Insilla AC, Faviana P, Pollina LE, Simone PD, Coletti L, Filipponi F, Campani D. Lymphoepithelioma-like hepatocellular carcinoma: Case report and review of the literature. World J Gastroenterol 2015; 21(36): 10468-10474 [PMID: 26420974 DOI: 10.3748/wjg.v21.i36.10468]
Corresponding Author of This Article
Daniela Campani, MD, Professor of Pathology, Department of Surgical, Medical, Molecular Pathology and Critical Area, Division of Surgical Pathology, University Hospital of Pisa, Via Paradisa 2, 56124 Pisa, Italy. daniela.campani@med.unipi.it
Research Domain of This Article
Pathology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Sep 28, 2015; 21(36): 10468-10474 Published online Sep 28, 2015. doi: 10.3748/wjg.v21.i36.10468
Lymphoepithelioma-like hepatocellular carcinoma: Case report and review of the literature
Andrea Cacciato Insilla, Pinuccia Faviana, Luca Emanuele Pollina, Paolo De Simone, Laura Coletti, Franco Filipponi, Daniela Campani
Andrea Cacciato Insilla, Pinuccia Faviana, Luca Emanuele Pollina, Daniela Campani, Department of Surgical, Medical, Molecular Pathology and Critical Area, Division of Surgical Pathology, University Hospital of Pisa, 56124 Pisa, Italy
Paolo De Simone, Laura Coletti, Franco Filipponi, Department of Surgical, Medical, Molecular Pathology and Critical Area, Division of Liver Surgery and Transplantation, University Hospital of Pisa, 56124 Pisa, Italy
Author contributions: Cacciato Insilla A and Campani D contributed equally to this work and reported the case; Coletti L researched the bibliography; Cacciato Insilla A and Campani D wrote the paper; Faviana P and Pollina LE contributed to the histopathological diagnosis; and De Simone P and Filipponi F provided clinical information and approved the submission of the paper.
Supported by University of Pisa funds.
Institutional review board statement: For case report, the Italian legislation requires patients have to consent to diffusion of personal data and health records. No further authorization is required nor approval from Local Ethics Committee.
Informed consent statement: The patient participant to the study provided informed written consent.
Conflict-of-interest statement: Daniela Campani has not received fees for serving as a speaker, a consultant or an advisory board member for any organizations.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Daniela Campani, MD, Professor of Pathology, Department of Surgical, Medical, Molecular Pathology and Critical Area, Division of Surgical Pathology, University Hospital of Pisa, Via Paradisa 2, 56124 Pisa, Italy. daniela.campani@med.unipi.it
Telephone: +39-50-995690 Fax: +39-50-996891
Received: February 13, 2015 Peer-review started: February 22, 2015 First decision: April 23, 2015 Revised: May 29, 2015 Accepted: July 3, 2015 Article in press: July 3, 2015 Published online: September 28, 2015 Processing time: 226 Days and 19.7 Hours
Abstract
Lymphoepithelioma-like hepatocellular carcinoma (LEL-HCC) is a rare form of undifferentiated carcinoma of the liver characterized by the presence of an abundant lymphoid infiltrate. Here, a case of LEL-HCC is described. An 81-year-old woman with a chronic hepatitis C infection was referred to the general surgery department of our hospital in August 2013 with a diagnosis of HCC. A past ultrasound examination had revealed a 60 mm-diameter nodular lesion in the third segment of the liver. After a needle biopsy, the lesion was diagnosed as HCC. The patient underwent surgery with a liver segmentectomy. Two additional nodes on the gastric wall were detected during the surgical operation. The histology of the removed specimen showed a poorly differentiated HCC with significant lymphoid stroma. Immunohistochemical studies revealed that the epithelial component was reactive for CK CAM5.2, CK8, CK18, CEA (polyclonal) and was focally positive for hepar-1 and that the lymphoid infiltrate was positive for CD3, CD4 and CD8. The tumor cells were negative for Epstein-Barr virus. The gastric nodes were ultimately determined to be two small gastrointestinal stromal tumors (GISTs). The synchronous occurrence of HCC and GIST is another very uncommon finding rarely described in the literature. Here, we report the clinicopathological features of our case, along with a review of the few cases present in the literature.
Core tip: Here a case of Lymphoepithelioma-like hepatocellular carcinoma (HCC) described in a 81-year-old woman with a chronic hepatitis C infection. An ultrasound examination revealed a nodular lesion in the third segment of the liver, diagnosed as HCC after a needle biopsy. The patient underwent surgery with a liver segmentectomy. Histology of the removed specimen showed a poorly differentiated HCC with a significant lymphoid stroma. Here we describe the clinico-pathological features of our case with a review of the few cases reported in literature.
