Lymphoepithelioma-Like Carcinoma of the Stomach with Epithelioid Granulomas

• Main Authors: Toshihisa Tamura, Tetsuo Hamada, Tatsuhiko Sako, Kosuke Makihara, Kozue Yamada, Kenji Kashima, Shigeo Yokoyama, Keiji Hirata, Yasutaka Hachiya, Tokihiko Fukuyama, Yutaka Hirano
• Format: Article
• Language: English
• Published: Karger Publishers 2010-09-01
• Series: Case Reports in Gastroenterology
• Subjects: Lymphoepithelioma-like carcinoma; Stomach; Granuloma; Epstein-Barr virus
• Online Access: http://www.karger.com/Article/FullText/320671

An 83-year-old Japanese man was admitted to our hospital for gastric adenocarcinoma mimicking a submucosal tumor in the gastric body. Considering his general condition, partial resection of the stomach and dissection of regional lymph nodes were performed; a dome-shaped tumor that was largely covered by normal mucosa and having a shallow central stellate ulcer was removed. Histopathologically, the carcinoma cell nests were surrounded by prominent lymphoid stroma. Sarcoid-like epithelioid granulomas were noted both in the tumor stroma and in the regional lymph node with metastasis. Epstein-Barr virus (EBV)-encoded RNA (EBER) in situ hybridization showed an intense and diffuse positive reaction in the carcinoma cells and no reaction in the surrounding gastric and lymphoid tissues. While the presence of lymphoid stroma is a characteristic finding in EBV-associated lymphoepithelioma-like carcinoma, sarcoid-like epithelioid granulomas might be associated with latent EBV infection.