Primary Pulmonary Lymphoepithelioma-like Carcinoma-Experience with Five Cases at MacKay Memorial Hospital

Primary pulmonary lymphoepithelioma-like carcinoma (LELC) is a rare subtype of nonsmall-cell lung cancer (NSCLC) and is mostly reported in Southeast Asia. It was first reported by Begin in 1987; it has pathological features similar to nasopharyngeal carcinoma and was associated with Epstein-Barr virus infections in Asia. We reported 5 cases of primary pulmonary LELC from Jan 1991 to Dec 2013, 3 of them were incidentally found as asymptomatic tumors or nodules on chest radiographs. Four patients were non-smokers and none of them was diagnosed as having advanced disease (2 stage IA, 2 stage IIA, 1 stage IIIA, respectively). The typical CT radiographs show single, centrally located tumors of various sizes. The typical pathologic features revealed sheet growth of tumor cells surrounded by lymphoplasmacytic cells; 4 of the specimens were positive for EBV stain. The 5 patients responded well to multi-modality treatment without progression during a follow-up of 10 to 93 months. Primary pulmonary LELC often affects asymptomatic and younger non-smokers without gender predilection. Patients diagnosed with early, resectable disease respond well to chemotherapy or radiotherapy.