Lymphoepithelioma-like carcinoma of the upper urinary tract

Antonio Lopez-Beltran, Gladell Paner, Ana Blanca, Rodolfo Montironi, Toyonori Tsuzuki, Yoji Nagashima, Shi Sung Chuang, Khin Than Win, Leo Madruga, Maria R. Raspollini, Liang Cheng

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

In this report, we summarized the clinicopathologic features of ten cases of lymphoepithelioma-like carcinoma (LELC) of the upper urinary tract (ureter n = 6; renal pelvis n = 4), a rare variant of urothelial cancer characterized by a malignant epithelial component densely infiltrated by lymphoid cells. The initial diagnosis was made on radical nephrectomy in five cases, nephroureterectomy in three cases, and ureterectomy in two others. Four patients had pathologic stage T1 (n = 2) or T2 (n = 2) tumors, and six patients had stage pT3 disease. Microscopically, all tumors contained pure (n = 3) or predominant (n = 7) LELC, which composed 60 to 80% of the entire tumor. Non-LELC tumor component was adenocarcinoma (n = 2), spindle cell carcinoma (n = 1), or high-grade conventional urothelial carcinoma (n = 4). The LELC component was characterized by indistinct cytoplasmic borders and a syncytial growth pattern. Immunohistochemical staining showed LELC to be positive for cytokeratin AE1/AE3, CK7, CK34ßE12 (rare cells), CK5/6 (rare cells), and CK20 (rare cells); rare cells were p40 positive. GATA 3 was positive in all cases in a variable proportion of cells (20–80%). Lymphoid markers showed a polyclonal proliferation of predominant T cells admixed with B cells. In situ hybridization for the HPV genome was negative in all ten cases. Survival analysis showed no differences between LELC and conventional upper urinary tract urothelial carcinoma, pT classification being the only significant prognostic parameter. Morphologic recognition and distinction from other (non-)neoplastic lesions with prominent lymphoid stroma are critical for its clinical management.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
JournalVirchows Archiv
DOIs
StateAccepted/In press - Apr 28 2017

Fingerprint

Urinary Tract
Carcinoma
Neoplasms
Kidney Pelvis
Survival Analysis
Ureter
Keratins
Nephrectomy
In Situ Hybridization
Adenocarcinoma
B-Lymphocytes
Genome
Lymphocytes
Staining and Labeling
T-Lymphocytes
Growth

Keywords

  • Lymphoepithelioma
  • Lymphoepithelioma-like
  • Renal pelvis
  • Ureter

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine

Cite this

Lopez-Beltran, A., Paner, G., Blanca, A., Montironi, R., Tsuzuki, T., Nagashima, Y., ... Cheng, L. (Accepted/In press). Lymphoepithelioma-like carcinoma of the upper urinary tract. Virchows Archiv, 1-7. https://doi.org/10.1007/s00428-017-2117-z

Lymphoepithelioma-like carcinoma of the upper urinary tract. / Lopez-Beltran, Antonio; Paner, Gladell; Blanca, Ana; Montironi, Rodolfo; Tsuzuki, Toyonori; Nagashima, Yoji; Chuang, Shi Sung; Win, Khin Than; Madruga, Leo; Raspollini, Maria R.; Cheng, Liang.

In: Virchows Archiv, 28.04.2017, p. 1-7.

Research output: Contribution to journalArticle

Lopez-Beltran, A, Paner, G, Blanca, A, Montironi, R, Tsuzuki, T, Nagashima, Y, Chuang, SS, Win, KT, Madruga, L, Raspollini, MR & Cheng, L 2017, 'Lymphoepithelioma-like carcinoma of the upper urinary tract', Virchows Archiv, pp. 1-7. https://doi.org/10.1007/s00428-017-2117-z
Lopez-Beltran A, Paner G, Blanca A, Montironi R, Tsuzuki T, Nagashima Y et al. Lymphoepithelioma-like carcinoma of the upper urinary tract. Virchows Archiv. 2017 Apr 28;1-7. https://doi.org/10.1007/s00428-017-2117-z
Lopez-Beltran, Antonio ; Paner, Gladell ; Blanca, Ana ; Montironi, Rodolfo ; Tsuzuki, Toyonori ; Nagashima, Yoji ; Chuang, Shi Sung ; Win, Khin Than ; Madruga, Leo ; Raspollini, Maria R. ; Cheng, Liang. / Lymphoepithelioma-like carcinoma of the upper urinary tract. In: Virchows Archiv. 2017 ; pp. 1-7.
@article{56542f7cca864d0a9377e959c3d6359c,
title = "Lymphoepithelioma-like carcinoma of the upper urinary tract",
abstract = "In this report, we summarized the clinicopathologic features of ten cases of lymphoepithelioma-like carcinoma (LELC) of the upper urinary tract (ureter n = 6; renal pelvis n = 4), a rare variant of urothelial cancer characterized by a malignant epithelial component densely infiltrated by lymphoid cells. The initial diagnosis was made on radical nephrectomy in five cases, nephroureterectomy in three cases, and ureterectomy in two others. Four patients had pathologic stage T1 (n = 2) or T2 (n = 2) tumors, and six patients had stage pT3 disease. Microscopically, all tumors contained pure (n = 3) or predominant (n = 7) LELC, which composed 60 to 80{\%} of the entire tumor. Non-LELC tumor component was adenocarcinoma (n = 2), spindle cell carcinoma (n = 1), or high-grade conventional urothelial carcinoma (n = 4). The LELC component was characterized by indistinct cytoplasmic borders and a syncytial growth pattern. Immunohistochemical staining showed LELC to be positive for cytokeratin AE1/AE3, CK7, CK34{\ss}E12 (rare cells), CK5/6 (rare cells), and CK20 (rare cells); rare cells were p40 positive. GATA 3 was positive in all cases in a variable proportion of cells (20–80{\%}). Lymphoid markers showed a polyclonal proliferation of predominant T cells admixed with B cells. In situ hybridization for the HPV genome was negative in all ten cases. Survival analysis showed no differences between LELC and conventional upper urinary tract urothelial carcinoma, pT classification being the only significant prognostic parameter. Morphologic recognition and distinction from other (non-)neoplastic lesions with prominent lymphoid stroma are critical for its clinical management.",
keywords = "Lymphoepithelioma, Lymphoepithelioma-like, Renal pelvis, Ureter",
author = "Antonio Lopez-Beltran and Gladell Paner and Ana Blanca and Rodolfo Montironi and Toyonori Tsuzuki and Yoji Nagashima and Chuang, {Shi Sung} and Win, {Khin Than} and Leo Madruga and Raspollini, {Maria R.} and Liang Cheng",
year = "2017",
month = "4",
day = "28",
doi = "10.1007/s00428-017-2117-z",
language = "English (US)",
pages = "1--7",
journal = "Virchows Archiv",
issn = "0945-6317",
publisher = "Springer Verlag",

