Case report

Journal of Gastroenterology

, Volume 42, Issue 2, pp 181-185

A case of lymphoepithelioma-like carcinoma of the colon with ulcerative colitis

  • Yasuyuki KojimaAffiliated withDepartment of Surgery, Yokosuka Kyosai Hospital
  • , Masatoshi MogakiAffiliated withDepartment of Surgery, Yokosuka Kyosai Hospital
  • , Ryo TakagawaAffiliated withDepartment of Surgery, Yokosuka Kyosai Hospital
  • , Ikuko OtaAffiliated withDepartment of Surgery, Yokosuka Kyosai Hospital
  • , Mitsutaka SugitaAffiliated withDepartment of Surgery, Yokosuka Kyosai Hospital
  • , Shiho NatoriAffiliated withDepartment of Surgery, Yokosuka Kyosai Hospital
  • , Yohei HamaguchiAffiliated withDepartment of Surgery, Yokosuka Kyosai Hospital
  • , Haruki KurosawaAffiliated withDepartment of Surgery, Yokosuka Kyosai Hospital
  • , Tadao FukushimaAffiliated withDepartment of Surgery, Yokosuka Kyosai Hospital
    • , Hidenobu MasuiAffiliated withDepartment of Surgery, Yokosuka Kyosai Hospital
    • , Shingo FukazawaAffiliated withDepartment of Surgery, Yokosuka Kyosai Hospital
    • , Shoji YamanakaAffiliated withDepartment of Pathology, Yokosuka Kyosai Hospital
    • , Yukio TsuuraAffiliated withDepartment of Pathology, Yokosuka Kyosai Hospital
    • , Kaoru NagahoriAffiliated withDepartment of Surgery, Yokosuka Kyosai Hospital

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Abstract

Follow-up colonoscopy of a 25-year-old Japanese man with ulcerative colitis (UC) who had undergone endoscopic mucosal resection twice for early colon cancers revealed the presence of a new 1.5-cm-diameter tumor in the sigmoid colon. It was diagnosed by preoperative biopsy as a poorly differentiated adenocarcinoma. Sigmoidectomy was performed, and the pathological findings revealed lymphoepithelioma-like carcinoma (LEC). In situ hybridization to detect Epstein-Barr virus (EBV)-encoded small RNAs showed positive signals in stromal lymphocytes, but weak signals in the tumor cells. The association between EBV and LEC was obscure in this case. Unlike typical UC-mediated colon cancers, the lesion was poorly differentiated, and negative for p53 signals immunohistochemically. These findings may hint at a novel mechanism of carcinogenesis in UC-mediated colorectal cancer.

Key words

lymphoepithelioma-like carcinoma UC EBV