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Vol. 57. Issue 10.
Pages 651 (October 2021)
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Vol. 57. Issue 10.
Pages 651 (October 2021)
Clinical Image
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88-Year-Old Woman With an Incidental Lung Mass
Mujer de 88 años con una masa pulmonar incidental
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Oriana Salamoa,
Corresponding author
, Sujith V. Cherianb, Rosa M. Estrada-Y-Martinb
a University of Texas Health Science Center at Houston, Department of Internal Medicine, Houston, TX, USA
b University of Texas Health Science Center at Houston, Department of Pulmonary, Critical Care and Sleep Medicine, Houston, TX, USA
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A 88-year-old woman was referred to the pulmonary clinic for evaluation of a asymptomatic left lung mass which was incidentally found on chest radiographs. CT scan of the thorax showed a 6.4cm mass, and additional PET scan failed to reveal metastatic disease. An endobronchial ultrasound guided-biopsy was performed, and pathology showed neoplastic cells with large nuclei arranged in nests, with positive staining for pancytokeratin AE1/AE3, CK5/6, P40 and EBER-in situ hybridization, ultimately favoring the diagnosis of Epstein–Barr virus positive lymphoepithelioma-like carcinoma (PLELC) instead of squamous cell carcinoma of the lung (Fig. 1). Further tests revealed a low pulmonary reserve, and given her age, lack of symptoms and the size of the primary lesion, a decision for “watchful waiting” with frequent surveillance imaging was made.

Fig. 1.

(A, B) 6.4cm heterogenous mass replacing the lingula with large endobronchial component. (C) Hematoxylin and eosin-stained section of lung (400×). (D) Tumor cells with positive CK5/6 staining (100×). (E) Neoplastic cells with positive staining for pancytokeratin AE1/AE3 (100×). (F) Neoplastic cells P40 positive (100×).

(0.37MB).

PLELC is a rare type of non-small cell lung cancer associated with Epstein–Barr; has been mostly described in young non-smoker Asians accounting for only 0.9% of primary lung malignancies.1 Noticeably, 35% of the patients are asymptomatic when the tumor is incidentally found. Unfortunately, there is no standard treatment for PLELC at this time due to its rarity, but overall, patients have a significantly better prognosis when compared to other lung malignancies.2

Conflict of Interests

The authors declare no actual or potential conflict of interests.

References
[1]
B. Chen, X. Chen, P. Zhou, L. Yang, J. Ren, X. Yang, et al.
Primary pulmonary lymphoepithelioma-like carcinoma: a rare type of lung cancer with a favorable outcome in comparison to squamous carcinoma.
Respir Res, 20 (2019), pp. 262
[2]
Y. Qin, G. Gao, X. Xie, Z. Zhu, W. Guan, X. Lin, et al.
Clinical features and prognosis of pulmonary lymphoepithelioma-like carcinoma: summary of eighty-five cases.
Clin Lung Cancer, 20 (2019), pp. e329-e337
Copyright © 2020. SEPAR
Archivos de Bronconeumología

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