Philippe Amandine, Rassy Marc, Craciun Ligia, Naveaux Céline, Willard-Gallo Karen, Larsimont Denis, Veys Isabelle
Departments of Pathology (A.P., M.R., L.C., D.L.) Surgery (I.V.) Molecular Immunology Unit (C.N., K.W.-G.), Institut Jules Bordet, Brussels, Belgium.
Int J Gynecol Pathol. 2018 Sep;37(5):482-487. doi: 10.1097/PGP.0000000000000446.
The aim of this study was to characterize the inflammatory infiltrate of the lymphoepithelioma-like carcinoma, a variant of squamous cell carcinoma clinically associated with a good prognosis. Immunohistochemistry was used to characterize 3 cases of lymphoepithelioma-like carcinoma in the uterine cervix, diagnosed over a period of 3 yr. The patients were between 30 and 50 yr old. Their cervical smears had shown atypical squamous cells of unknown significance or high-grade squamous intraepithelial lesions, and the initial cervical biopsy showed high-grade cervical intraepithelial neoplasia (CIN3) or squamous cell carcinoma. All patients underwent a Wertheim operation, 2 of which were preceded by a cervicectomy. Microscopically, all tumors were characterized by poorly defined sheets of undifferentiated squamous cells with a syncytial pattern and a dense background of infiltrating lymphocytes. Immunohistochemical analysis revealed that the lymphocytes were predominantly CD3 and CD8 T cells. The tumor lobules contained isolated CD8 T cells, whereas CD4 T cells and CD20 B cells surrounded the tumor lobules. CD56 NK cells and CD79 B cells were scattered in the tumor tissue. An in situ hybridization staining for Epstein-Barr encoding region was negative but all cases were immunohistochemically positive for P16. Follow-up varied between 2 mo and 2.7 yr. All 3 patients were disease free. Lymphoepithelioma-like carcinoma of the uterine cervix is a variant of squamous cell carcinoma, known for its better prognosis. The good prognosis of this tumor is potentially explained by the high levels of infiltrating CD8 T cells.
本研究的目的是对淋巴上皮瘤样癌的炎性浸润进行特征描述，淋巴上皮瘤样癌是鳞状细胞癌的一种变体，临床上与良好预后相关。采用免疫组织化学方法对3例子宫颈淋巴上皮瘤样癌进行特征描述，这些病例是在3年期间诊断出来的。患者年龄在30至50岁之间。她们的宫颈涂片显示意义不明确的非典型鳞状细胞或高级别鳞状上皮内病变，最初的宫颈活检显示高级别宫颈上皮内瘤变（CIN3）或鳞状细胞癌。所有患者均接受了Wertheim手术，其中2例在手术前进行了宫颈切除术。显微镜下，所有肿瘤的特征是未分化鳞状细胞片层界限不清，呈合体细胞模式，并有密集的浸润淋巴细胞背景。免疫组织化学分析显示，淋巴细胞主要是CD3和CD8 T细胞。肿瘤小叶内含有孤立的CD8 T细胞，而CD4 T细胞和CD20 B细胞围绕在肿瘤小叶周围。CD56 NK细胞和CD79 B细胞散在于肿瘤组织中。爱泼斯坦-巴尔编码区的原位杂交染色为阴性，但所有病例P16免疫组织化学染色均为阳性。随访时间为2个月至2.7年。所有3例患者均无疾病。子宫颈淋巴上皮瘤样癌是鳞状细胞癌的一种变体，以其较好的预后而闻名。这种肿瘤的良好预后可能是由浸润性CD8 T细胞的高水平所解释的。
