上皮瘤样癌（皮肤LELC）是一种极其罕见的恶性肿瘤，其组织发生尚不清楚。其组织病理学特征与发生于鼻咽部及内脏器官尤其是涎腺的淋巴上皮瘤样癌相似。
作者报告了1例男性和2例女性皮肤LELC患者，并进行了免疫组织化学和电子显微镜研究。所有患者均为老年。本报告中的所有皮肤LELC均发生于患者面部，分别位于眼睑、结膜和颊部各1例。
所有切除标本均显示出LELC典型的组织病理学特征，即界限清楚的肿瘤小叶主要位于真皮并延伸至皮下组织。这些肿瘤小叶通常表现为界限不清的大上皮样细胞簇/巢，胞质淡嗜酸性，核呈非典型泡状，有明显核仁，周围有密集的淋巴浆细胞浸润。免疫细胞化学检查显示，这些上皮样细胞通过表达上皮膜抗原（EMA）、P63、CK5/6和CAM5.2表现出上皮分化，但对CK20、CEA和EB病毒（EBV）呈阴性。电子显微镜研究还发现2例患者（病例1和3）有桥粒，提示有鳞状细胞分化。
上述结果表明，皮肤LELC是一种表现为鳞状细胞分化的恶性肿瘤。
