Relationship between Epstein-Barr virus and lymphoepithelioma-like carcinoma of the lung: a clinicopathologic study of 6 cases and review of the literature

Hum Pathol. 2001 Aug;32(8):863-72. doi: 10.1053/hupa.2001.26457.


Lymphoepithelioma-like carcinoma (LELC) is a rare form of lung cancer, usually encountered in Chinese patients. Similar to nasopharyngeal carcinoma, LELC of the lung is strongly associated with Epstein-Barr virus (EBV) infection in Asian patients, but there is controversy over whether an association exists in patients from Western countries. To determine whether such a relationship exists, we retrospectively studied 6 cases of primary LELC of the lung, all of which were in Western patients. There were 4 men and 2 women, ranging in age from 49 to 75 years. The tumors ranged from 1 to 4.5 cm in diameter. Four patients had stage I disease, 1 had stage IIb disease, and 1 had stage IIIa disease. All patients are alive without evidence of disease with a follow-up of 18 to 30 months. Formalin-fixed, paraffin-embedded tissue was stained with hematoxylin-eosin for routine evaluation and immunostained for keratin and leukocyte common antigen (LCA). LCA staining was performed to exclude large-cell lymphoma. Immunoperoxidase staining (1:500 clone CS1-4; Dako, Carpinteria, CA) and in situ hybridization were performed to detect EBV. Tumors consisted of solid nests of undifferentiated tumor cells in a syncytial arrangement surrounded by heavy lymphoplasmacytic infiltrate. Tumor cells stained positively for keratin but negative for LCA. All 6 cases were negative for EBV, suggesting no association between EBV and LELC in the Western population.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Biomarkers, Tumor / analysis
  • Carcinoma, Squamous Cell / chemistry
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / virology*
  • DNA, Viral / analysis
  • Epstein-Barr Virus Infections* / metabolism
  • Epstein-Barr Virus Infections* / pathology
  • Epstein-Barr Virus Infections* / virology
  • Female
  • Herpesvirus 4, Human / genetics
  • Herpesvirus 4, Human / isolation & purification*
  • Humans
  • Immunoenzyme Techniques
  • In Situ Hybridization
  • Leukocyte Common Antigens / analysis
  • Lung Neoplasms / chemistry
  • Lung Neoplasms / pathology
  • Lung Neoplasms / virology*
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Retrospective Studies


  • Biomarkers, Tumor
  • DNA, Viral
  • Leukocyte Common Antigens