HEPATOBILIARY LYMPHOEPITHELIOMA-LIKE CARCINOMA-ASSOCIATED WITH EPSTEIN-BARR-VIRUS

We describe the clinical and pathologic features of a lymphoepitheliom a-like carcinoma (LELC) that originated in the hepatobiliary system. A woman, aged 71 years, was first seen with a noncholangiolar adenocarc inoma with lymphoid stroma, which was discovered by open liver biopsy in 1993. In 1995, retroperitoneal and peripancreatic lymph nodes were involved by LELC. There currently is no evidence of distant metastasis outside the hepatobiliary peripancreatic region. Review of the biopsy material revealed a well-differentiated adenocarcinoma with transitio n into LELC. Epstein-Barr virus (EBV) transcripts were expressed in al l histologic phases of the tumor by in situ hybridization using immuno alkaline phosphatase-labeled oligonucleotide probes for EBV-encoded RN A I on formalin-fixed, paraffin-embedded sections. Polymerase chain re action analysis for EBV nuclear antigen 2 was consistent with EBV stra in type A. The LMP-I gene was found to be wild type by polymerase chai n reaction analysis. To our knowledge, this is the first report of a p rimary hepatobiliary adenocarcinoma associated with EBV infection that transformed into an undifferentiated LELC.