Nabe Yusuke, Mizuuchi Hiroshi, Inoue Masaaki, Yoshida Junichi
Department of Chest Surgery, Shimonoseki City Hospital, Yamaguchi, JPN.
Cureus. 2025 Aug 20;17(8):e90617. doi: 10.7759/cureus.90617. eCollection 2025 Aug.
The etiology of pulmonary lymphoepithelioma-like carcinoma (PLELC) remains unclear. We report the case of an 83-year-old man with a history of smoking who presented without any significant complaints. Computed tomography (CT) performed to investigate emphysema revealed a nodular shadow in the left upper lobe. A subsequent CT performed three months later showed an increase in the size of the nodule, raising suspicion of lung cancer. Thoracoscopic partial left upper lobectomy was conducted, and pathological examination confirmed left PLELC with a granulomatous reaction, classified as pT1bN0M0, stage IA2. Despite negative Epstein-Barr virus (EBV)-encoded small RNA (EBER) in situ hybridization, serum anti-viral capsid antigen immunoglobulin G (VCA IgG) and anti-Epstein-Barr nuclear antigen (EBNA) IgG antibodies were positive, indicating a history of Epstein-Barr virus infection. The postoperative course was uneventful, and the patient was discharged on the sixth postoperative day (POD). No adjuvant chemotherapy was administered, and the patient remained disease-free nine months after surgery. The interplay between scarring and carcinogenesis in PLELC remains poorly understood, highlighting the need for further case investigations.
肺淋巴上皮瘤样癌（PLELC）的病因仍不清楚。我们报告一例83岁有吸烟史的男性患者，其就诊时无任何明显不适。为检查肺气肿而进行的计算机断层扫描（CT）显示左上叶有一个结节状阴影。三个月后进行的后续CT显示结节增大，怀疑为肺癌。遂行胸腔镜左上叶部分切除术，病理检查确诊为左肺PLELC伴肉芽肿反应，分类为pT1bN0M0，IA2期。尽管爱泼斯坦-巴尔病毒（EBV）编码的小RNA（EBER）原位杂交结果为阴性，但血清抗病毒衣壳抗原免疫球蛋白G（VCA IgG）和抗爱泼斯坦-巴尔核抗原（EBNA）IgG抗体呈阳性，表明有爱泼斯坦-巴尔病毒感染史。术后过程顺利，患者于术后第6天出院。未给予辅助化疗，术后9个月患者仍无疾病复发。PLELC中瘢痕形成与致癌作用之间的相互作用仍知之甚少，这凸显了进一步病例研究的必要性。
