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. 2014 Jan;63(1):112-4.
doi: 10.7727/wimj.2012.294. Epub 2014 Jan 16.

Epstein-Barr Virus Associated Lymphoepithelioma-like Carcinoma at the Lesser Curvature of the Upper Gastric Body: A Case Report

Q Zhang  1 , C Shou  1 , X Liu  1 , H Yu  1 , J Yu  1
Affiliations

Epstein-Barr Virus Associated Lymphoepithelioma-like Carcinoma at the Lesser Curvature of the Upper Gastric Body: A Case Report

Q Zhang et al. West Indian Med J. 2014 Jan.

Abstract
in English, Spanish

Lymphoepithelioma-like gastric carcinoma (LELGC) is a rare neoplasm of the stomach with dense lymphocytic infiltration. More than 80% of LELGCs are positive for the Epstein-Barr virus (EBV). Here, we report a 64-year old Chinese man with swallowing discomfort while eating food. Endoscopy and computed tomography both showed a submucosal lesion at the lesser curvature of the upper gastric body. The first diagnostic impression was a gastrointestinal stromal tumour. Subsequently, the patient received a wedge resection of the stomach. On histopathological examination, the tumour was found to consist of small nests of neoplastic cells within dense lymphocytic infiltration. Additionally, most of the neoplastic cells were positive for cytokeratin and Epstein-Barr virus-encoded RNA (EBER). Subsequently, the diagnosis of LELGC was made. We believe that physicians should be aware of the diagnosis of submucosal gastric lesions, particularly in older male patients.

El carcinoma gástrico de tipo linfoepitelioma (CGLE) es una neoplasia rara del estómago con una infiltración linfocítica densa. Más del 80% de los CGLEs son positivos al virus de Epstein-Barr (EBV). Aquí reportamos el caso de un paciente chino de 64 años, que sentía malestar al efectuar la deglución de alimentos. Tanto la endoscopia como la tomografía computarizada mostraron una lesión submucosa en la curvatura menor de la parte superior del cuerpo gástrico. La primera impresión diagnóstica fue de un tumor del estroma gastrointestinal Posteriormente, al paciente se le hizo una resección en cuña del estómago. En el examen histopatológico, se halló que el tumor consistía de pequeños nidos de células neoplásicas dentro de una infiltración linfocítica densa. Además, la mayoría de las células neoplá-sicas eran positivas a la citoqueratina y al ARN codificado por el virus de Epstein-Barr (EBER). Posteriormente, se realizó el diagnóstico de CGLE. Creemos que los médicos deben tomar conciencia del diagnóstico de las lesiones submucosas gástricas, especialmente en los pacientes mayores hombres.

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Figures

Fig. 1
Fig. 1. Ultrasonic endoscopy shows a submucosal lesion with an active ulcer on the mucosal surface (arrow). The lesion is approximately 1.47 x 0.54 cm.
Fig. 2
Fig. 2. Abdominal contrast-enhanced computed tomography scan showed a lesion at the lesser curvature near to the cardia (arrow). The lesion was 1.6 x 1.1 cm in size and was apparently enhanced.
Fig. 3
Fig. 3. Histopathological features of the lymphoepithelioma-like gastric carcinoma (LELGC). The tumour consisted of nests of neoplastic cells within a dense lymphocytic infiltration (A: ×100, B: ×400). Immunohistochemistry shows the tumour cells are positive for cytokeratin (C: ×100, D: ×400). In situ hybridization, most of the tumour cells stain positively for Epstein-Barr virus encoded RNA (E: ×100, F: ×400).
Fig. 4
Fig. 4. Immunohistochemistry shows the infiltrating lymphocytes are composed predominantly of CD4+T cells (A: × 100, B: ×400) and CD8+T cells (C: ×100, D: ×400).
See this image and copyright information in PMC

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