Pan Shien-Tung, Wang Ren-Ching, Liu Ming-Yueh, Chuang Shih-Sung
Anal Quant Cytopathol Histpathol. 2013 Dec;35(6):344-8.
Lymphoepithelioma-like bladder carcinoma (LELBC) is a rare variant of infiltrating urothelial carcinoma according to the recent World Health Organization classification, with only 3 previously reported cases from Asia. Histologically, LELBC is classified into pure, predominant and focal forms, depending on the relative amount of the lymphoepithelioma-like component. The tumor may have a concurrent component of other histological types, usually high-grade urothelial carcinoma. Patients with the pure and predominant forms have a better response to chemotherapy and outcome than those with a focal form. Unlike its histological counterpart in the nasopharynx, which is prevalent among Southeastern Asia and has a strong association with Epstein-Barr virus (EBV), LELBC is universally EBV negative.
We report 2 new cases of LELBC, one treated with transurethral resection and the other, cystoprostatectomy. Histologically, both tumors were of the predominant form and were both negative for EBV by in situ hybridization. Both patients were subsequently treated with chemotherapy and were free of disease 6 months after diagnosis.
Our detailed clinicopathological report adds 2 new Asian cases to our understanding of this extremely rare variant of urothelial carcinoma.
根据世界卫生组织最新分类,淋巴上皮瘤样膀胱癌(LELBC)是浸润性尿路上皮癌的一种罕见变体,此前亚洲仅有3例相关报道。从组织学角度来看,LELBC根据淋巴上皮瘤样成分的相对含量分为纯型、优势型和局灶型。该肿瘤可能同时伴有其他组织学类型成分,通常为高级别尿路上皮癌。纯型和优势型患者对化疗反应及预后较局灶型患者更佳。与在东南亚地区高发且与爱泼斯坦 - 巴尔病毒(EBV)密切相关的鼻咽部组织学对应物不同,LELBC普遍为EBV阴性。
我们报告2例新的LELBC病例,1例接受经尿道切除术,另1例接受膀胱前列腺切除术。组织学检查显示,两例肿瘤均为优势型,原位杂交检测EBV均为阴性。两名患者随后均接受化疗,诊断后6个月时均无疾病迹象。
我们详细的临床病理报告为我们对这种极其罕见的尿路上皮癌变体的认识增添了2例新的亚洲病例。