Case Report
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 14, 2016; 22(10): 3056-3061
Published online Mar 14, 2016. doi: 10.3748/wjg.v22.i10.3056
Lymphoepithelioma-like gastric carcinoma: A case report and review of the literature
Zhao-Hui Wang, Jun-Jun Zhao, Zhao Yuan
Zhao-Hui Wang, Zhao Yuan, Department of Gastroenterology, Dalian Municipal Central Hospital, Dalian 116033, Liaoning Province, China
Jun-Jun Zhao, Department of Pathology, Dalian Municipal Central Hospital, Dalian 116033, Liaoning Province, China
Author contributions: All authors contributed to the acquisition of data; Wang ZH and Yuan Z designed the research; Wang ZH was the physician in charge and participated in endoscopic treatment; Zhao JJ made the histopathologic and immunohistochemistry diagnosis, and provided the pathologic images; Wang ZH and Yuan Z performed the research and data analysis; Yuan Z wrote the manuscript; Wang ZH and Yuan Z revised the manuscript.
Institutional review board statement: The study was reviewed and approved by the Dalian Municipal Central Hospital Institutional Review Board.
Informed consent statement: The patient involved in this study gave her written informed consent authorizing use and disclosure of her protected health information.
Conflict-of-interest statement: None of the authors have any conflicts of interest to declare.
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:
Correspondence to: Zhao-Hui Wang, MD, PhD, Department of Gastroenterology, Dalian Municipal Central Hospital, No. 42 Xuegong Street, Dalian 116033, Liaoning Province, China.
Telephone: +86-411-84412001-523 Fax: +86-411-84411941
Received: May 12, 2015
Peer-review started: May 14, 2015
First decision: July 10, 2015
Revised: July 27, 2015
Accepted: September 30, 2015
Article in press: September 30, 2015
Published online: March 14, 2016

Lymphoepithelioma-like gastric carcinoma is a rare type of gastric cancer characterized by a carcinoma with intense stromal lymphocytic infiltration. Although lymphocytic infiltration is closely associated with Epstein-Barr virus (EBV) infection, concomitant occurrence with differentiated adenocarcinoma is relatively rare. The clinical manifestations of lymphoepithelioma-like gastric carcinoma (including EBV-positive and -negative forms) are similar to those of gastric cancer, and the diagnosis is based on pathologic, histologic, and immunohistochemical findings. This report describes the case of a 55-year-old female patient who presented with a 10-year history of recurrent and worsening abdominal pain and melena that had been occurring for 2 mo. An ulcerative lesion was detected in the stomach by endoscopic examination, which raised suspicion of early gastric cancer. A subsequent preoperative endoscopic biopsy showed adenocarcinoma, but the postoperative pathologic, histologic, and immunohistochemical analyses of the resected specimen revealed a final diagnosis of lymphoepithelioma-like gastric carcinoma.

Keywords: Epstein-Barr virus, Lymphoepithelioma-like carcinoma, Stomach neoplasms

Core tip: Lymphoepithelioma-like gastric carcinoma is a rare subtype of gastric carcinoma with a better survival rate than other gastric cancers. It is similar to gastric cancer, with no obvious early symptoms. Lymphoepithelioma-like gastric carcinoma is difficult to discern from biopsy specimens because of the stromal lymphocyte infiltrates. As preoperative diagnosis is difficult and it is easily misdiagnosed, cases are usually diagnosed pathologically after tumor surgery. In order to gain a detailed understanding of this rare disease, we reviewed the literature and report here on a recent case of epithelioid gastric cancer in our hospital.