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Case Reports
. 2022 Sep 5;10(9):165.
doi: 10.3390/dj10090165.

Lymphoepithelial Subtype of Oral Squamous Cell Carcinoma: Report of an EBV-Negative Case and Literature Review

Rodopi Emfietzoglou  1 , Efstathios Pettas  2 , Maria Georgaki  2 , Erofili Papadopoulou  2 , Vasileios Ionas Theofilou  3 , Nikolaos Papadogeorgakis  4 , Evangelia Piperi  2 , Marcio Ajudarte Lopes  5 , Nikolaos G Nikitakis  2
Affiliations
Case Reports

Lymphoepithelial Subtype of Oral Squamous Cell Carcinoma: Report of an EBV-Negative Case and Literature Review

Rodopi Emfietzoglou et al. Dent J (Basel). .

Abstract

Lymphoepithelial carcinoma (LEC) of the oral mucosa is a rare histopathologic subtype of squamous cell carcinoma (SCC), which shares morphologic similarities with nasopharyngeal carcinoma (NPC), non-keratinizing undifferentiated subtype. The admixture of neoplastic epithelial tumor cells and a dense lymphoplasmacytic infiltrate makes microscopic diagnosis challenging. LEC etiopathogenesis has been variably associated with Epstein-Barr virus (EBV) infection, depending on the specific anatomic location and racial predilection, with a higher incidence in endemic populations. Although described in several subsites of the head and neck region, including the major salivary glands, the oral mucosa is considered an infrequent location for LEC development, deriving either from minor salivary glands (MSGs) or the surface epithelium. Herein, we report a rare case of an EBV-negative LEC arising from the oral surface epithelium, presenting as gingival swelling, and review the pertinent English-language literature, which revealed only 26 previously reported oral LECs. Our case is only the fourth oral LEC originating from the surface epithelium and the first one to affect the gingiva.

Keywords: EBV; lymphoepithelial carcinoma; minor salivary glands; oral cavity; squamous cell carcinoma; surface epithelium.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(a–c) Intraoral clinical examination showing (a) exophytic, hemorrhagic ulcerated mass surrounding the gingiva of the right mandibular premolars extending posteriorly to the edentulous alveolar mucosa, (b) gingival enlargement in the left posterior mandibular buccal gingiva, and (c) gingival enlargement in left posterior maxillary palatal gingiva. (d) Extraoral clinical examination demonstrating an enlarged lymph node in the right submandibular area.
Figure 2
Figure 2
(a) Panoramic radiograph showing alveolar bone loss in proximity to the right mandibular premolar area. (b) Cross-sectional and axial views of cone-beam computed tomography (CBCT) revealing superficial resorption of the alveolar ridge and destruction of the buccal cortical bone in the area of the right mandibular premolars.
Figure 3
Figure 3
Histopathologic examination (Hematoxylin and Eosin, initial magnification 200×): (a) diffuse infiltration of the underlying connective tissue by neoplastic cells arising from a partially ulcerated and non-keratinized stratified squamous epithelium, (b) diffuse dense lymphoplasmacytic cell infiltrate surrounding the neoplastic epithelial cells and obscuring the tumor islands, (c) focal keratin pearl formation, and (d) focal areas of tissue necrosis.
Figure 4
Figure 4
Immunohistochemical analysis showing positivity of the tumor cells for (a) cytokeratin AE1/AE3 and (b) p63.
See this image and copyright information in PMC

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