Download PDF
CC BY-NC-ND 4.0 · Avicenna J Med 2018; 8(02): 58-62
DOI: 10.4103/ajm.AJM_135_17
CASE REPORT

CD4-positive lymphoepithelial-like carcinoma: Report of unusual case

Luaay Aziz
Department of Ent and Head and Neck Surgery, Healthpoint Hospital, Abu Dhabi, United Arab Emirates
,
Raya Saab
Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon
,
Toufic Eid
Department of Radiation Oncology, American University of Beirut, Beirut, Lebanon
,
Mousa A Al-Abbadi
Department of Pathology and Laboratory Medicine, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
› Author Affiliations Financial support and sponsorship Nil.
› Further Information
Also available at
   Permissions and Reprints

Abstract

We are reporting an unusual case of lymphoepithelial-like carcinoma (LELC) in an 8-year-old female patient where the tumor cells showed unusual CD4 expression. The lesion was found in the left submandibular neck region, in the vicinity of the submandibular gland. The salivary gland was not infiltrated by the tumor, and the tumor exhibited a classic LELC with single and clusters of tumor cells surrounded by many hematolymphoid cells. The tumor cells revealed strong positivity for Epstein–Bar virus as confirmed by the EBER: Epstein-Barr Virus in situ hybridization (EBER-ISH) method of staining. Interestingly, the tumor cells expressed membranous immunostaining for the T-helper lymphocyte antibody (CD4) in addition to pan-cytokeratin. A brief discussion about this unusual finding is offered. The patient was treated as a case of Epstein–Bar virus-associated nasopharyngeal carcinoma with excellent response.

Keywords

CD4 - Epstein–Bar virus - lymphoepithelial-like carcinoma - nasopharyngeal carcinoma


Publication History

Article published online:
12 August 2021

© 2018. Syrian American Medical Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Douglass EC, Pratt CB. Management of infrequent cancers of childhood. In: Pizzo PA, Poplack DG. editors Principles and Practice of Pediatric Oncology.3rd ed. Philadelphia: Lippincott-Raven; 1977. 3. 977-81
    Search in Google Scholar
  • 2 Wenig BM. Lymphoepithelial-like carcinomas of the head and neck. Semin Diagn Pathol 2015; 32: 74-86
    CrossrefPubMedSearch in Google Scholar
  • 3 Ellouz R, Cammoun M, Attia RB, Bahi J. Nasopharyngeal carcinoma in children and adolescents in Tunisia: Clinical aspects and the paraneoplastic syndrome. IARC Sci Publ 1978; 20: 115-29
    Search in Google Scholar
  • 4 Stiller CA. International variations in the incidence of childhood carcinomas. Cancer Epidemiol Biomarkers Prev 1994; 3: 305-10
    PubMedSearch in Google Scholar
  • 5 Wolf H, zur HausenH, Becker V. EB viral genomes in epithelial nasopharyngeal carcinoma cells. Nat New Biol 1973; 244: 245-7
    CrossrefPubMedSearch in Google Scholar
  • 6 Attia AB, Maalaj M, Ellouz R, Ayed FB. et al. Results of radiotherapy and adjuvant chemotherapy in the treatment of nasopharyngeal cancer in young patients. A review of 28 cases. J Eur Radiother 1986; 2: 61-7
    Search in Google Scholar
  • 7 Ayan I, Altun M. Nasopharyngeal carcinoma in children: Retrospective review of 50 patients. Int J Radiat Oncol Biol Phys 1996; 35: 485-92
    CrossrefPubMedSearch in Google Scholar
  • 8 Pao WJ, Hustu HO, Douglass EC, Beckford NS, Kun LE. Pediatric nasopharyngeal carcinoma: Long term follow-up of 29 patients. Int J Radiat Oncol Biol Phys 1989; 17: 299-305
    CrossrefPubMedSearch in Google Scholar
  • 9 Fernandez CH, Cangir A, Samaan NA, Rivera R. Nasopharyngeal carcinoma in children. Cancer 1976; 37: 2787-91
    CrossrefPubMedSearch in Google Scholar
  • 10 Jenkin RD, Anderson JR, Jereb B, Thompson JC, Pyesmany A, Wara WM. et al. Nasopharyngeal carcinoma – A retrospective review of patients less than thirty years of age: A report of children's cancer study group. Cancer 1981; 47: 360-6
    CrossrefPubMedSearch in Google Scholar
  • 11 Mertens R, Granzen B, Lassay L, Gademann G, Hess CF, Heimann G. et al. Nasopharyngeal carcinoma in childhood and adolescence: Concept and preliminary results of the cooperative GPOH study NPC-91. Gesellschaft für pädiatrische onkologie und hämatologie. Cancer 1997; 80: 951-9
    CrossrefPubMedSearch in Google Scholar
  • 12 Wenig BM. Lymphoepithelial-like carcinomas of the head and neck. Semin Diagn Pathol 2015; 32: 74-86
    CrossrefPubMedSearch in Google Scholar
  • 13 Ellis GL, Auclair PL. Lymphoepithelial carcinoma. In: Ellis GL, Auclair PL. editors Tumors of Salivary Glands. AFIP Atlas of Tumor Pathology. Series 4; Fascicle 9. Silver Spring: ARP Press; 2008. p. 349-56
    Search in Google Scholar
  • 14 Tsang WY, Kuo TT, Chan JK. Lymphoepithelial carcinoma. In: Barnes L, Eveson JW, Reichart P, Sidransky D. editors World Health Organization Classification of Tumours: Pathology & Genetics. Head and Neck Tumours. Lyon: IARC Press; 2017. p. 251-2
    Search in Google Scholar
  • 15 Tao CJ, Chen YY, Jiang F, Feng XL, Jin QF, Jin T. et al. Aprognostic model combining CD4/CD8 ratio and N stage predicts the risk of distant metastasis for patients with nasopharyngeal carcinoma treated by intensity modulated radiotherapy. Oncotarget 2016; 7: 46653-61
    CrossrefPubMedSearch in Google Scholar
  • 16 Sinha S, Moss DJ, Lutzky VP. EBV-specific immune response: Early research and personal reminiscences. Curr Top Microbiol Immunol 2015; 390: 23-42
    PubMedSearch in Google Scholar
  • 17 Zheng Y, Parsonage G, Zhuang X, Machado LR, James CH, Salman A. et al. Human leukocyte antigen (HLA) A*1101-restricted epstein-barr virus-specific T-cell receptor gene transfer to target nasopharyngeal carcinoma. Cancer Immunol Res 2015; 3: 1138-47
    CrossrefPubMedSearch in Google Scholar
  • 18 Mrizak D, Martin N, Barjon C, Jimenez-Pailhes AS, Mustapha R, Niki T. et al. Effect of nasopharyngeal carcinoma-derived exosomes on human regulatory T cells. J Natl Cancer Inst 2015; 107: 363
    CrossrefPubMedSearch in Google Scholar
  • 19 Qin Y, Weng J, Lan G, Wei H, Huang B, Sun J, Sarin YK. et al. Effect of p53 gene therapy on the local immunity and the efficacy of patients with nasopharyngeal carcinoma. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2012; 26: 980-3
    PubMedSearch in Google Scholar