Pulmonary Lymphoepithelioma-like Carcinoma Disguised as Squamous Cell Carcinoma

Anand, Ankit; Zayac, Adam; Curtiss, Christopher; Graziano, Stephen L.

doi:10.1016/j.jtho.2017.11.133

Cited by 18 publications

(19 citation statements)

References 3 publications

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“…A closeassociation of EBV and LELC has been widely accepted [21, 22]. Due to the strong resemblance to squamous carcinoma in radiological and pathologic manifestations, LELC is frequently misdiagnosed [11, 12]. In the current study, we focused on the primary pulmonary LELC and compared its clinical and prognostic characteristics with primary pulmonary squamous carcinoma.…”

Section: Discussionmentioning

confidence: 99%

“…This resemblance increases the diagnostic difficulties apparently. Several misdiagnosed primary pulmonary LELC cases, mainly as pulmonary squamous carcinoma, have been reported [11, 12], which greatly facilitates the necessity of illustrating the features of primary pulmonary LELC. Unfortunately, little literature involves the knowledge and management of primary pulmonary LELC due to its uncommon occurrence, in spite that it is routinely perceived with a favorable outcome when compared with other lung cancers [9, 13].…”

Section: Introductionmentioning

confidence: 99%

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Primary pulmonary lymphoepithelioma-like carcinoma: a rare type of lung cancer with a favorable outcome in comparison to squamous carcinoma

Chen

Zhou

et al. 2019

Respir Res

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BackgroundPrimary pulmonary lymphoepithelioma-like carcinoma (LELC) is a rare tumor and often misdiagnosed as squamous carcinoma. In the current study, clinical characteristics and outcome of primary pulmonary LELC were systematically compared with pulmonary squamous carcinoma.MethodsForty-two cases of primary pulmonary LELC and 134 squamous carcinomas were enrolled retrospectively. Characteristic and prognosis difference between the two groups was compared, and the independent prognostic factor for pulmonary LELC was identified as well.ResultsIn comparison to squamous carcinoma, pulmonary LELC was more common in women with a younger median age and less smokers. LELC seemed to be smaller in diameter on computed tomography (CT) scans than squamous carcinoma, with scarce spiculation and vascular convergence signs. Epstein-Bar virus-encoded RNA (EBER) by in-situ hybridization was detected in 33 LELC cases, among whom 27 ones were positive in serum EBV-DNA examination. LELC patients presented a much longer median progression-free survival (PFS) than squamous carcinoma. Positive serum EBV-DNA, distant lymph node invasion, advanced clinical stage and receiving radiotherapy were correlated with the shorter PFS in LELC patients. However, only positive serum EBV-DNA was the independent PFS predictor.ConclusionPulmonary LELC looks like distinct from squamous carcinoma. Middle-aged women and nonsmokers are comparatively predominated. CT features of pulmonary LELC are relatively less-malignant. Correspondently, the progression of pulmonary LELC is seemingly favorable than squamous carcinoma and the positive serum EBV-DNA appears to be the predictor of PFS.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Primary pulmonary lymphoepithelioma-like carcinoma: a rare type of lung cancer with a favorable outcome in comparison to squamous carcinoma

Chen

Zhou

et al. 2019

Respir Res

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“…As a rare type of primary lung cancer, pulmonary LELC was estimated to account for 0.9% of all lung malignancies, 7 and less than accumulative 600 cases were reported since its initial discovery 8 . Because of the low incidence, the optimal treatment strategy for this distinctive subtype of lung cancer remains controversial 9 .…”

Section: Introductionmentioning

confidence: 99%

Clinicopathological and prognostic analyses of 86 resected pulmonary lymphoepithelioma‐like carcinomas