}

TY - JOUR

T1 - Lymphoepithelioma-like carcinoma of the upper urinary tract

AU - Lopez-Beltran, Antonio

AU - Paner, Gladell

AU - Blanca, Ana

AU - Montironi, Rodolfo

AU - Tsuzuki, Toyonori

AU - Nagashima, Yoji

AU - Chuang, Shi Sung

AU - Win, Khin Than

AU - Madruga, Leo

AU - Raspollini, Maria R.

AU - Cheng, Liang

PY - 2017/4/28

Y1 - 2017/4/28

N2 - In this report, we summarized the clinicopathologic features of ten cases of lymphoepithelioma-like carcinoma (LELC) of the upper urinary tract (ureter n = 6; renal pelvis n = 4), a rare variant of urothelial cancer characterized by a malignant epithelial component densely infiltrated by lymphoid cells. The initial diagnosis was made on radical nephrectomy in five cases, nephroureterectomy in three cases, and ureterectomy in two others. Four patients had pathologic stage T1 (n = 2) or T2 (n = 2) tumors, and six patients had stage pT3 disease. Microscopically, all tumors contained pure (n = 3) or predominant (n = 7) LELC, which composed 60 to 80% of the entire tumor. Non-LELC tumor component was adenocarcinoma (n = 2), spindle cell carcinoma (n = 1), or high-grade conventional urothelial carcinoma (n = 4). The LELC component was characterized by indistinct cytoplasmic borders and a syncytial growth pattern. Immunohistochemical staining showed LELC to be positive for cytokeratin AE1/AE3, CK7, CK34ßE12 (rare cells), CK5/6 (rare cells), and CK20 (rare cells); rare cells were p40 positive. GATA 3 was positive in all cases in a variable proportion of cells (20–80%). Lymphoid markers showed a polyclonal proliferation of predominant T cells admixed with B cells. In situ hybridization for the HPV genome was negative in all ten cases. Survival analysis showed no differences between LELC and conventional upper urinary tract urothelial carcinoma, pT classification being the only significant prognostic parameter. Morphologic recognition and distinction from other (non-)neoplastic lesions with prominent lymphoid stroma are critical for its clinical management.

AB - In this report, we summarized the clinicopathologic features of ten cases of lymphoepithelioma-like carcinoma (LELC) of the upper urinary tract (ureter n = 6; renal pelvis n = 4), a rare variant of urothelial cancer characterized by a malignant epithelial component densely infiltrated by lymphoid cells. The initial diagnosis was made on radical nephrectomy in five cases, nephroureterectomy in three cases, and ureterectomy in two others. Four patients had pathologic stage T1 (n = 2) or T2 (n = 2) tumors, and six patients had stage pT3 disease. Microscopically, all tumors contained pure (n = 3) or predominant (n = 7) LELC, which composed 60 to 80% of the entire tumor. Non-LELC tumor component was adenocarcinoma (n = 2), spindle cell carcinoma (n = 1), or high-grade conventional urothelial carcinoma (n = 4). The LELC component was characterized by indistinct cytoplasmic borders and a syncytial growth pattern. Immunohistochemical staining showed LELC to be positive for cytokeratin AE1/AE3, CK7, CK34ßE12 (rare cells), CK5/6 (rare cells), and CK20 (rare cells); rare cells were p40 positive. GATA 3 was positive in all cases in a variable proportion of cells (20–80%). Lymphoid markers showed a polyclonal proliferation of predominant T cells admixed with B cells. In situ hybridization for the HPV genome was negative in all ten cases. Survival analysis showed no differences between LELC and conventional upper urinary tract urothelial carcinoma, pT classification being the only significant prognostic parameter. Morphologic recognition and distinction from other (non-)neoplastic lesions with prominent lymphoid stroma are critical for its clinical management.

KW - Lymphoepithelioma

KW - Lymphoepithelioma-like

KW - Renal pelvis

KW - Ureter

UR - http://www.scopus.com/inward/record.url?scp=85018336883&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85018336883&partnerID=8YFLogxK

U2 - 10.1007/s00428-017-2117-z

DO - 10.1007/s00428-017-2117-z

M3 - Article

SP - 1

EP - 7

JO - Virchows Archiv

JF - Virchows Archiv

SN - 0945-6317

ER -