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Table of Contents
Vol. 56, No. 1, 2012
Issue release date: January–February
Acta Cytologica 2012;56:85–91
(DOI:10.1159/000330677)

Lymphoepithelioma-Like Carcinoma of the Breast: Cytological and Histological Features and Review of the Literature

Trihia H. · Siatra H. · Gklisty H. · Diamantopoulos P. · Arapantoni-Dadiotis P. · Kalogerakos K.
aDepartment of Pathology and bBreast Unit, ‘Metaxas’ Anticancer Hospital, Piraeus, Greece

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Abstract

Objective: We present, for the first time, the cytological features of lymphoepithelioma-like carcinoma (LELC) of the breast in preoperative fine-needle aspiration (FNA) and touch imprints from secondary deposits in the sentinel lymph node (SLN). Study Design: We report a case of a 53-year-old woman who was diagnosed with breast carcinoma on preoperative FNA and was subjected to SLN biopsy, partial mastectomy and axillary lymph node dissection. The final diagnosis was LELC of the breast. Cytological and histological features were analyzed. Results: The smears from preoperative FNA contained cohesive clusters and isolated tumour cells in a haemorrhagic background with scattered lymphocytes. Some of the clusters were infiltrated by the inflammatory cells. The cells had large, pleomorphic nuclei and scanty, ill-defined cytoplasm. The intraoperative touch imprints from the SLN were highly cellular, comprising abundant scattered lymphoid cells, among which were tight clusters of indistinct cells, about 3 times larger than the lymphocyte population. Conclusion: In our case, LELC shares many cytological features with LELC described in other organs. Immunostains with epithelial markers play an important role in establishing the epithelial nature of the neoplastic cells. LELC should be borne in mind in the evaluation of breast lesions with prominent lymphoid cell infiltration. Its cytological features, as presented, could contribute to its preoperative evaluation on cytological grounds.



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References

  1. Regaud C, Reverchen L: Sur un cas d’épithélioma épidermoïde développé dans le massif maxillaire supérieur étendu aux ligaments de la face, aux cavités buccale, nasale et orbitaire ainsi qu’aux ganglions du cou guéri par la radiothérapie. Rev Laryngol Otol Rhinol 1921;42:369–378.
  2. Schmincke A: Über lymphoepitheliale Geschwülste. Beitr Pathol Anat 1921;58:161–170.
  3. Miettinen M, Lehto VP, Virtanen I: Nasopharyngeal lymphoepithelioma: histological diagnosis as aided by immunohistochemical demonstration of keratin. Virchows Arch B Cell Pathol Incl Mol Pathol 1982;40:163–169.
  4. Jezzoni JC, Gaffey MJ, Weiss LM: The role of Epstein-Barr virus in lymphoepithelioma-like carcinomas. Am J Clin Pathol 1995;103:308–315.
  5. Chen F-F, Yan J-J, Lai W-W, Jin Y-T, Su I-J: Epstein-Barr virus-associated non small cell lung carcinoma. Undifferentiated ‘lymphoepithelioma-like’ carcinoma as a distinct entity with better diagnosis. Cancer 1998;82:2334–2342.
  6. Kuo T, Hsueh C: Lymphoepithelioma-like salivary gland carcinoma in Taiwan: a clinicopathological study of nine cases demonstrating a strong association with Epstein-Barr virus. Histopathology 1997;31:75–82.
  7. Min KW, Holmquist S, Peiper SC, O’Leary TJ: Poorly differentiated adenocarcinoma with lymphoid stroma (lymphoepithelioma-like carcinomas) of the stomach: report of three cases with Epstein-Barr virus genome demonstrated by the polymerase chain reaction. Am J Clin Pathol 1991;96:219–227.
  8. Martorell MA, Julian JM, Calabuig C, Garcia-Garcia JA, Perez-Valles A: Lymphoepithelioma-like carcinoma of the uterine cervix: a clinicopathologic study of 4 cases not associated with Epstein-Barr virus, human papilloma virus or simian virus 40. Arch Pathol Lab Med 2002;126:1501–1505.
  9. Kumar S, Kumar D: Lymphoepithelioma-like carcinoma of the breast. Mod Pathol 1994;7:129–131.
  10. Ilvan S, Celik V, Akyildiz EU, Bese NS, Ramazanoglu R, Calay Z: Lymphoepithelioma-like carcinoma of the breast: is it a distinct entity? Clinicopathological evaluation of two cases and review of the literature. Breast 2004;13:522–526.
  11. Chan M, McGuire L, Kee J: Fine needle aspiration cytodiagnosis of nasopharyngeal carcinoma in cervical lymph nodes: a study of 40 cases. Acta Cytol 1989;33:344–350.
  12. Jaharam G, Swain M, Khanijow V, Jalaludin M: Fine-needle aspiration cytology of metastatic nasopharyngeal carcinoma. Diagn Cytopathol 1998;19:168–172.
  13. Chow LTC, Chow WH, Tsui WMS, et al: Fine-needle aspiration cytologic diagnosis of lymphoepithelioma-like carcinoma of the lung: report of two cases with immunohistochemical study. Am J Clin Pathol 1995;103:35–40.
  14. Guresci S: Cytology of lymphoepithelioma-like carcinoma of the urinary bladder. Cytopathology 2009;20:268–269.
  15. Cai G, Parwani A: Cytomorphology of lymphoepithelioma-like carcinoma of the urinary bladder: report of two cases. Diagn Cytopathol 2010;36:600–603.

