Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
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Case Report

Volume 6, Number 7, July 2015, pages 297-303

Lymphoepithelioma-Like Hepatocellular Carcinoma: Report of Three Cases and Review of Literature


Figure 1.
Figure 1. Gross photograph of right hepatectomy specimen from an 89-year-old female patient with a solitary liver mass. A 5.1 cm well-circumscribed, soft, white mass was present within the resection specimen.
Figure 2.
Figure 2. Histopathology of lymphoepithelioma-like hepatocellular carcinoma in the right lobectomy specimen, illustrating the pleomorphic malignant cells and the intimately associated lymphoplasmacytic infiltrate. (A) H&E, × 40. (B) H&E, × 100. (C) H&E, × 200. (D) H&E, × 400.
Figure 3.
Figure 3. Immunophenotype of lymphoepithelioma-like hepatocellular carcinoma in the resection specimen, revealing the hepatocellular origin of the malignant cells and a prominent cytotoxic T-cell population, without evidence of Epstein-Barr virus infection. (A) Hep-Par-1, × 100. (B) CD3, × 100. (C) CD4, × 100. (D) CD8, × 100. (E) TIA-1, × 100. (F) EBER chromogenic in situ hybridization, × 100.


Table 1. Literature Review of Lymphoepithelioma-Like Hepatocellular Carcinoma
Case numberAuthor and yearAge (years)GenderUnderlying liver diseaseCirrhosisTumor size (cm)CD20CD3CD8TIAEBVFollow-up durationOutcome
N/A: information not available. 1By report, case 6 showed a lymphocytic infiltrate composed primarily of T lymphocytes, demonstrated by positivity for ubiquitin carboxyl-terminal hydrolase L1 (UCHL-1) [12]. 2Case 18 showed cholangiolar differentiation (focal CK19 immunoreactivity) [18]. 3Cases 22 and 23 showed lymphoid infiltrate consisting predominantly of T cells (case 22) or mixed T and B cells (case 23). Immunophenotype of the lymphoid cells is not reported [22].
1Emile et al, 2000 [10]50MHepatitis B and C infectionYes4.0 cmRarePositiveN/APositiveNegative10 yearsAlive without recurrence
2Emile et al, 2000 [10]54MPrevious HCC, status post right hepatectomy 2 years prior to liver transplantationNo2.0 cmRarePositiveN/APositiveNegative7.7 yearsDied of disease
3Emile et al, 2000 [10]59MHepatitis B and CYes5.0 cmRarePositiveN/APositiveNegative8 yearsAlive without recurrence
4Emile et al, 2000 [10]45MHepatitis CYes2.0 cmRarePositiveN/APositiveNegative4.7 yearsAlive without recurrence
5Emile et al, 2000 [10]64MFamilial hemochromatosisYes4.0 cmRarePositiveN/APositiveNegative3 yearsAlive without recurrence
61Shirabe et al, 1995 [12]58FHepatitis B infectionYes2.2 cmN/AN/AN/AN/AN/A6.9 yearsAlive without recurrence
7-17Wada et al, 1998 [13]44 - 77 years10 M:1 FHepatitis C viral antibody positive (11/11 cases)Yes in 6/11 casesAll tumors less than 3 cm (mean 2.2 cm)RareN/APositiveN/AN/A5 yearsAlive (11/11); without recurrence (10/11)
182Min et al, 2007 [18]62MNone describedNoN/AN/APositivePositiveN/AFocal positive EBV ISH, LMP1+Of unknown durationAlive without recurrence
19Si et al, 2004 [19]39FHepatitis CYes1.0 cmPositivePositiveN/AN/APositive4.5 monthsDied of disease
20Chen et al, 2007 [20]56MHepatitis CYes3.2 cmPositivePositiveN/AN/ANegative21 monthsDied of disease
21Nemolato et al, 2008 [21]47FNone describedNo2.2 cmN/APositivePositiveN/ANegative15 monthsAlive without recurrence
223Choi et al, 2008 [22]64MAlcohol historyNoN/AN/APositiveN/AN/ANegativeN/AUnknown
233Choi et al, 2008 [22]62FClonorchis infectionNoN/APositivePositiveN/AN/ANegativeN/AUnknown
24Park et al, 2009 [23]57MHepatitis BYes2.7 cmRarePositivePositiveN/ANegative50 monthsAlive without recurrence
25Current report89FHepatitis CNo5.1 cmRarePositivePositivePositiveNegative38 monthsAlive without recurrence
26Current report64MHepatitis BNo3.7 cmRarePositivePositivePositiveNegative26 monthsAlive without recurrence
27Current report60MHepatitis CNo5.6 cmN/AN/AN/AN/ANegative31 monthsDied of disease