Lymphoepithelioma-like carcinoma of the urinary bladder: a report of two cases.

Abstract Lymphoepithelioma-like bladder carcinoma (LELBC) is a rare variant of infiltrating urothelial carcinoma according to the recent World Health Organization classification, with only 3 previously reported cases from Asia. Histologically, LELBC is classified into pure, predominant and focal forms, depending on the relative amount of the lymphoepithelioma-like component. The tumor may have a concurrent component of other histological types, usually high-grade urothelial carcinoma. Patients with the pure and predominant forms have a better response to chemotherapy and outcome than those with a focal form. Unlike its histological counterpart in the nasopharynx, which is prevalent among Southeastern Asia and has a strong association with Epstein-Barr virus (EBV), LELBC is universally EBV negative. We report 2 new cases of LELBC, one treated with transurethral resection and the other, cystoprostatectomy. Histologically, both tumors were of the predominant form and were both negative for EBV by in situ hybridization. Both patients were subsequently treated with chemotherapy and were free of disease 6 months after diagnosis. Our detailed clinicopathological report adds 2 new Asian cases to our understanding of this extremely rare variant of urothelial carcinoma.