Clinicopathological Analysis of 14 Cases of Primary Pulmonary Lymphoepithelial Carcinoma
Background and objective Primary pulmonary lymphoepithelial carcinoma(PPLEC)is a rare form of lung malignancy,accounting for only 0.7％of all lung cancers.It is currently classified as a distinct subtype within squamous cell carcinomas.This study aims to explore the clinicopathological characteristics of PPLEC and its subtypes,with the objective of enhancing understanding and improving diagnostic accuracy for this disease.Methods A retrospec-tive analysis was conducted on the clinical,pathological,imaging,and prognostic data of 14 patients diagnosed with PPLEC at the First Affiliated Hospital of Soochow University between February 2019 and June 2023.Results A total of 14 cases of PPLEC were identified,including 5 cases of the Regaud type,with ages ranging from 33 to 73 years,comprising 2 males and 3 females;and 9 cases of the Schmincke type,with ages ranging from 36 to 79 years,including 4 males and 5 females.Computed tomography(CT)scans consistently demonstrated soft tissue masses or nodular shadows.Reagud type mainly showed peripheral masses and Schmincke type mainly showed central masses.Pathological examination revealed tumor cells exhibiting syncytial-like growth,accompanied by lymphocytic infiltration and stromal fibrosis,with the Regaud type showing well-defined borders combined with granulomatous inflammation,while the Schmincke type exhibited indistinct tumor margins.Immunohistochemistry showed that CK,CK5/6,P40 and P63 were positive,and the Ki-67 index of Regaud type was lower than that of Schmincke type;notably,all 8 cases tested for programmed death-ligand 1(PD-L1)were posi-tive.Epstein-Barr virus-encoded RNA(EBER)in situ hybridization was positive in all instances.Among these cases,6 under-went surgical treatment,and 8 received comprehensive therapy;by the end of the follow-up period,all 14 patients remained alive.Conclusion PPLEC is a rare form of malignant lung tumor associated with Epstein-Barr virus(EBV)infection.The Regaud and Schmincke subtypes display distinct imaging and pathological characteristics.In the early stages of the disease,surgical intervention is the primary treatment method;however,for advanced stages,a multimodal treatment approach is utilized,resulting in a relatively favorable prognosis.Immunotherapy represents a promising and effective treatment modal-ity for patients with middle to advanced stage disease exhibiting high PD-L1 expression levels.
万方数据
维普