    External Resources

  16. Christina S, Boldorini R, Brustia F: Lymphoepithelioma-like carcinoma of the breast: an unusual pattern of infiltrating lobular carcinoma. Virchows Arch 2000;437:198–202.
  17. Pesterelli H, Erdogan O, Resmiye K, et al: Lymphoepithelioma-like carcinoma of the breast: a newly recognized subtype of lobular carcinoma. APMIS 2002;110:447–450.
  18. Carbone A, Micheau C: Pitfalls in microscopic diagnosis of undifferentiated carcinoma of nasopharyngeal type (lymphoepithelioma). Cancer 1982;50:1344–1351.
  19. Zukerberg LR, Harris NL, Young RH: Carcinomas of the urinary bladder simulating malignant lymphoma: a report of five cases. Am J Surg Pathol 1991;15:569–576.
  20. Sanati S, Ayala AG, Middleton LP: Lymphoepithelioma-like carcinoma of the breast: report of a case mimicking lymphoma. Ann Diagn Pathol 2004;8:309–315.
  21. Powers CN, Raval P, Schmidt WA: Fine needle aspiration of metastatic lymphoepithelioma: a case report. Acta Cytol 1989;33:254–258.
  22. Ziegels-Weissman J, Nadji M, Penneys NS, Morales AR: Prekeratin immunohistochemistry in the diagnosis of undifferentiated carcinoma of the nasopharyngeal type. Arch Pathol Lab Med 1984;108:588–589.
  23. Sharanamma K, El Hag A: Fine-needle aspiration cytology of metastatic nasopharyngeal carcinoma in cervical lymph nodes: comparison with metastatic squamous-cell carcinoma and Hodgkin’s and non-Hodgkin’s lymphoma. Diagn Cytopathol 2002;28:18–22.

    External Resources

  24. Ridolfi RL, Rosen PP, Port A, Kinne D, Mike V: Medullary carcinoma of the breast: a clinicopathologic study with 10 year follow-up. Cancer 1977;40:1365–1385.
  25. Kurose A, Ichinohasama R, Kanno H, et al: Lymphoepithelioma-like carcinoma of the breast: report of a case with the first electron microscopic study and review of the literature. Virchows Arch 2005;447:653–659.
  26. Dadmanesh F, Peterse JL, Sapino A, Fonelli A, Eusebi V: Lymphoepithelioma-like carcinoma of the breast: lack of evidence of Epstein-Barr virus infection. Histopathology 2001;38:54–61.
  27. Kulka J, Kovalszky I, Svastics E, et al: Lymphoepithelioma-like carcinoma of the breast: not Epstein-Barr virus-, but human papilloma virus-positive. Human Pathol 2008;39:298–301.
  28. Naidoo P, Chetty R: Lymphoepithelioma-like carcinoma of the breast with associated lymphocytic lobulitis. Arch Pathol Lab Med 2001;125:669–672.


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