Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Kaohsiung J Med Sci. 2012 Sep;28(9):509-13. doi: 10.1016/j.kjms.2012.04.010. Epub 2012 Jul 7.
Lymphoepithelioma-like carcinoma (LELC) is best known to occur in the nasopharynx. When LELC occurs in the urinary tract, this extremely rare neoplasm most commonly affects the bladder but has also been reported in the renal pelvis, ureter, prostate [1], and urethra [2]. We present a case of LELC arising in the right proximal ureter of a 64-year-old male patient with hydronephrosis and nausea. Computed tomography demonstrated right ureter tumor. On biopsy, the patient was diagnosed with infiltrating urothelial carcinoma. An operation consisting of right nephroureterectomy and bladder cuff removal was carried out. The pathologic examination showed pure subtype of LELC, pT3N0. Unlike lymphoepithelioma in the nasopharynx, immunohistochemical analysis of this urinary LELC was negative for the Epstein-Barr virus. No disease progression was noted at 6 months' follow-up. Only eight previous cases of LELC involving the ureter have been reported, and a review of the available literature and a summary of ureter cases are presented here. This is the first report of a ureteral LELC case and third urothelial LELC cases [3] in Taiwan.
淋巴上皮样癌(LELC)最常发生于鼻咽部。当 LELC 发生于泌尿道时,这种极其罕见的肿瘤最常影响膀胱,但也曾有报告发生于肾盂、输尿管、前列腺[1]和尿道[2]。我们报告一例发生于 64 岁男性患者右侧输尿管上段的 LELC,该患者因肾积水和恶心而就诊。计算机断层扫描显示右侧输尿管肿瘤。经活检,患者被诊断为浸润性尿路上皮癌。实施了包括右肾输尿管切除和膀胱袖套切除的手术。病理检查显示为纯型 LELC,pT3N0。与鼻咽部的淋巴上皮瘤不同,该泌尿道 LELC 的免疫组织化学分析为 EBV 阴性。6 个月随访时未见疾病进展。仅报告过 8 例涉及输尿管的 LELC 病例,本文对现有文献进行了复习,并对输尿管病例进行了总结。这是首例输尿管 LELC 病例报告,也是台湾地区的第 3 例尿路上皮 LELC 病例[3]。