Lymphoepithelioma-like Carcinoma of Endometrium; A Rare Case Report

Abstract

Lymphoepithelioma -like carcinomas (LELCs) are tumors with histological features similar to those of lymphoepithelioma of nasopharynx. They have been described in many organs including female genital tract. Their histology is characterized by sheets, nests and cords of large syncytial tumor cells containing round nuclei with prominent nucleoli and dense lymphoplasmacytic infiltrate in the stoma. The association of Epstein-Barr virus (EBV) with LELCs has not been observed in western patients. But a few Asian patients with these tumors in uterine cervix have shown positive association of EBV. Cervical LELCs harbor EBV more frequently than cervical squamous cell carcinomas. These tumors are rarer in endometrium. Only 3 cases have been reported and the association of EBV has not been observed. We present here a rare case of LELC in endometrial polyp from India, who presented with postmenopausal vaginal bleeding. The tumor cells were positive for cytokeratin and EBV Latent membrane protein-1.

Keywords: EBV; Endometrial carcinoma; LMP 1; Lymphoepithelioma- like carcinoma.

Fig. 1

Endometrial cavity shows polyp cut surface with solid whitish tumor, small cystic spaces and intramural fibroid

Fig. 2

Histology of Polyp shows solid sheets of tumor cells, lymphoid infiltrate and compressed hyperplastic endometrial glands (H&E, ×400)

Fig. 3

Sheets of classical syncytial tumor cells, round nuclei with prominent nucleoli (H&E, ×400)

Fig. 4

Metastatic tumor cells in right pelvic lymph node (H&E, ×400)

Fig. 5

Tumor cells were positive for Cytokeratin AE1/AE3. (H&E, ×400)

Fig. 6

Tumor cells were positive (arrow) for EBV LMP1.(H&E, ×400)