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Int J Clin Exp Pathol 2010;3(7):736-741

Case Report
Primary mixed lymphoepithelioma-like carcinoma and intra-hepatic cholangiocarcinoma:
a case report and review of literature

Evita Henderson-Jackson, Nelly A. Nasir, Ardeshir Hakam, Aejaz Nasir, Domenico Coppola

Department of Pathology and Laboratory Medicine, Moffitt Cancer Center, Research Institute, University of South Florida, College of Medicine,
Tampa, Florida, USA

Received August 2, 2010; accepted August 15, 2010; available online August 18, 2010

Abstract: Primary lymphoepithelioma-like carcinomas (LELC) of the hepatobiliary tract are quite rare and the majority are associated with the
Epstein-Barr virus (EBV). Here we report an unusual case of intrahepatic cholangiocarcinoma (ICC), admixed with LELC in a 63 year-old
Filipino woman who presented clinically with right flank and back pain. Histologically, the tumor showed a dense lymphocytic infiltrate,
predominantly composed of CD3 (+) T cells, and two components: an undifferentiated carcinoma, morphologically similar to nasopharyngeal
carcinoma, and a poorly differentiated ICC intimately admixed. Immunohistochemical studies revealed that both components were
immunoreactive for AE1/AE3, cytokeratin 7 and, focally, for monoclonal CEA. Both components were negative for cytokeratin 20 and HePar 1.
EBER-1 in situ hybridization was uniformly positive in the tumor cells. The presence of EBV in ICC and LELC suggests that the virus may be
linked to the pathogenesis of both components of the tumor. The mechanism of virus-driven neoplastic transformation needs further
study.(IJCEP1008001).

Keywords: lymphoepithelioma-like carcinoma, cholangiocarcinoma, review

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Address all correspondence to:
Domenico Coppola, MD
Professor of Pathology and Oncological Sciences
Department of Anatomic Pathology
Division of Experimental Therapeutics
Moffitt Cancer Center & Research Institute,
University of South Florida, College of Medicine
12902 Magnolia Dr., Tampa FL 33612.  
Tel: (813)745-3275; Fax: (813)632-1708;
E-mail:
Domenico.Coppola@moffitt.org