Chen

et al. 2020

Journal of Surgical Oncology

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BackgroundPulmonary lymphoepithelioma‐like carcinoma (LELC) is a rare subtype of primary lung cancer. The present study aims at investigating clinicopathological features and prognostic characteristics of the resected pulmonary LELC.MethodsPatients with resected pulmonary LELC were identified in our hospital from December 2008 to December 2018. Data of these patients were retrospectively reviewed, clinicopathological features and prognostic characteristics were analyzed subsequently.ResultsIn total, 86 patients were enrolled in the study, including 39 (45.3%) males and 47 (54.7%) females. Most of the serum tumor markers were normal. Immunohistochemical staining result showed frequent differentiation traits of epithelial tissue such. Positive PD‐L1 (15 of 19, 78.9%) and PD‐1 (13 of 17, 76.5%) were also common, but cancer‐related genetic mutation was scarce (1 of 47, 2.1%). Survival analyses demonstrated that the N stage (p = .011) and extent of resection (p = .023) were identified as independent predictive factors for overall survival.ConclusionsPulmonary LELC is a distinctive subtype of lung cancer with several exclusive traits, such as the trend to happen among nonsmoking young people, epithelial origin of tumor differentiation, frequent expression of the immune checkpoint, and scarce presence of driver mutation. In addition, pulmonary LELC was apt to get a favorable outcome, especially in cases diagnosed and treated in the early stage.

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“…It is reported that PLELC might be misdiagnosed as lung SCC because they share similar immunohistochemical markers such as CK5/6 and P63. 46 Therefore, EBERs in situ hybridization is vital for the diagnosis of PLELC and poorly differentiated lung SCC.…”

Section: Discussionmentioning

confidence: 99%

Low frequency of mutation of epidermal growth factor receptor (EGFR) and arrangement of anaplastic lymphoma kinase (ALK) in primary pulmonary lymphoepithelioma‐like carcinoma

Yin

Feng

et al. 2019

Thoracic Cancer

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Background: Primary pulmonary lymphoepithelioma-like carcinoma (PLELC) is a rare and unique subtype of lung cancer. However, the prevalence of driver alterations, such as epidermal growth factor receptor (EGFR) mutations and anaplastic lymphoma kinase (ALK) rearrangements, and the response of tyrosine kinase inhibitor (TKIs) in PLELC has not been thoroughly investigated. Method: We retrospectively reviewed the genetic profiles and treatment course of 330 PLELC patients at the Guangdong Lung Cancer Institute (GLCI) from based on their mention of "driver mutations" and "the response of TKIs to mutant PLELC". Results: Genetic alterations of EGFR/ALK were tested in 203 patients (203/330, 61.5%). Five patients (5/175, 2.9%) had EGFR mutation and three patients (3/140, 2.1%) had ALK alteration. From the total of 15 articles identified from electronic searches, 1071 PLELC cases mentioned the driver mutations. EGFR mutation and ALK rearrangement were detected in 15 patients and one patient, respectively. In total, there were four EGFR/ALK mutant PLELC patients who received targeted therapy as palliative treatment at the GLCI and in the literature. However, there was disease progression in all cases one month after use of TKIs. Conclusion: The mutation rates of EGFR and ALK were low in PLELC. EGFR and ALK TKIs showed limited response in EGFR/ALK mutant PLELC. Further studies are needed to explore other molecular targets to optimize the therapeutic strategy for PLELC. Key points• The mutation rates of EGFR and ALK in PLELC were lower than other common types of non-small cell lung cancer. • EGFR/ALK TKIs showed a limited response in EGFR/ALK mutant PLELC.• This large cohort study demonstrates the prevalence of EGFR mutation and ALK alteration, and summarizes the response of targeted therapy in mutant PLELC patients.

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Pulmonary Lymphoepithelioma-like Carcinoma Disguised as Squamous Cell Carcinoma

Abstract: References 1. Yener NA, Balikci A, Cubuk R, Midi A, Orki A, Eren Topkaya A. Primary lymphoepithelioma-like carcinoma of the lung: report of a rare case and review of the literature. Turk Patoloji Derg. 2012;28:286-289.

Cited by 18 publications

References 3 publications

Primary pulmonary lymphoepithelioma-like carcinoma: a rare type of lung cancer with a favorable outcome in comparison to squamous carcinoma

Primary pulmonary lymphoepithelioma-like carcinoma: a rare type of lung cancer with a favorable outcome in comparison to squamous carcinoma

Clinicopathological and prognostic analyses of 86 resected pulmonary lymphoepithelioma‐like carcinomas

Low frequency of mutation of epidermal growth factor receptor (EGFR) and arrangement of anaplastic lymphoma kinase (ALK) in primary pulmonary lymphoepithelioma‐like carcinoma

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