EBV相关性肺癌 建议以此术语替代并扩展肺淋巴上皮瘤样癌的组织学谱系
  --本文经《美国外科病理学杂志》授权发布,其他媒体转载或引用须经《美国外科病理学杂志》同意,否则追究法律责任。
  摘要:肺淋巴上皮瘤样癌(lymphoepithelioma-like carcinoma,LELC)是一种少见的EB病毒(Epstein-Barr virus,EBV)相关性癌。其组织学特征是合体样生长方式伴有明显的淋巴细胞浸润,在组织学上与未分化鼻咽癌无法区分。然而,已有研究发现,LELC可以表现为非经典形态并缺乏显著的淋巴细胞浸润。本研究中,我们对61例肺LELC患者进行了系统的临床病理分析,并使用IHC分析软件对淋巴细胞浸润进行自动定量分析。结果表明,肺LELC具有形态学上的连续性,从具有高密度淋巴细胞浸润的经典低分化肿瘤形态,到几乎没有淋巴细胞浸润的非经典形态。这些EBV相关性肿瘤代表了一类特殊疾病,通常发生于女性和非吸烟患者。低密度淋巴细胞浸润的肿瘤与非角化性鳞状细胞癌非常相似,通常瘤体较大、在影像学上具有更高的最大标准化摄取值,且复发时间短于具有高密度淋巴细胞浸润的肿瘤。通过细致的病理检查,我们观察到一些肺LELC独特的形态学特征,包括肉芽肿性炎、局灶角化、肺泡腔播散及附壁样播散方式。我们还发现,表现为肉芽肿性炎的肿瘤患者预后较好;但是,是否存在肺泡腔播散与预后没有显著相关性。由于这些“LELC”与未分化鼻咽癌或淋巴上皮癌不同,我们建议使用另一个术语,EBV相关性肺癌,以涵盖这一特殊疾病的全部形态谱系。
  关键词:淋巴上皮瘤样癌、EB病毒、淋巴细胞、鳞状细胞癌、肺泡腔播散
  (Am J Surg Pathol 2019;43:211-219)
  美国外科病理学杂志中文版2019年第三期摘要NO.9
  ( 吴江华 翻译 林冬梅 审校 )








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