Abstract

AVILES-SALAS, Alejandro; VELEZ-VALLE, Alina; BRYON-GALLEGO, Adriana  and  ARRIETA, Oscar. Pulmonary lymphoepithelioma-like carcinoma with ex pression of Epstein-Barr virus and PD-L1. Medicina (B. Aires) [online]. 2023, vol.83, n.2, pp.319-322. ISSN 0025-7680.

Pulmonary lymphoepithelioma-like carcinoma is a rare type of non-small cell lung cancer, it accounts for approximately 0.7% of all cases. It is usually associated with Epstein-Barr virus infection and is more prevalent in Southeast Asia; however, it is extremely rare in Latin America. We present a 65-year-old man with a primary pulmonary lymphoepithelioma-like carcinoma, who presented with cough, dyspnoea and weight loss. Com puter tomographic scan of the thorax showed a nodule localized in the right lung. A transthoracic biopsy of the lung lesion was made and the microscopic obser vation revealed large polygonal cells that proliferated in a nest pattern with infiltration by lymphocytes and plasma cells around the interstitium. The tumour cells were positive for citokeratin 5/6 and p63, and negative for Napsin A and thyroid transcription factor 1 (TTF-1). PD-L1 expression was positive (approximately 100%) in the immunohistochemical study, and the nuclei of the tumour cells were positive for EBV-encoded small RNA in-situ hybridization (EBER-ISH). The patient underwent six cycles of platinum-based combination (gencitabine/ carboplatin) chemotherapy plus durvalumab. He pre sented progression of the disease and finally he died 9 months after diagnosis.

Keywords : Pulmonary lymphoepithelioma-like carci noma; Non-small cell lung cancer; Epstein-Barr virus; Im munohistochemistry; Epstein Barr virus-encoded small RNA in-situ hybridization.