The Role of Epstein-Barr Virus in Lymphoepithelioma-like Carcinomas

Abstract

Epstein-Barr virus (EBV) has been implicated in the pathogenesis of a variety of lymphoproliferative disorders and several epithelial neoplasms, including undifferentiated nasopharyngeal carcinoma (UNPC; lymphoepithelioma). Lymphoepithelioma-like carcinomas (LEC) are tumors with morphologic features identical to UNPC that occur outside the nasopharynx. To determine whether EBV is associated with LEC, the authors conducted a comprehensive literature review of all pathologically documented LEC reported to date in the English literature. In summary, EBV is associated consistently with LEC from only four anatomic sites: stomach, salivary gland, lung, and thymus. Racial and/or geographic factors influence the association of EBV with LEC in some of these organs. Specifically, the association of EBV with LEC of the salivary gland and lung is restricted to Asian patients, whereas the association of EBV with gastric and thymic LEC is independent of race. The presence or absence of EBV in LEC does not appear to be prognotically important in those cases studies to date.

Molecular Diagnosis of Epstein-Barr Virus-Related Diseases

“…2,6,29 The majority of nasopharyngeal carcinoma patients initially present with enlarged lymph nodes containing metastatic undifferentiated carcinoma of unknown primary, and EBER expression is touted as an indicator of nasopharyngeal origin.…”

“…Nasopharyngeal carcinomas and posttransplant lymphoproliferative disorders are nearly always EBV-associated, whereas several other tumors, such as Hodgkin's disease, nonHodgkin's lymphoma, lymphoepithelioma-like carcinoma, gastric adenocarcinoma, and several types of sarcoma, are less uniformly EBV-associated. [2][3][4][5][6][7] EBV causes benign transient lymphoproliferative lesions at the time of primary infection, and it is found in a benign lesion of the tongue called oral hairy leukoplakia. 8,9 Patients affected by these benign or malignant diseases may benefit from laboratory detection of EBV to confirm their diagnosis or to monitor disease burden after the initiation of therapy.…”

Salivary Gland Neoplasia: A Review for the Practicing Pathologist

“…However, no increased risk is documented for infections with herpes, papilloma or HIV viruses (3,4). Contrary to one previous study (5), it is acknowledged now that there is no increased risk of a second primary breast cancer in women who have had previous salivary gland cancer.…”

Epstein-Barr virus–associated lymphoproliferative disorders

“…It has been associated with almost all cases of nasopharyngeal carcinoma [14], a subset of gastric carcinomas [15], lymphoepitheliomas of a variety of foregut sites [14], inflammatory pseudotumors of the liver and spleen [16], and HIV-associated smooth muscle neoplasms [17]. In this review, we will only discuss the EBV-associated lymphoproliferative disorders, dividing them into B-cell, T/NK-cell, and HIV-related lymphoproliferative disorders.…”