Intrahepatic cholangiocarcinoma with lymphoepithelioma-like component

We present two cases of intrahepatic cholangiocarcinoma with lymphoepitheli oma-like component The patients included one woman and one man, aged 67 and 41 years, respectively. They presented with right upper quadrant pain and epigastralgia. Histologically, both tumors showed two distinct histological patterns with dense lymphoplasma cell infiltration, The first pattern was a well to moderately differentiated adenocarcinoma; the second component sh owed a feature similar to lymphoepithelioma-like carcinoma Granulomatous re action was noted in one case. Immunohistochemical study revealed that both tumors were immunoreactive with AE1/AE3, cytokeratin 7, and cytokeratin 19 but negative for carcinoembryonic antigen and cytokeratin 20. The stromal l ymphocytes were composed of predominantly CD3(+) T cells. In situ hybridiza tion for Epstein-Barr virus (EBV)-encoded RNA (EBER) showed positive nuclea r signal in tumor cells but not in inflammatory cells in one case. The pres ence or absence of EBV genome was confirmed by polymerase chain reaction of LMP-1 gene in both cases. The LMP-1 gene also had a 30-bp deletion in Exon 3 as compared with the products from B95-8 cells. We further sequenced the PCR product and confirmed a 30-bp deletion between Nucleotide (nt) 168,282 and nt 168,253 corresponding to the B95-8 sequence. The clinical significa nce of 30-bp deletion in Exon 3 of the LMP-1 gene in lymphoepithelioma-like carcinoma of the liver warrants further investigation.